{"id":6579,"date":"2011-08-03T09:33:52","date_gmt":"2011-08-03T13:33:52","guid":{"rendered":"http:\/\/www.bumc.bu.edu\/busm-news\/?p=1673"},"modified":"2011-08-03T09:33:52","modified_gmt":"2011-08-03T13:33:52","slug":"addiction-expert-designated-white-house-champion-of-change-busms-daniel-alford-has-a-question-for-you-how-often-do-you-drink","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/camed\/2011\/08\/03\/addiction-expert-designated-white-house-champion-of-change-busms-daniel-alford-has-a-question-for-you-how-often-do-you-drink\/","title":{"rendered":"Addiction Expert Designated White House Champion of Change. BUSM\u2019s Daniel Alford has a question for you: How often do you drink?"},"content":{"rendered":"
\"The<\/a>
The White House is honoring Daniel Alford for his work with addiction.<\/figcaption><\/figure>\n

President Obama\u2019s father<\/a> was an alcoholic whose drunken driving killed a friend and put the elder Obama in the hospital with two broken legs. \u2028That unfortunate bit of history may help explain the White House\u2019s interest in addiction, which includes honoring BU addiction expert Daniel Alford with a visit there on August 5.<\/p>\n

Alford (SPH\u201986, MED\u201992), a School of Medicine associate professor, is the medical director of MASBIRT<\/a> (Massachusetts Screening, Brief Intervention, Referral and Treatment), a federally funded program at Boston Medical Center and seven other hospitals and community health centers in the state that screens for risky alcohol, tobacco, and drug use. \u201cWhen you come to see your doctor for your diabetes management or hypertension or just for your annual visit, you\u2019ll be asked questions about unhealthy substance use,\u201d Alford says.<\/p>\n

Alford will be in Washington Friday, courtesy of Obama\u2019s Champions of Change<\/a> program, which hosts weekly White House visits for innovators in various fields. He\u2019ll participate in a roundtable with federal drug policy experts, write a short blog entry about his work, and film a short biographical piece for the White House website.<\/p>\n

Through MASBIRT, BMC and participating organizations now have trained health promotion advocates, who work throughout the institutions, from primary care offices to emergency rooms, screening people for risky substance use and assessing what the next step should be to help those with problems. The goal is to identify people at risk of addiction before the addiction consumes them, an approach that Alford says has been overlooked by the medical establishment. \u201cIf we waited for patients with kidney disease to need dialysis, that would be malpractice,\u201d he says. \u201cThat\u2019s kind of what we\u2019ve done with addiction. We basically ignore unhealthy substance use until the person\u2019s coming in with alcoholism or drug addiction.\u201d<\/p>\n

Alford, who joined the BU faculty in 1996, also leads BMC\u2019s program to train medical residents in a new (for nonpsychiatric doctors) subspecialty, addiction medicine. BMC recently appointed its first addiction resident<\/a>, one of only 20 such residents nationwide. BU Today spoke with Alford about his work and Friday\u2019s event.<\/p>\n

BU Today<\/em>: My doctor asks me, \u201cDo you smoke? Do you drink?\u201d Is that a result of MASBIRT?<\/strong><\/p>\n

Alford:<\/strong> Certainly some doctors were doing it before. But there are ways of asking it, and then there are ways of asking it. You can say, \u201cYou don\u2019t drink or use drugs, right?\u201d as opposed to asking it with questions that have been shown to be more reliable. When you phrase a question as, \u201cHow often do you do something?\u201d it normalizes it, and patients feel more comfortable answering.<\/p>\n

The state would like to expand this approach. The majority of our work this past year has been, how do we sustain these efforts? Is it trying to sustain this health promotion advocate model? Nurses, medical assistants, docs could probably ask those questions. It\u2019s probably going to be different, depending on the treatment center.<\/p>\n

Is training in addiction medicine feasible when there are so many addictions out there? Being addicted to drugs or alcohol is different from being addicted to gambling or the Internet or sex.<\/strong><\/p>\n

There\u2019s a lot of commonality, no matter what the substance or behavior. Addiction starts to disrupt someone\u2019s life, despite negative consequences. It turns out that a lot of the neurobiology\u2014what\u2019s happening in the brain\u2014that reinforces those unhealthy behaviors is similar as well. And they respond to a lot of treatments in a similar way.<\/p>\n

Have there been advances in treating addiction?<\/strong><\/p>\n

The answer\u2019s definitely yes. A perfect example is methadone maintenance<\/a>. Methadone was developed for pain, but was found to be effective in treating opiate addiction. There\u2019s a lot of stigma around it and people who don\u2019t believe in methadone for treatment, but there\u2019s more evidence over the last 40 years showing efficacy around methadone than pretty much anything else that I do in primary care.<\/p>\n

A lot of behavioral therapies can be effective in treating lots of addictions as well as behavioral addictions, like gambling. All of the medications work better when you include nonpharmacological therapy, like counseling. In order for treatment to work, it needs to be continued. Historically, people got treatment, they stopped using, they then got discharged, they relapsed, and we said, \u201cAha, the treatment doesn\u2019t work because they relapsed,\u201d as opposed to saying, \u201cThe treatment works; it just needs to be continued.\u201d Some people are cured permanently and don\u2019t require extensive treatment. But the large majority needs sustained treatment.<\/p>\n

What got you interested in addiction?<\/strong><\/p>\n

When I finished my residency, there was an opportunity, part-time, to be the medical director of a methadone maintenance program at the Boston Public Health Commission<\/a>. I loved it immediately. I realized there were a lot of success stories within that treatment model that we as physicians didn\u2019t know about.<\/p>\n

This BU Today<\/em> story was written by Rich Barlow. He can be reached at barlowr@bu.edu<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

President Obama\u2019s father was an alcoholic whose drunken driving killed a friend and put the elder Obama in the hospital with two broken legs. \u2028That unfortunate bit of history may help explain the White House\u2019s interest in addiction, which includes honoring BU addiction expert Daniel Alford with a visit there on August 5.<\/p>\n

Alford (SPH\u201986, MED\u201992), a School of Medicine associate professor, is the medical director of MASBIRT (Massachusetts Screening, Brief Intervention, Referral and Treatment), a federally funded program at Boston Medical Center and seven other hospitals and community health centers in the state that screens for risky alcohol, tobacco, and drug use. \u201cWhen you come to see your doctor for your diabetes management or hypertension or just for your annual visit, you\u2019ll be asked questions about unhealthy substance use,\u201d Alford says.<\/p>\n","protected":false},"author":903,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[91],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/6579"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/users\/903"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/comments?post=6579"}],"version-history":[{"count":0,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/6579\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/media?parent=6579"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/categories?post=6579"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/tags?post=6579"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}