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Foundation support will boost generalist MDs' addiction training

October 14, 2013
by Gary A. Enos, Editor
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A charitable foundation that includes substance use prevention among its priority areas for funding will support the extension of an ongoing effort to train generalist physicians in uncovering and treating addictions in their patients.

The Conrad N. Hilton Foundation will award a total of $2 million over three years to the American Board of Addiction Medicine (ABAM) Foundation, which has to date accredited 19 fellowship programs to train physicians in addiction medicine topics. ABAM’s president said in an interview with Addiction Professional that in keeping with the Hilton Foundation’s focus, the board agreed to make prevention and treatment targeting adolescents and young adults a prominent feature of this funded effort, though it will not be exclusively focused on young people.

“The focus will be on the training of addiction medicine fellows, in a way that they will be able to take on leadership roles in [Screening, Brief Intervention and Referral to Treatment], youth prevention, etc.,” says Jeffrey H. Samet, MD, MPH, professor at the Boston University School of Medicine. “Prevention is of course part of the skill set we want doctors to have.”

Samet adds, ““Invariably we anticipate that the majority of the trained fellows will be in family medicine and internal medicine, but we hope there will be people from pediatrics too.”

History of progress

Richard Blondell, MD, professor of family medicine at the University at Buffalo School of Medicine and Biomedical Sciences, will direct a new center that the foundation funding will bring forth at the school; it will be called the National Center for Physician Training in Addiction Medicine.

Samet says the funding will allow ABAM to build on what he considers the surprisingly extensive success it has had in its short history. While preferring not to put numbers on his expectations for the future reach of the physician training effort, Samet says he never would have imagined that 19 certified fellowship programs already would exist. “Some see as many as 50 programs being in existence in five to seven more years,” he says.

He believes funding will play a critical role in maintaining the momentum. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) was instrumental in ABAM’s early progress through its National Infrastructure for Translating Addiction Research into Clinical Practice initiative, but once that funding source of just under $1 million was exhausted, ABAM needed to locate additional support.

Samet acknowledges that at the individual fellowship program level in academic institutions, funding support is often “slim, slim, slim.” He says, “In some of these programs, the people who run them get no additional salary for doing it. Everyone is kind of doing things by the seat of their pants, but then again that’s how these kinds of things happen.”

Samet says a key marker of ABAM’s success to this point involves the high number of physicians—around 3,000—who have become certified in addiction medicine during an initial grandfathering period managed by the board; these doctors must document their experience and take an exam in order to receive the certification. This has been a heartening development for a generalist physician who agreed with some of his colleagues several years ago that addiction medicine specialists needed help from primary care doctors to meet a growing demand for substance use screening, assessment, referral and treatment services in the population.