“Addiction Medicine” NOT a Recognized Medical Specialty

“Addiction Medicine” is not recognized by the American Board of Medical Specialties (ABMS)–It is a “self-designated-practice specialty” (SDPS) and indicates neither knowledge nor expertise. – Disrupted Physician – 6/14/2015

This article shows exactly how flimsy the requirements are to become an “Addiction Medicine” specialist.

With little training in anything by the 12-step model, such specialists are supremely unqualified to deal with the complexities and social consequences of addiction.

The increasingly rapid growth and complexity of medical knowledge in twentieth century American medicine resulted in the creation of specialties and subspecialties.  

A related development was the creation of “boards” to “certify” physicians as  knowledgeable and competent in the specialties and subspecialties in which they claimed to have expertise

As the number of medical specialties proliferated an umbrella organization was formed to accomplish this task. The Advisory Board for Medical Specialties was created  in 1933 and reorganized as the American Board of Medical Specialties (ABMS) in 1970.  This non-profit organization oversees board certification of all physician specialists and sub-specialists in the United States

The ABMS recognizes 24 medical specialties in which physicians can pursue additional training and education to pursue Board Certification

All of the ABMS Member Boards are:

“committed to the principle of examining doctors based on six general competencies designed to encompass quality care:

1. patient care,
2. medical knowledge,
3. practice-based learning and improvement,
4. interpersonal and communication skills,
5. professionalism, and
6. systems-based practice.”

An example of a proper and rigorous sub-specialty certification:

Addiction Psychiatry became a subspecialty of ABPN in 1993

The ABPN governs the specialty of Psychiatry, of which Addiction Psychiatry is a subspecialty.   Board Certification in Addiction Psychiatry requires a four-year psychiatric-residency program for training in the prevention, diagnosis and treatment of mood, anxiety, substance-abuse as well as other psychological and interpersonal problems followed by an additional year of training in one of the 40 accredited Addiction Psychiatry Fellowship programs.

When this rigorous education and training is complete a candidate is Board Eligible and can then take the subspecialty certification exam. The exam assesses competency in the dand consultation, pharmacotherapy, pharmacology of drugs, psychosocial treatment and behavioral basis of practice to be Board Certified in the subspecialty of Addiction Psychiatry by the ABPN

Candidates must then be assessed in  a number of areas including

• psychiatric evaluation and consultation,
• pharmacotherapy,
• pharmacology,
• toxicology,
• psychosocial treatment,
• behavioral basis of practice, and
• many other areas in which for the past half-decade they where taught and apprenticed.

The American Academy of Addiction Psychiatry (AAAP) is the only professional organization in the US focused on the subspecialty of Addiction Psychiatry.

Self-Designated Practice Specialty 

This is an AMA Census Term Indicating What a Group of Doctors are Calling Themselves.

The American Medical Association records a physician’s Self-Designated Practice Specialty (SDPS) in response to an annual credentialing survey.

According to the AMA, SDPS are “historically related to the record-keeping needs of the American Medical Association and do not imply ‘recognition’ or ‘endorsement’ of any field of medical practice by the Association.

SDPS refers to a self-designated specialty and this is not equivalent nor does it imply ABMS Board Certification.

“The fact that a physician chooses to designate a given specialty/area of practice on our records does not necessarily mean that the physician has been trained or has special competence to practice the SDPS“

Compare the scant requirements for “Addiction Medicine” below with the rigorous education and experience required of “Addiction Psychiatry” above.

In contrast to these accepted board credentials,American Board of Addiction Medicine (ABAM)  certification requires only

• a medical degree,
• a valid license to practice medicine,
• completion of a residency training in ANY specialty, and
• one year‘s full time involvement
• plus 50 additional hours of medical education in the field of alcoholism and other drug dependencies.

The majority of American Society of Addiction Medicine (ASAM) physicians meet these requirements by “working in a chemical dependency treatment facility, taking continuing medical education courses in addiction, or participating in research.”

The American Society of Addiction Medicine’s mission is to

“establish addiction medicine as a specialty recognized by professional organizations, governments,, physicians, purchasers, and consumers of health care products, and the general public.   

They have succeeded in doing this as many consider them to be the experts in addiction medicine including regulatory agencies.

This is the equivalent of “saying so, makes it so”. These self-anointed “addiction specialists” are corrupting the care of people suffering from addiction.

They cling to an ancient model of addiction as a spiritual disease and reject scientifically proven treatments. This intrusion of an unproven non-medical treatment for a medical problem should be illegal but has become so knit into the American consciousness that medical health insurance is required to pay for these quasi-spiritual treatments.

But Addiction Medicine is currently not recognized by the ABMS.  It is still a Self-Designated Practice Specialty and the ABAM is a Self-Designated Board.

Addiction Medicine has deep pockets, and if the November 2014 issue of the Journal of the American Medical Association (JAMA) is a harbinger of what’s to come, this self-designated practice specialty currently being certified by a self-designated Board and bereft of anything resembling the the educational and professional standards for quality practice in a particular medical specialty or subspecialty may soon robber baron its way into acceptance by the American Board of Medical Specialties

One thing is for certain.  When society gives power of diagnosis and treatment to individuals within a group schooled in just one uncompromising model of addiction with the majority attributing their very own sobriety to that model, they will exercise that power to diagnose and treat anyone and everyone according to that model.  

The birth of Addiction Medicine as an ABMS accepted discipline is sure to be a success for the drug and alcohol testing and 12-step treatment industry, but its spawn is sure to be an inauspicious mark on the Profession and Guild of Medicine and a bane of society for years to come