Doctors with Substance Use Disorders

See an article here about physicians who have substance use disorders.  I was quoted in US News and World Report, saying that the reasons that physicians use drugs are largely the same reasons why everyone else does so.

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3 Responses to Doctors with Substance Use Disorders

  1. EB says:

    The ASAM and FSPHP are front groups for AA that have taken over evidence-based addiction medicine treatment and research. They have infiltrated regulatory medicine and pose grave danger to both individual physicians and the profession. They wish to establish the 12-step prohibitionist brain disease model of addiction with lifelong spiritual recovery as the only treatment for addiction with a long-term goal of expanding to other populations. We are all at risk. This needs to be exposed and dismantled before it is too late.

    1. ASAM/FSPHP is AA
    The American Society of Addiction Medicine (ASAM) and the Federation of State Physician Health Programs (FSPHP) are “front groups” for AA and the 12-step “Minnesota Model,” of addiction treatment with lifelong abstinence and prohibition and spiritual recovery. The history of the ASAM and FSPHP are well recorded and can be traced back to the New York City Medical Society on Alcoholism founded by Dr. Ruth Fox in 1954. The goal of the ASAM has always been acceptance of 12-step doctrine, lifelong abstinence, and spiritual recovery as the one and only treatment for alcoholism and addiction.

    2. Conflicts-of-Interest. Goals are control and conformity.
    With strong ties to the drug-testing industry and a network of 12-step rehabilitation facilities (Talbott, Marworth, Hazelden, etc.) staffed by like-minded ASAM physicians and 12 step indoctrinated staff the conflicts-of-interest are staggering. Ideology trumps evidence based medicine resulting in false diagnoses, confirmatory distortion, coercion, and the political abuse of psychiatry.

    3. Self-declared experts
    The ASAM is an American Medical Association (AMA) “self-designated medical specialty” (SDMS). SDMS “recognition” means that the AMA recognizes that a group of physicians are calling themselves something. It is a categorization term the AMA uses for physician census.

    4. Diploma Mill
    The only requirement for ABAM “board certification” is an MD, some sort of experience/interest/background in addiction medicine, and passing the ABAM exam. It does not involve the rigorous training, experience, and knowledge that is required of the American Board of Medical Specialties and is not even recognized by the ABMS.
    Addiction psychiatry is the only ABMS recognized addiction medicine subspecialty and requires an internship, psychiatry residency, and an additional year of full time training in qualified fellowship program and passing the Addiction Psychiatry Board Exam. The exam tests evidence based basic science and clinical knowledge of toxicology, psychology, pharmacology, and multiple other aspects of addiction medicine.

    By proclaiming themselves the experts in addiction medicine through a well funded propaganda aimed at the general public, politicians, regulatory agencies, medical societies, and others, the ASAM has successfully convinced others that they are experts. By convincing others of their expertise they have successfully lobbied for regulatory changes that facilitate the political agenda of the ASAM as well as the 12-step rehabilitation facilities and drug testing companies they work with.

    The self-promotion of propaganda and misinformation includes the publication of scientifically unsound, biased, ,methodologically flawed, and amount to little more than opinion pieces. Making the data fit the hypotheses, they then parade these puff pieces as science that further supports their expertise.

    6. Control of organized medicine and individual physicians. PHP’s and the FSPHP.
    In the past decade ASAM members have joined, gained power, and taken over the “impaired physician” programs in almost every state. These programs were set up as a “safe haven” to help physicians battling addiction or substance abuse and were designed to both help physicians and protect the public. They were organized in almost every state and staffed by volunteer physicians out of altruism and good-faith. The perceived benevolence has created absence of a need to guard and they are unregulated, accountable to no one, and without transparency. ASAM physicians have joined these groups, removed qualified and caring physicians who did not fully conform to AA groupthink, and taken over these programs in most states. They have increased secrecy gained power by taking advantage of peer reviewed protection, confidentiality statutes, and peer reviewed immunity laws. They encourage confidential referral with immunity for referral of physicians. If they think a referred physician is “in need of treatment” the physician has no recourse or appeal and must comply under threat of loss of licensure. The evidentiary standard is low and the physician has no right of appeal. Once contracted the physician must abide by all recommendations including weekly urine drug screens and forced participation in 12-step recovery.

    7. Ideology and indoctrination has replaced science and ethics in PHPs.
    The goal of the FSPHP is universal 12-step indoctrination. Physicians under the control of the PHP must accept any and all requirements and if you do not abide they will use any means necessary to remove you. Coercion, control, and conformity is the goal. Black and white thinking and ends justifies the means ideology has led to all sorts of abuses including threats and intimidation, falsifying drug tests, collusion with others to give false diagnosis, the political abuse of psychiatry. Civil rights abuses, ethical transgressions, and crimes are being committed with impunity. The attached documents are an example of how they falsify drug tests by colluding with the labs. This has created a culture of fear.

    8. Junk science and pseudoscience.

    The biomarkers EtG and PEth were introduced by Dr. Greg Skipper as laboratory developed drug tests for alcohol testing. With an arbitrary cutoff point they then tested EtG and PEth on physicians in PHP programs. With very high sensitivity and poor sensitivity due to the ubiquity of alcohol in foods, cosmetics, medications, and aerosols they have attempted to legitimize these tests. There is no cochrane review of any of the studies. They continue to attempt to validate the use of these tests through their own studies in an effort to expand the testing to other populations.

    9. Expanding scope and power.
    Based on a retrospective cohort study that is of poor validity, methodologically flawed in multiple ways, and inherently biased they are claiming an 80% success rate. The “Physician Health Study” blueprint is being paraded as the “paradigm” of addiction medicine treatment. Doing a google search one will find myriad congratulatory proclamations of the “amazing,” “incredible” and “unparalleled” success.

    The reason they are brandishing this “blueprint” is because they want to use it on other populations including employee assistance programs, DOT, and criminal justice.

    As with all of the other studies they have done for self-promotion, it does not take a lot of investigation to see that this claim is misleading and false. All the congratulatory backslapping is based on a retrospective cohort study looking at the recorded outcomes of 904 participants in 16 State Physician Health Programs. Of the 904 participants 102 were “lost to follow up” and of the remaining 802, 155 physicians failed to complete the contract. They have interpreted this as remarkable by pointing out this 80% success is beyond the pale when you compare it to other populations. But we are comparing apples to oranges.

    The outcomes they used were the last reported status of the PHP participant enrolled in the program. Measuring success of program completion in doctors compared to the general population is meaningless as the short-term outcomes are quite different in terms of the external consequences imposed. The consequence of not completing a PHP is the invariably career ending. So what happened to the 24 of who “left care with no apparent referral,” the 85 who “voluntarily stopped or retired,” and the 48 who “involuntarily stopped or license revoked.”

    Whether you leave a PHP voluntarily, involuntarily, or with no apparent referral it is the end game and your career is over. Comparing this to other populations where the consequences of failing to complete the program are not so final is inappropriate. Claiming superiority over programs with a 40% success rate is unfounded because for most of those people the consequences are not so final and may mean nothing more than an increase in testing frequency.

    The big question is what happened to the 157 physicians who left or stopped? How many of those killed themselves 6 reported suicides 22 deaths, and another 157 no longer doctors. I would venture to say the number of suicides is a lot higher than they claim. But using the last recorded PHP status as the final outcome obfuscates this. Due to the severity of the consequences a 20% failure rate is quite concerning. And with the planned expansion and growing power of these zealots this should be a concern to all of us. If nobody speaks up now they will obtain ABMS accreditation, they will be in charge of random drug testing of all physicians using their homemade junk-science alcohol tests, they will expand to other employee assistance programs, and you too are at risk for coercion, control, and conformity to a lifetime of abstinence and 12 step indoctrination.

    Please take a look at some of this and do the fact checking as it is easily verified-the organizations, architects, ideology, and future plans. The ASAM and FSPHP are political front groups for AA and the 12-step drug testing industry. Well funded financially and in numbers, the “prime-directive” is to take make the “Hazelden model” of 12-step prohibitionist spiritual recovery the one and only treatment for addiction. This has been the goal for the past several decades, but with evidence-based medicine, critical thought, and scientific reasoning precluding this goal–what they could not take by persuasion they are now taking by force. By infiltrating “impaired physicians” programs in all 50 states and gaining control under the organization of the FSPHP they are in charge of the PHP programs, shaping public policy, creating the myth of hidden cadres of drug addicted doctors protected by a medical conspiracy of silence to promote random MD drug testing, helped shape the DSM-V, and are now promoting the PHP model of rehab as the “gold-standard” of addiction treatment based on a methodologically flawed retrospective cohort study which is misleading and biased. The ABAM certification amounts to little more than a diploma mill. The PHP’s are now targeting the “aging” physician, going after the nebulous “disruptive physician,” and have convinced regulatory boards and public policy makers that they are indeed experts. No one is paying any attention to this and it is imperative they be exposed, regulated, and controlled.

    Quote from the ASAM

    “Physicians have played a role in the treatment of alcoholism, or as we recognize it today, Chemical Dependence, since the time of Hippocrates. A large amount of this treatment by physicians has been well-meaning but ill-informed. Actually, it has taken a largely lay organization, Alcoholics Anonymous, to show the medical profession the most effective approach to the treatment of this disease. However, most physicians still do not understand what chemical dependence is and what is necessary for recovery from it. This lack of knowledge is largely due to a lack of education at the medical school level. I would like to review some of the history of the medical profession concerning this disease before I consider the important recent developments”.

  2. Wow, very well said. Can I get you on my team? I have been working loosely over the past few years with a couple of other doctors who know how this system works and we have also done our research. We try to get the word out. May I republish your letter on Quora on my blog> I spent half the night writing about this on Quora as I am in the midst of 6 years thus far of fighting the system – I am one of those “lost to follow up” or perhaps they just said I left the profession as I gave up my license rather than be forced to participate in a fraudulent scheme of which I have been fully aware since my husband was assigned some drug and alcohol commitments as a young lawyer in 1980 or so. I am not certain about how this works, and there is one particular jerk who keeps posting a letter I wrote 3 or 4 years ago on Link’d In expressing similar opinions, as evidence of my clearly deviant behavior. Let’s get together – I am doing other medical related things like writing and medical software, but frankly must get the license back now as I am raising capital for my startup of 2 years and my lawyer said this is killing me on due diligence. So, we will see – I can’t tell you how the Medical Licensure Board has lied, obfuscated and employed dilatory tactics in what they thought would be a relatively short war of attrition. I have lost my home, etc., but it was too big anyway, lol.

    • Yes, what we need to do is attack these witchprickers on all levels. The only way they are able to exist is in dark secrecy because behind the curtain nothing is there. The so called “federation” of state physician health programs consists of around 60 people–all ASAM physicians who joined the medical society funded state physician health programs (which were sitting ducks), incorporated under FSHPH, took over, kicked out the good guys (like Wes Boyd) who did not agree with their simple minded groupthink. At the same time they created their own “board specialty” under ABAM (I took it just to make a point without picking up a book and passed by about 180 questions over the cutoff–it was more like the “food handlers permit” test I took when I applied at Baskin and Robbins in High School than a board exam. It is a joke), claimed they were the experts, and immediately started cozying up to the FSMB (it is all documented). The first thing they did is pitch the EtG to the Board, fostered a “moral panic” with the junkie in the OR by propaganda designed to correlate it with medical error (no evidence base). They planted the seed for the “disruptive physician” with propaganda designed to correlate these hooligans with communications error and costing money (malpractice, time, etc). The next target is the “aging physician” and they are trying to correlate it with dementia. It is all out there if you look for it.

      They have essentially bamboozled the FSMB and administrative and regulatory medicine who need to WTFU but they don’t like to admit error as we know.

      What we need is a concerted attack on these witch-prickers on all levels including trying to gain support on a grassroots level by showing:

      I. The emperor has no clothes

      a. Where they came from: AA > AMSA > ASAM > FSPHP {corporate (12-step rehab, drug testing industry) and political (AA prohibitionist lifelong brain disease with spiritual recovery) FRONT GROUPS

      b. lack of qualifications:

      ASAM not recognized by ABMS as a true specialty like neurology, pediatrics, cardiology, or addiction psychiatry. It is a “self designated medical specialty” which is a census term used by the AMA to keep track of what doctors are calling themselves. If enough doctors are calling themselves “space doctors” they want to know about it for census purposes. It indicates neither expertise nor capability.

      ABAM certification a diploma mill. Not worth the paper it is printed on. All you need is an MD in ANY SPECIALTY and to pass this joke of a test.

      Sample question: Which of the following are true A=1, B=2 C=3 D= 4, E = all of the above. Fill in the appropriate oval

      1) AA by and large works better than anything we have been able to devise with all our science and all our money and all our efforts
      2) If you are ignoring the utilization of AA groups-interaction with them, referral to them-then you are ignoring a critical crucial part of the import and kinds of care people with this disorder deserve and must have
      3) AA has shown the way and presented us with a model of long term care that is really not care. It is participatory self-management . It is an assertion of the autonomy of the individual. Instead of his thinking of himself as a victim, a helpless person
      4) AA gives a person the kind of sense of self-worth and along with it the kind of humility and reality-testing that are absolutely essential in the management of alcohol problems.

      I answered E (all of the above) and dagnabit nailed it! My approach to taking the test was to put myself in a lobotomized mindset-how would I answer this question with no frontal lobes while sitting in a miasma of ether–again–nailed it!

      3. Expose the sketchy individuals involved in the FSPHP. The FSPHP contains a lot of doctors who had revoked licenses for doing very bad things. It also contains felons. Skipper is a felon. There are also some sexual predators as card carrying members. Is it really a good idea to put these kind of people in charge of our profession. Old habits die hard don’t they?

      4. Expose the junk science. It’s all junk. If you look at the studies they would not even make honorable mention in the junior high science fair. Easy pickings. Time to take aim.

      5. Expose the “like minded docs” who are the point people the FSPHP uses for “leverage”. All the medical directors of the 12-step rehab programs the refer to are on there. The majority are “in recovery” themselves but the wizard (dupont) and the witchpricker (Skipper) are also members. So is Gitlow (ASAM President). The Oz behind the curtain (Talbott ) is a silent member. Silence of the lambs-12 step redux.

      Also see the tweets below. Favorite and retweet

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