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Treatment CEOs continue to hone stance on role of medications

December 24, 2012
by Gary A. Enos, Editor
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A group of addiction treatment CEOs concerned about what they consider a growing disregard for 12-Step-based residential modalities of treatment continues to meet to clarify their position on medication-assisted treatment’s role in a field traditionally dominated by abstinence-based approaches.

In a statement obtained by Addiction Professional, members of the group referring to itself as the “Nashville Summit” (leaders have met twice in Tennessee in recent months at the invitation of the Cumberland Heights organization) say that at their most recent meeting on Dec. 5 they “reinforced their commitment to a balanced approach to treatment that was not limited to medications alone, but to include every level of care.”

According to the statement, “Summit members insisted that their intent is to emphasize the value of abstinence-based, 12-Step oriented residential treatment as a critical component of the continuum for substance use disorders.”

The group is emphasizing in its communications the input it is receiving from physicians, and one of those medical experts is now serving as the group’s spokesman. Ken Thompson, MD, medical director at Caron Treatment Centers, says he and two Cumberland Heights physicians, chief medical officer Chapman “Chappy” Sledge, MD, and Healthcare Professionals Program medical director Terry Alley, MD, were in attendance with CEOs at the early December meeting. Many of the most prominent treatment centers represented in the National Association of Addiction Treatment Providers (NAATP) have been participating in the discussions.

The physicians emphasized to the group that with treatment intended to improve wellness and begin a path of lifelong recovery in the patient, medications may need to be employed as part of that strategy on either a short-term or more extended basis.

“Abstinence from all abusable drugs is to be considered an optimal component of wellness, but certain medications may be necessary along the path to recovery to support the best state of wellness at a given time,” the summit group’s statement reads. “Depending on psychosocial, demographic, economic and medical factors, [physicians] emphasized that there may be some persons who might require medications for some period of time and perhaps some indefinitely.”

What has had the group of CEOs particularly concerned, however, are field developments that they see as signaling a wholesale shift to medication-assisted treatment regardless of the patient profile. Examples of this, they have said, include the growing dominance of medication topics at the national conference of the American Society of Addiction Medicine (ASAM), as well as an attempt by some insurers to steer young opiate-addicted patients into office-based buprenorphine treatment rather than traditional residential care.

A formal action plan from the group remains to be determined.

The Nashville Summit group’s statement mentions that its participating physicians see 12-Step, abstinence-oriented treatment as “a disease-modifying modality” and not incompatible with  medication interventions.

The statement concludes, “The group also cited the need for addiction treatment professionals to support continued scientific research and outcome studies on 12-Step recovery, spiritual interventions, opioid maintenance, anti-craving drugs, blockers and deterrents.”             

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