Profession’s roots in substance abuse treatment run deep
Osteopathic medicine has played a significant role in addiction treatment for many years, even going back to the profession’s roots, said Anthony H. Dekker, DO, the director of addiction medicine at Fort Belvoir Community Hospital in Virginia. In an OMED presentation Sunday put on by the American Osteopathic Academy of Addiction Medicine (AOAAM), Dr. Dekker discussed how A.T. Still viewed addiction and how today’s osteopathic medical community has built on his example.
Andrew Taylor Still, MD, DO, and his family members were part of the Temperance League, a society of people against the use and abuse of alcohol, Dr. Dekker said. Dr. Still wrote about drunkenness in his autobiography; it was an illness that had to be treated, he wrote, and it was important to not ignore people who had this disease. Bill Wilson, the co-founder of Alcoholics Anonymous, was the son of a DO and also had a DO brother-in-law who assisted him in preliminary fundraising efforts that enabled the organization to take shape.
“We have to make sure that the curriculum for osteopathic medicine includes the very things that A.T. Still taught us back in 1870-92 when he was formulating this whole concept of osteopathic medicine,” Dr. Dekker said.
Addressing the evolution of addiction treatment since Dr. Still’s day, Dr. Dekker emphasized the need for simplicity. “A lot of people think addiction medicine should be expensive and hard to get,” he said. “They think you have to be a fellowship-trained, board-certified addictionist to take care of people who have tobacco, alcohol or drug problems. I’ve always felt the simpler you make it, the better it is.”
Dr. Dekker cited physician health programs as an example of the direction addiction treatment should be heading. Treatment of physicians with substance abuse via their state medical board has a 94% success rate, he said.
Physicians with substance abuse problems are typically treated confidentially, and they stay engaged with a treatment program for many years. If the general population received addiction treatment with a longer time frame, the chances of success may well be higher than the current 8% rate for general detox programs, he said.
Recent developments in the field suggest that new pharmacologic therapies may hold promise. Baylor University has developed a vaccine that prevents people from getting high when they take cocaine. So far, the vaccine has not been approved by the U.S. Food and Drug Administration, and it only works consistently for 40% of patients. But it’s an exciting development in addiction medicine, Dr. Dekker said.
Robert D. Birch, DO, of Salt Lake City, thought Dr. Dekker’s report on the cocaine vaccine was one of the most intriguing aspects of the presentation. But he said he also enjoyed learning the history of the profession’s involvement in addiction medicine.
“He gave an excellent presentation on the history of addiction and how it has progressed to a culture of understanding,” Dr. Birch said.