"The Voice For Treatment"
Newsletter of the California Society of Addiction Medicine
Winter 2020 | Vol. 45 | No. 2
CSAM President's Message
Dear CSAM Members,

I don’t believe any of us will ever forget the year 2020. The events of this year including the world-wide COVID-19 pandemic, international tensions, widespread unemployment, the recognition of structural racism, social unrest, and contested elections have tested our mettle. Through it all, CSAM members have found creative ways to care for patients struggling with addiction. Author & Pastor Rick Warren has said “Life is a series of problem-solving opportunities. The problems you face will either defeat you or develop you depending on how you respond to them.” I want to thank you for your courage and hard work; and encourage you not to get weary in well-doing. As we are assembling this newsletter, the FDA is reviewing COVID-19 vaccine safety and efficacy data from two pharmaceutical companies for potential Emergency Use Authorization. There is light at the end of the tunnel.

I want to give a special shout-out to our State of the Art and Test Taking Track planners and speakers for putting together a terrific virtual conference this year. With about 500 registered participants, the conference was a huge success. Because the timeline for wide distribution of the COVID vaccines is still not clear, we’ve decided to use the virtual format for our 2021 CSAM Review Course (scheduled for early September). If safety permits, we plan to offer a “co-location” option for those who would like to attend the virtual conference together at the San Diego Sheraton. Special events will be scheduled for those who attend in person and more information about the co-location option will be forthcoming. Please be on the look-out for information about the CSAM virtual leadership retreat we are planning for late spring (May-June) 2021. The retreat will be led by CSAM President-Elect Karen Miotto and will focus on our role in addressing racism and improving diversity. I also want to give a shout-out to our treasurer Mario San Bartolome, Kimberly Andosca, and the AMG administrative team who worked hard to make sure that CSAM has remained fiscally sound through this year.

Finally, we have entered the season (between Thanksgiving and the Christmas-New Year holidays) known to psychologists as the most stressful time of the year. Please don’t neglect your own wellness. Prioritize your spiritual, mental, physical, and emotional health so that you will be personally well, and able to engage your family, friends, patients, and colleagues with creativity, focus, and vigor. A few years back I attended my 40th high school reunion and was asked to give a quote to accompany my profile. I’ve never been (intentionally) funny, so decided to be serious and describe an important life lesson. “Gratitude is the antidote.”

Stay Safe and Well,

Anthony Albanese
SOA 2020 --

CSAM State of the Art brings together national experts to share frontiers of research, treatments, and policies in the field of Addiction Medicine. This conference covers expansion of treatment into correctional health, hospital consultation services, emergency rooms, and even across the Border. It will cover how, despite the pandemic, telehealth can reach those who are isolated. It will address the worrisome trends in fentanyl, methamphetamine, tobacco and benzodiazepines use; legalization of cannabis, treatment updates for youth, cannabis and alcohol in pregnant women; and novel treatments such as non-benzodiazepines for alcohol withdrawal and psychedelics for substance use disorders.
The activity consists of 22 lectures that were presented live (virtually) on September 22 - 25, 2020.

Earn up to 17.25 AMA PRA Category 1 Credits™ and 16.25 MOC credits!
Member Rate - $345
Non-Member Rate - $495

For this and other online educational offerings click below:
Two courses just added!
This virtual workshop, part of the 2020 State of the Art Conference, will address the delivery of addiction medicine treatment within correctional health settings. Presenters will review the structure of correctional health systems with jails and prisons in general and highlight the application of a medication-first (low barrier) approach to providing medications for opioid use disorder to inmates within one California county jail system. The workshop will also review trauma-informed care for patients in correctional settings and discuss implications of the COVID-19 pandemic on the delivery of addiction medicine in correctional health settings.

Earn up to 3.5 AMA PRA Category 1 Credits™ and 3.5 MOC credits
Member Rate $125 | Non-Member Rate - $225
This virtual workshop, part of the 2020 State of the Art Conference, will address psychiatric diagnosis and treatment interventions relevant to non-psychiatric addiction medicine providers. Among the topics to be covered are approaches to treating anxiety, depression, psychosis and personality disorders in patients with active substance use. Clinical approaches to address depression and anxiety caused or exacerbated by the COVID-19 pandemic will be covered.

Earn up to 3.5 AMA PRA Category 1 Credits™ and 3.5 MOC credits
Member Rate $125 | Non-Member Rate - $225
CSAM Public Policy 2020
By Randolph Holmes, MD
Despite all the obstacles that the COVID 19 pandemic placed in the way of CSAM’s advocacy work, 2020 turned out to be a banner year for us. CSAM’s Public Policy Committee reviewed and took positions on many bills at the beginning of the legislative session. By April, the legislature had left Sacramento and was working remotely. Word from the Governor was that any legislation that was not related to COVID 19 would be considered for 2020. Some bills CSAM supported and worked on were shelved; but, surprisingly, several bills were moved on and passed due to efforts by many people. The governor signed four CSAM supported bills, which is a tremendous accomplishment in any year! Thanks to all our volunteers on the Public Policy Committee for a job well done. The bills are:
  • SB 855 mandates that health plans cover Mental Health and Substance Abuse treatment at the same level they cover other medical conditions (Parity).
  • SB 793 bans flavored tobacco products, including e-cigarettes.
  • SB 803 creates a certification process for peer support specialists
  • AB 2265 establishes the Mental Health Services Fund to fund mental health and substance abuse treatment.
Looking forward to 2021, we hope to have back some legislation leftover from the 2020 session. Several legislators who have been good friends to CSAM have termed out, so there will be new faces in Sacramento to get to know. We expect to have a bill on Safe Injection Sites again. We got a similar bill to Governor Brown’s desk several years ago, but he did not sign it. CSAM expects to co-sponsor this bill and provide legislative support in committees.

Another bill we expect to be re-introduced will be to license outpatient treatment programs. We got a similar bill to Governor Newsom in 2019 but he did not sign it. There will be more movement on increasing funding to youth treatment programs coming from monies derived from Prop 64 (cannabis). We are continuing to work on implementing the Physician Health Program through the Medical Board, a long overdue goal for CSAM. More bills will certainly be introduced in the New Year.

Again, thanks to all our CSAM Public Policy Committee Members,

-- Randy Holmes, MD
News From the Education Committee
By Jean Marsters, MD
As Chair of the Education Committee for the past seven years, each year has been its own exciting ride, with CSAM Education program as my dopamine and epinephrine. That said, 2020 was a ride beyond all others. The complete re-tooling of the yearly conference to a virtual format included re-negotiating our previous contract with the hotel followed by massive behind-the-scenes reworking of many essentials such as the fee and honorarium structure, securing two host web platforms, flipping to entirely virtual publicity, and training all planners and speakers to this new web-based format. We also pushed out the dates of the conference and spread the Board Exam Study Track, Pre-conference workshops and the main plenary across 3 weeks instead of the usual 4 days. Dr. Cynthia Chatterjee, this year’s conference chair, her Planning Committee, and the administrative staff will go down in CSAM history for their dedicated and tireless work under unprecedented circumstances. Please take a moment to thank them in person when we are all able to gather again! And, how amazing was the conference?! After months of COVID-19 doldrums, with weeks in the office and no real summer that blurred into a grey haze, the line-up of amazing speakers made me feel alive again! If you missed the conference, you can still experience what CSAM Past-President, Dr. Tim Cermak coined the zing at the CSAM Education Center site where the conference is posted for sale. For those who attended the conference, you can relive “the zing” for free online for the next three years.

2020 was also our first year with our new management firm, Association Management Group (AMG). I am deeply grateful to our Executive Director, Kim Andosca and her team: Felicia Price, Elizabeth Vang and Anne Mullinax for supporting us in doing what we do.

As if that wasn't enough activity for a pandemic year when many organizations canceled their conferences, CSAM also underwent recertification as an independent CME provider as overseen by the California Medical Association (CMA). This involved lengthy data collection and completion of a 450-page “deeper dive” document called a Self-Study on randomly selected CSAM activities spanning the last six years. The process culminated in a live audit interview of our working group who fielded questions on all aspects of our educational offerings. This is the rigor and quality control CSAM is dedicated in undergoing to deliver quality education for addiction medicine physicians and providers. We now wait to hear back from CMA in the spring on whether we passed the review.

Only about 20% of CSAM’s operating budget comes from yearly dues. The rest comes from the powerful combination of the two key elements above: the yearly conference and being a CME/CE provider. This is what gives CSAM fiscal stability and contributes to our national and international profile. We had 586 attend our first full virtual conference this year. This compares very favorably with 675 attending the State of the Art two years ago in San Francisco. As I write this, the financials are being finalized, but we will certainly have surpassed what was budgeted. This is a blessing in a year where many organizations are facing financial hardship.

With respect to our contract-funded activities, this year was the final of three years of CSAM’s participation in the California Department of Public Health State Opioid Response (SOR) Funding as part of a multi-organizational effort to increase services in the state for those with opioid use disorder (OUD) and reduce overdose deaths. Our role has been to host two webinars for “spoke” clinicians ( and here and here); to re-write the CSAM Guidelines for Opioid Treatment Programs (here); and, through our sister organization Medical Education and Research Foundation (MERF), to offer group learning intensives (MERF MATES) to cohorts of clinician learners for three years. Our involvement in this project has been a win-win situation benefitting the state, the people of California and CSAM. As a participant, UCLA Integrated Substance Abuse Programs (ISAP) measured elements of how impactful our education is. Look at this link for a short summary of UCLA’s outcome data comparing a sample group of “spoke” clinicians who participated in either MERF MATES or the conference plenary versus a sample group who did not participate in terms of outcomes such as practice habits and attitudes (here).

When I first became Chair, I decided to get CSAM involved in training primary care providers in Medication-Assisted Treatment (MAT). The board supported this. It all started with a webinar on naloxone, which was followed by our securing a $45K grant from the California Health Care Foundation to create 12 monthly MAT webinars. These had a total of 1,024 viewers for the live events and many more when they were posted for on-demand viewing. Fast forward and now we are completing our final year of the $950K, three year SOR contract project. During this time we have formed relationships with other organizations in the state and nation, which have benefitted us. One example of this is that through key contacts we were able to successfully do outreach this year to two groups traditionally underrepresented at our conferences: the clinicians in the California Department of Corrections and primary care providers working in Native American health clinics in California.

Where does CSAM Education go from here? I expect that this will be a year when volunteerism will drop off due to increased demands of work and family, so part of the answer will be determined by physician members with interest in quality education stepping forward to volunteer. If you would like to get involved, please send an e-mail to Executive Director, Kim Andosca. COVID permitting, we are looking at the feasibility of a hybrid Review Course conference in 2021 with options of virtual and on-site activities in San Diego August 31-September 3rd. We will continue to offer board preparation activities for those who plan to sit for the exam as part of the Practice Pathway, which has been extended to 2025.

Finally, I will be stepping down as Chair of the Education Committee in January 2021 and Dr. Mason Turner will step into this role. He will lead CSAM Education into its next chapter. We are looking at restructuring the committee a bit in response to lessons learned during the CME recertification. As always, priorities for the future will need to be set moving forward. I expect that core values will be reflected in our future such as racial and gender inclusivity, ethics, access to care and evidence-based practice. My advice to our incoming Chair is to be fair, get the job done and continue our tradition of challenging our audience to think outside the box. My advice to you, the membership, is to find what you love within CSAM and be a part of it. We want you to help grow it, innovate, and serve. CSAM is an amazing and powerful society. It is a Big Dog. We have a long history of leading our nation from “the Left Coast,” so let’s continue it! Continue to harness the power of CSAM to make the world a better place.

-- Jean Marsters, MD