Conference Call #8

June 12, 2006

Present on the line were Drs. Neufeld, Brown, Busch, Bogunovic, Williams, Hernandez-Avila, Fong, Campbell, Tapert, and Schuckit, along with Marcy Gregg.

The call began with a review of AMSP-related activities for the June 2006 Research Society on Alcoholism meeting in Baltimore, Maryland. Around 10 current and graduate AMSP members will get together for breakfast at 8:00 a.m. on Tuesday, June 27th. In addition, on Wednesday afternoon, Carlos Hernandez-Avila will be presenting the AMSP poster. Marcy Gregg will send out a memo reminding AMSP participants who are attending RSA to be available whenever possible to help Carlos man the poster.

Our group next discussed issues of recruitment for 2007. Alisa Busch has a potentially impressive candidate who is a faculty member at one of the other relatively independent Harvard programs. She will encourage that person to write to Marc. In addition, Marc recently received a request for consideration from a junior faculty person in Canada, and he, Marianne Guschwan, and Susan Tapert will discuss the pros and cons of including people from Canadian medical schools.

Randy Brown from the University of Wisconsin, a second-year scholar, next presented his progress report. Dr. Brown continues in his lecture and teaching activities as outlined in his 12/20/05 progress report. In addition, he has been invited to lecture to residents and medical students at the University of Washington-affiliated Family Practice Residency of Idaho. He will speak on the use of opioids in the setting of chronic non-cancer pain and monitoring for substance misuse in this clinical setting. Dr. Brown will also participate as a lecturer in the University of Wisconsin School of Medicine and Public Health’s Summer Research Program for 1st- and 2nd-year medical students, will serve as a mentor for students with interest in research regarding substance-related disorders, and will speak as part of the Wisconsin Department of Health and Human Services conference series on substance misuse in September 2006. At the same time, he continues his involvement in mentoring of family practice residents (one resident per year) and on the University of Wisconsin’s Resident Education committee; continues to be active in research with six publications submitted so far in 2006 (four published or in press, two under review). In this regard, Dr. Brown is an invited speaker for the annual conference of the European Opiate Addiction Treatment Association in October 2006 in Oslo, Norway, and has presented research findings related to his drug court research at three national/international conferences in 2006, and has had abstracts accepted at two further conferences in the fall of this year.

Senior Scholar, Alisa Busch, from Harvard University, next updated the group on her AMSP-related activities. Beginning with her new activities, Dr. Busch presented to approximately 10 undergraduate and graduate students from the Harvard University Drug and Alcohol Peer Advisor (DAPA) Program about the medical consequences of drug, alcohol, and tobacco use disorders. She also continues to work with the Internal Medicine Clerkship Director regarding providing a lecture to the core medicine clerkship students. Relevant to other activities/events fostered by AMSP, she has presented to the Medical Scientist Training Program students in February about substance use disorders and plans this to be an ongoing annual activity; twice yearly leads a case conference for second-year psychiatry residents, during which a patient from the inpatient detoxification program is interviewed and is followed by a discussion of important clinical teaching points; and supervises the addiction fellow for two months, providing him or her with an annual didactic session pertaining to substance use disorders. In December 2005, Dr. Busch was awarded her K01 grant (“Quality of Care for Bipolar Disorder”), during which she will receive specific mentoring pertaining to substance use disorder comorbidity issues for patients with bipolar disorder. Also in May 2006, Dr. Busch published her study “Schizophrenia, Co-Occurring Substance Use Disorders and Quality of Care: The Differential Effect of a Managed Behavioral Health Care Carve-Out” in the journal Administration and Policy in Mental Health and Mental Health Services Research.

Finally regarding senior scholars, Carlos Hernandez-Avila delivered his report of activities at the University of Connecticut Medical School. During the last three months he continued his teaching assignments for medical students and psychiatric residents, and he is developing a new lecture scheduled for the month of July on the management of emergencies related to opioid use. He also recently presented the results of the survey examining AMSP impact in substance use disorders education in U.S. medical schools to the Alcohol Research Center at the University of Connecticut School of Medicine. Additionally, Carlos is working on the analysis of a recently collected dataset pertaining to the effects of an opioid receptor gene (OPRM1) variant (Asn40Asp) on ACTH and cortisol response to naloxone. Eventually, this analysis will be the basis for a peer-reviewed publication. Finally, Carlos has been working on the final details of the project aiming to evaluate the efficacy of brief interventions in reducing risky drinking of approximately 8,000 risky-drinking college students who have been identified to this data at the National Autonomous University of Mexico (UNAM).

Next, Karin Neufeld, a first-year scholar from Johns Hopkins University, updated the group on her recent activities. Since her report in March 2006, new activities include her delivery of a new 1 1/2-hour lecture to the first-year medical students in March, and her attendance at the Department of Psychiatry’s Educational Policy Committee meeting where plans for improving the curriculum with regard to motivated behaviors (such as substance use disorders) are underway. Other activities also include the development of a new elective being offered to 4th-year medical students at Addiction Treatment Services (to start this summer) and the inclusion of a rotation in the PGY-1 rotation during the coming academic year.

The next update was given by Olivera Bugonovic from the State University of New York at Buffalo. Olivera told us that since the March meeting she has given a half-day inservice on buprenorphine to the behavioral health care and primary care physicians. She also gave a lecture to the emergency room physicians and nursing on clinical assessment of withdrawal symptoms associated with substance use. She is currently working with a 4th-year medical student who is doing an elective on the inpatient rehab unit. The Chair of the department has asked her permission to tape her lectures on addictions delivered to psychiatry residents, for which she will be using some lectures from the Web site.

Jill Williams from the Robert Wood Johnson Medical School next presented her recent activities. She continues to do: a new two-hour lecture on the Introduction to Substance Use Disorders for the MS-III clerkship, as well as annual lectures on Tobacco Dependence and Club Drugs and Hallucinogens to the MS-II students as part of the Behavioral Science and Psychiatry course, which receives good evaluations from students. She also was reappointed to the University Student Assistance Campus Committee (SACC) for another three years. This committee is working to expand its role in educating students about substance abuse through lunchtime seminars in order to create an atmosphere where faculty and students feel comfortable making referrals. Dr. Williams continues to recruit a minimum of one MS-IV student per year in her Tobacco Dependence Research and Treatment elective. Jill reports that she continues to use skills she has improved through AMSP for her expanding role as a trainer teaching tobacco dependence treatment to mental health professionals. She has begun a training grant from the American legacy Foundation to provide a two-day training on tobacco dependence treatment for psychiatrists and advanced practice nurses.

Following that presentation, the first-year scholar Tim Fong from UCLA shared his recent activities. Regarding educational activities, Tim has completed the following: 1) the Medical Students Selective on Substance Use Disorders was completed in May, 2006 with 10 first-year students (8 weeks); 2) the Freshman Seminar on Pathological Gambling was completed in May 2006 with 15 freshman undergraduates (6 weeks); 3) an informal dinner was held with medical students, addiction psychiatry fellows, and three addiction psychiatry attendings on May 17th at a fabulous Chinese restaurant; 4) the elective in addiction psychiatry for 4th-year medical students was formalized with the medical student curriculum; 5) a field trip was held with 10 medical students to a residential treatment center, B’eit T’shuvah; 6) two 3rd-year medical students have asked Tim to serve as “career mentors”; and 7) Dr. Fong administered the addiction psychiatry tests to the UCLA residents rotating through the Addiction Medicine Clinic. From a career perspective, Tim passed the ABPN Addiction Psychiatry Boards in April 2006 and will become the Addiction Psychiatry Fellowship Director. He also received a K23 Career Award from NIDA that started on June 1, 2006, and he joined the medical staff committee, which manages and deals with impaired physicians who work at UCLA.

Tim has several planned activities for the next few months including: establishing a network of substance use disorder advisors for the residents; 2) setting up funding for the UCLA Addiction Psychiatry Fellowships from an outside source; repeating the medical student Selective in the Fall of 2006 and Spring 2007; 4) increasing visibility of substance use disorders treatment services with the Family Medicine and Internal Medicine Departments, and 5) planning for a lecture in the medical student orientation week.

The final update from first-year scholars came from Nikki Campbell of the Medical College of South Carolina. Since the last meeting, Nikki has continued the lecture series on substance use disorders for the third-year medical student clerkship at the University of South Carolina School of Medicine, as well as mentor the peer advocate liaison program for students with mental illness and/or substance use disorders. She is preparing a presentation for her departmental grand rounds on nicotine use and dependence by using the slides from a recent AMSP lecture series. Finally, Nikki is planning to attend the annual ADMSEP meeting in Baltimore, in June where she will be presenting an AMSP poster with former alumna, Marian Fireman.

Finally, Susan Tapert, Associate Director of AMSP, updated the group on recent developments regarding the Web site. The use rate for the Web site is continuing to steadily grow, perhaps in part reflecting the fact that all five of the new lectures developed by first-year scholars have been edited and added to the site.

The meeting adjourned with a sad farewell to the senior scholars, along with the hope that they will continue to function as AMSP alumni.

Marc A. Schuckit, M.D.

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