I’m writing this first President’s column shortly after returning to Rochester, New York from NYSAM’s 16th annual Statewide “Intersection of Science, Treatment and Policy Conference. Before discussing the conference I want to say it is an honor to represent NYSAM as President and I look forward to all of the opportunities that lie ahead for our organization. We have a passionate and dedicated Board and dedicated members with expertise in clinical addiction medicine, policy, advocacy, research and education to engage for the many opportunities ahead of us. For my part I will work hard with the rest of the Board and NYSAM members to support the activities and goals of our chapter and ASAM and to improve access and treatment for addiction across our state for our patients and their families.
This year we had record numbers attending the conference with over 300 attendees registered days before the conference started and additional ‘walk in’ registration the day of coming from all across New York State. We also had 30 exhibitors, and two 2 sponsors, that supported this event. The conference was held at the Crowne Plaza Times Square hotel where it has been held for the past several years and I have heard from many attendees that they come to Manhattan not just for the conference but also because they are able to enjoy some relaxation with dinner and a show. The city is not a hard sell for a conference destination when one considers not only the networking opportunities and connection to colleagues and the outstanding educational content (14.5 credits worth of CME) but also the dining, arts and other activities that travel to New York City brings. For members that live in and around Manhattan and New York Burroughs I’m always looking for tips on good places to eat (in particular good sushi) and other city ‘pearls’.
This year’s conference was spread over two full days starting with the annual Public Policy Day Friday 2/7. The morning began with an interactive panel discussion with audience participation led by Dr. Greg Bunt. The panel included a number of leaders in public health, law enforcement and addiction medicine. In addition to moderated discussion there were a number of questions posed related to cannabis use, indication and availability where audience participation occurred through an interactive polling application that attendees were able to use in real time via simple cell phone response. The rest of the Public Policy day featured content related to expanding access to buprenorphine, treatment of refractory opioid use disorder, and on the application of the ASAM Definition of Addiction and Recovery. Dr. Ed Salsitz, who has been Chair of the Education Committee and who has led the annual conference organizing committee for many years –this year jointly with Dr. Kelly Ramsey, presented with Dr. Keren Bachi on a new way of thinking about the treatment of substance use disorders and addiction through the application of a staging and disease stratification model based on response to treatment and degree and severity of addiction –should a treatment model and the lexicon of traditional palliative care medicine be used in clinical addiction medicine? Other presentations on the Public Policy day were provided by Kimberly Sue, MD, PhD, and Medical Director of the Harm Reduction Coalition who provided an overview of Harm Reduction strategies and provided examples of how primary care and other clinicians can work with harm reduction agencies. This was followed by interactive panel discussion involving complicated cases and challenging patients. Panelists included experts with a range of backgrounds and perspectives. Dr. Norm Wetterau represented perspective brought by his years of practice and medical direction in a rural primary care based program and clinic. Drs. Kelly Ramsey and Kimberly Sue represented harm reduction models and support. Dr. Marc Manseau, Chief of Medical Services for the New York State Office of Addiction Services and Supports (OASAS)) provided his expertise as an addiction psychiatrist and perspective of OASAS. Dr. Manseau also provided the evening dinner presentation, “Sticks, Carrots, and Everything Else: How the New York State Office of Addiction Services and Supports is Using Policy to Address the Opioid and Drug Overdose Crisis.”
Those of you that have attended previous conferences have noticed posters up for attendees to peruse during breaks. This year we had 8 posters representing a variety of different groups and individual presenters from around the state including one from medical students and another from resident presenters. Each year there is more interest and appreciation of the posters featured at NYSAM and I look forward to expanding this again in 2021.
The resident contest had a number of high quality submissions with the winners one winner representing downstate (Michele J Buonora, MD, Montefiore Medical Center –How do clinicians document their rationale for opioid tapering?) and upstate (Drs. Nilbhi Pael and Kriti Thappa, University of Rochester Medical Center –Naloxone Prescription Upon Hospital Discharge) and each presenting on Friday at the end of the Public Policy day. After this we heard from Dr. Jeff Selzer and several medical students describe their participation at the ASAM annual Hill and Advocacy Day. I was very encouraged to hear the stories from the medical students on how their experience informed their interest in participating in ASAM advocacy activities.
Saturday morning started at 7:00 AM with a Mutual Help Meeting followed by the traditional Clinical Vignette Presentation organized by Dr. Ed Salsitz which featured a series of 3 ‘unknown’ and interesting cases the audience was led to puzzle through. Cases featured a unique presentation by a prison inmate who used quetiapine to ‘come down’ from synthetic cannabinoid intoxication, a cluster of synthetic cannabinoid-related fatalities from a particularly toxic chemical and the startling effect that the rou en y type gastric bypass surgery has on alcohol absorption and subjective effect –I was listening closely and caught the call out to the Cmax and Tmax. Saturday morning also included an outstanding presentation by Dr. Yasmin Hurd from her research on cannabis and the developing brain and Tomas Hildebrandt, Psy.D. gave an overview on the use of Appearance and Performance Enhancing Drugs (APED) use, body image and the relationship to exercise as the ‘object’ of addiction – an area of increasing importance yet challenging to treat with broad implications involving the patient’s overall health and need for specialty expertise in not just addiction medicine but endocrinology as well. Dr Hildebrandt stressed that connecting with these patients can be challenging as most use close knit communities on the Internet and communicate via social media for support and for advice related to health and wellbeing –not a physician or other medical provider. Therapeutic use of Psychedelics in Addiction was presented by Dr. Silvia Franco Corso a resident physician entering addiction psychiatry from Columbia who has had experience on the use of psychedelics in the treatment of gambling disorder. Psychedelics are gaining acceptance for a wide range of disorders and this is an evolving area that has important implications for addiction medicine and public health policy. Several breakout sessions were included as options including sessions on adolescents and substance use disorder, implementing universal trauma precautions and on personality disorders in substance abuse treatment. The final sessions of the day included a presentation by my Medical Toxicology and Addiction Medicine colleague at the University of Rochester Medical Center, Dr. Nicholas Nacca on Electronic Cigarette or Vaping Product Associated Lung Injury: An Update for Addiction Providers and this was followed by the Toxicology Panel moderated by myself with Dr. Russ Sullivan an Emergency Medicine, Medical Toxicology and Addiction provider from Syracuse, New York, along with Dr. Nacca and myself. The panel featured an update and overview of ten years of synthetic and designer drug in New York State followed by some ‘tricks of the trade’ involving benzodiazepine detoxification protocols and buprenorphine induction in the setting of fentanyl and fentanyl-adulterated heroin use.
In addition to the educational content we were able to meet the MSSNY officials we will be working closely with as they take over supporting our administrative and advocacy activities. I was able to meet the MSSNY President Dr. Bonnie Litvack who joined us for Saturday and also Philip Schuh, CPA on Friday. We look forward to tremendous opportunities for outreach, advocacy and impact as this new relationship moves forward.
I thank those of you who have already provided comments and feedback; we look at the comments every year in order to bring new and important content back the following year and if you have a twitter handle I encourage you to check out, “nysam_connect” to see all of the interesting posts related to this year’s conference tweeted by a number of the attendees.
Special thanks to Elisabeth Kranson, John Coppola and Lou Desso from New York State Alcoholism and Substance Abuse Providers (NY ASAP) who helped plan the conference, organize the event, arrange exhibitors and sponsors as they did an outstanding job, again, with this year’s conference. Planning the NYSAM conference is tremendous work and it came together again as an outstanding event.
So thank you if you attended the conference and if you didn’t please consider joining us in 2021. There are lots of opportunities to participate in NYSAM so please don’t hesitate to reach out. Conference presentations have been uploaded to the NYSAM website and we will also include the 2020 poster presentations along with author information.
Tim Wiegand, MD, FACMT, FAACT, DFASAM
President, the New York Society of Addiction Medicine