Dear Friends and Colleagues:
I just returned from an ASAM Chapter Council meeting (10/27-10/28/07) in Washington and want to share some of my observations and thoughts with you.
Almost thirty representatives from eleven state, two regional chapters and one international chapter were present for the two-day meeting.
With 136 chapter members Florida has met its 2007 recruitment goal - more can be achieved - and now ranks No.3 after California and New York.
Among others we discussed:
1) MAKING OF OUR MEDICAL SPECIALTY: hopefully, most of you know that ASAM has founded the American Board of Addiction Medicine (ABAM) and has created the 14-member Medical Specialty Action Group, yours truly included, to select specialty directors to serve on the new board. This is a tedious and long process but we anticipate that within 3-15(?) years we will have established the specialty of addiction medicine. We heard a detailed report by Kevin Kunz regarding the progress made and please contact me for further details.
2) PARITY ISSUES: Ken Roy provided us with a superb overview of the status of two bills in the House (HR 1424) and Senate (S 558) and he outlined the pros and cons of both versions. At this point in time ASAM is pleased that both chambers of congress deal with the issues of Mental Health and Addiction Treatment parity. ASAM prefers and supports the House version and is concerned about the many flaws contained in the Senate version. If those bills pass both chambers of congress they will be discussed in the conference committee to find a compromise version. We will keep you posted about the progress made.
3) ADOPT A RESIDENCY: Norm Wetterau presented a program that intends to improve the education in primary care regarding addiction medicine related issues by adopting a residency program to precept student, train faculty and to help make changes in the residency that would improve treatment of addictive diseases. Some of you may already pursue similar activities and I suggest that we all pool our experience and resources to improve the outcome of our efforts.
4) CAPITOL CAMPAIGN: develop a program that will raise funds to support ABAM, Parity efforts, he work of the chapters council and other projects. We also heard a presentation from a consultant group in Washington how to obtain federal funds to finance and support projects on state and national level. I will forward more detailed information and a project proposal, which we should submit for funding through federal earmarks. Project examples could include substance abuse counseling at schools, specific substance abuse counseling and treatment programs etc.
I also want to remind you that I persistently pursue the realization of the following goals set by my person at the beginning of my presidency:
1.Reorganize FSAM as a full-service membership organization promoting the interest of healthcare professionals involved in addiction care, research and treatment.
STATUS: Formation of a membership committee (pending) and development of a recruitment and retention program. VOLUNTEERS WANTED!!
2.Promote excellence of care in addiction medicine through education and training of physicians and other allied healthcare professionals.
STATUS: We develop and prepare an enhanced and improved annual meeting.
3.Achieve cooperative relationships with other medical specialties to foster the integration of screening and intervention modalities in patient care.
STATUS: All THREE FSAM resolution submitted at the FMA Annual meeting (Parity included) passed including SBI efforts to be supported by the FMA.
4.Create a FSAM Political Action Committee (PAC), educate political decision makers about the importance of sustainable funding mechanism for community based addiction treatment modalities and advocate for the promotion of addiction care and research in primary care.
STATUS: PENDING. VOLUNTEERS NEEDED. We have developed a close working relationship with a legislator (Florida House Representative Ed Homan) who has introduced a Metal Health Parity bill in the House. We not only need to support him verbally but also FINANCIALLY!!!
5.Establish a planning committee to design a strategic plan outlining the vision of our organization for a statewide drug control and treatment program.
STATUS; PENDING. IDEAS? VOLUNTEERS?
PLEASE CONTACT ME VIA E-MAIL info@miamihealth.com or PHONE (305)940-8717 FOR MORE INFORMATION, YOUR QUESTIONS OR SUGGESTIONS.
YOURS
Bernd
Monday, October 29, 2007
Wednesday, October 10, 2007
JOURNAL CLUB
Dear Friends and Colleagues:
Attached a very interesting article regarding the promising results of a study using Topiramate for the treatment of alcohol dependence. For more information see http://jama.ama-assn.org/cgi/content/full/298/14/1641.
The authors conclude that:
"Our finding in this study that topiramate is a safe and consistently efficacious medication for treating alcohol dependence is scientifically and clinically important. Alcoholism ranks third and fifth on the US and global burdens of disease, respectively. Discovering pharmacological agents such as topiramate that improve drinking outcomes can make a major contribution to global health. Because topiramate pharmacotherapy can be paired with a brief intervention deliverable by nonspecialist health practitioners, a next step would be to examine its efficacy in community practice settings."
Looking forward to your comments.
Yours
Bernd
============================================================================
Topiramate for Treating Alcohol Dependence
A Randomized Controlled Trial
Bankole A. Johnson, DSc, MD, PhD; Norman Rosenthal, MD; Julie A. Capece, BA; Frank Wiegand, MD; Lian Mao, PhD; Karen Beyers, MS; Amy McKay, PharmD; Nassima Ait-Daoud, MD; Raymond F. Anton, MD; Domenic A. Ciraulo, MD; Henry R. Kranzler, MD; Karl Mann, MD; Stephanie S. O’Malley, PhD; Robert M. Swift, MD, PhD; for the Topiramate for Alcoholism Advisory Board and the Topiramate for Alcoholism Study Group
JAMA. 2007;298:1641-1651.
ABSTRACT
Context Hypothetically, topiramate can improve drinking outcomes among alcohol-dependent individuals by reducing alcohol's reinforcing effects through facilitation of -aminobutyric acid function and inhibition of glutaminergic pathways in the corticomesolimbic system.
Objective To determine if topiramate is a safe and efficacious treatment for alcohol dependence.
Design, Setting, and Participants Double-blind, randomized, placebo-controlled, 14-week trial of 371 men and women aged 18 to 65 years diagnosed with alcohol dependence, conducted between January 27, 2004, and August 4, 2006, at 17 US sites.
Interventions Up to 300 mg/d of topiramate (n = 183) or placebo (n = 188), along with a weekly compliance enhancement intervention.
Main Outcome Measures Primary efficacy variable was self-reported percentage of heavy drinking days. Secondary outcomes included other self-reported drinking measures (percentage of days abstinent and drinks per drinking day) along with the laboratory measure of alcohol consumption (plasma -glutamyltransferase).
Results Treating all dropouts as relapse to baseline, topiramate was more efficacious than placebo at reducing the percentage of heavy drinking days from baseline to week 14 (mean difference, 8.44%; 95% confidence interval, 3.07%-13.80%; P = .002). Prespecified mixed-model analysis also showed that topiramate compared with placebo decreased the percentage of heavy drinking days (mean difference, 16.19%; 95% confidence interval, 10.79%-21.60%; P < .001) and all other drinking outcomes (P < .001 for all comparisons). Adverse events that were more common with topiramate vs placebo, respectively, included paresthesia (50.8% vs 10.6%), taste perversion (23.0% vs 4.8%), anorexia (19.7% vs 6.9%), and difficulty with concentration (14.8% vs 3.2%).
Conclusion Topiramate is a promising treatment for alcohol dependence.
Attached a very interesting article regarding the promising results of a study using Topiramate for the treatment of alcohol dependence. For more information see http://jama.ama-assn.org/cgi/content/full/298/14/1641.
The authors conclude that:
"Our finding in this study that topiramate is a safe and consistently efficacious medication for treating alcohol dependence is scientifically and clinically important. Alcoholism ranks third and fifth on the US and global burdens of disease, respectively. Discovering pharmacological agents such as topiramate that improve drinking outcomes can make a major contribution to global health. Because topiramate pharmacotherapy can be paired with a brief intervention deliverable by nonspecialist health practitioners, a next step would be to examine its efficacy in community practice settings."
Looking forward to your comments.
Yours
Bernd
============================================================================
Topiramate for Treating Alcohol Dependence
A Randomized Controlled Trial
Bankole A. Johnson, DSc, MD, PhD; Norman Rosenthal, MD; Julie A. Capece, BA; Frank Wiegand, MD; Lian Mao, PhD; Karen Beyers, MS; Amy McKay, PharmD; Nassima Ait-Daoud, MD; Raymond F. Anton, MD; Domenic A. Ciraulo, MD; Henry R. Kranzler, MD; Karl Mann, MD; Stephanie S. O’Malley, PhD; Robert M. Swift, MD, PhD; for the Topiramate for Alcoholism Advisory Board and the Topiramate for Alcoholism Study Group
JAMA. 2007;298:1641-1651.
ABSTRACT
Context Hypothetically, topiramate can improve drinking outcomes among alcohol-dependent individuals by reducing alcohol's reinforcing effects through facilitation of -aminobutyric acid function and inhibition of glutaminergic pathways in the corticomesolimbic system.
Objective To determine if topiramate is a safe and efficacious treatment for alcohol dependence.
Design, Setting, and Participants Double-blind, randomized, placebo-controlled, 14-week trial of 371 men and women aged 18 to 65 years diagnosed with alcohol dependence, conducted between January 27, 2004, and August 4, 2006, at 17 US sites.
Interventions Up to 300 mg/d of topiramate (n = 183) or placebo (n = 188), along with a weekly compliance enhancement intervention.
Main Outcome Measures Primary efficacy variable was self-reported percentage of heavy drinking days. Secondary outcomes included other self-reported drinking measures (percentage of days abstinent and drinks per drinking day) along with the laboratory measure of alcohol consumption (plasma -glutamyltransferase).
Results Treating all dropouts as relapse to baseline, topiramate was more efficacious than placebo at reducing the percentage of heavy drinking days from baseline to week 14 (mean difference, 8.44%; 95% confidence interval, 3.07%-13.80%; P = .002). Prespecified mixed-model analysis also showed that topiramate compared with placebo decreased the percentage of heavy drinking days (mean difference, 16.19%; 95% confidence interval, 10.79%-21.60%; P < .001) and all other drinking outcomes (P < .001 for all comparisons). Adverse events that were more common with topiramate vs placebo, respectively, included paresthesia (50.8% vs 10.6%), taste perversion (23.0% vs 4.8%), anorexia (19.7% vs 6.9%), and difficulty with concentration (14.8% vs 3.2%).
Conclusion Topiramate is a promising treatment for alcohol dependence.
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