ASAM Science Initiative: Guidance on Improving Addiction Medicine Research
Representatives of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Agency for Healthcare Research and Quality (AHRQ) have requested input from ASAM members on how to improve the clinical relevance of their addiction medicine research portfolios. Please provide input on their questions below, and add any questions or comments you may have at the end of the form.

In the meantime, please continue to visit www.asam.org/ScienceInitiative for updates on our work and to learn about opportunities for joining our efforts. Thank you!
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Alicia Pinto
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LMHC, MCAP- Utilization Review Supervisor for Detox/Residential LOC
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Are you a current ASAM Member?
NIAAA Q1: Would a real-time, wearable biosensor for measuring blood alcohol levels be of clinical value? Why or why not? Yes, it could measure withdrawal potential and the severity of the withdrawal including needing intensive medical services and life threatening complications of withdrawal. If a patient has a BAL and begins to experience withdrawal symptoms that is very concerning so the higher the CIWA score while patient still has a positive BAL the more severe their withdrawal will be.
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NIAAA Q2: Would a general consensus definition of recovery facilitate research on recovery from alcohol use disorder? Why or why not? Sure BUT if you are going to define recovery- and if you are going to call addiction a disease- then treat it like one. That involves giving it a definition of medical recovery meaning that if someone is in recovery from their addiction they are in the process of healing. Recovery suggests that you once suffered from something- pain and suffering either emotional or physical. OR better explained - moving back towards baseline functioning that they deviated any progress or stability in it suggests you are recovering, recovery can only be measured by the individual and not by a whole and it primary focus is on improving quality of life at that time, if that is not complete abstinence from substances but harm reduction with a commitment and dedication to move towards improving their quality of life and desire to go back to baseline- is that not someone in recovery also? They don't have a name for when people are in these phases it's still called “contemplation or preparation” and i do not think that is fair to patients because I have never met or heard of an substance user that was not ready for change- they are miserable, they do not want to continue to use.. It is beyond that and the stages of change are irrelevant AND INSURANCE COMPANIES WILL TRY TO USE THEM TO DENY TREATMENT. New research on solution focused patient centered THERAPY change model or motivational interviewing change model - Maybe people can start thinking that they are in recovery from their substance use disorder making progress towards it little by little every day a lot earlier than when they hit total abstinence from now on- things will not be so overwhelming for them. I was taught harm reduction in graduate school for substance abuse, incorporate that with ASAM and make it an option for people with immediate risk for harm first. What if an alcoholic could acknowledge within himself that he stopped drinking vodka but still drinks beer and gets drunk BUT that is still progress because he does not BLACKOUT anymore- that is actually a significant thought process to have and would make me very happy to hear a patient struggling tell me he was able to do that on his own.
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NIAAA Q3: Would a core resource of evidence-based information about alcohol be of use to the addiction community?If so, which formats, features, and/or types of information would be most useful? Yes but keep in mind who needs all this information and needs to interpret it across all the different sectors INCLUDING the patient. But due the current situation and my job- There needs needs to be a utilization review resource guidebook- I've developed my own resources because the lengths I have had to go through to get a patient approved for detox level of care is unbelievable so- As a therapist I have learned EVERY possible little thing I could imagine what could be related medically to alcohol use- but no other therapist knows that.. and no other utilization reviewer knows that (you do not need credentials to be one, I just have a weird passion for it) and the significance to knowing it is very important to 1. getting the care covered in the first place 2. educating the patient/therapist on the medical issues from this (im talking about thiamine deficiency etc etc.
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NIDA Q2: How can NIDA make its research more accessible? Let American Counseling Association know about it, ASAM and if its not free then MAKE IT FREE PLEASE, free ceus for therapists and certified addiction professionals - therapists do not make a lot of money we have to pay for all our ceus and licensures I Was making 38k in a private facility having to maintain licensures- just keep that in mind we need access to free education because a lot of therapists will use that as an excuse to say " i can not afford it"
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NIDA Q3: How might we better engage clinicians and patients to inform research?
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NIDA Q4: What are your suggestions for highest priority for NIDA’s next strategic plan? (2021-2025)
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AHRQ Q1: What research questions around evidence, practice improvement, and healthcare systems should be a priority for AHRQ?
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AHRQ Q2: What kinds of information/practice support/tools and resources would make your work more effective?
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AHRQ Q3: What kind of digital resource capabilities are most needed to enhance patient care?
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Additional questions/comments
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May we include your responses/comments in the discussion portion of the "Bridging the Gap" virtual conference session on April 14th, 2020? (names will not be used; please consult asam.org for more information on the virtual ASAM 2020 conference)
Are you interested in learning more about ASAM's Science Initiative and opportunities for collaboration with the Science Initiative Subcommittee?
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