Author: CSAM Admin

By: Jean Marsters, MD, Committee on Membership & Communications Co-Chair,

The Membership Committee decided to look at the race and ethnic identification of our membership at the end of 2022. We evaluated a Dec 22, 2022, data pull of the race/ethnic identification as entered in ASAM’s membership database by members when they first joined. The option of identifying as multi-racial was not offered as a choice at that time, so at least some of those people may be in the “other” category. We wanted to see if active members in the organization mirrored the race/ethnic composition of all members. As a proxy for active members, we used all members listed on the CSAM website’s committee list that same day. Members on committees were only counted once (people on 2 committees were only counted once). Committees not listed on the website were not included such as Nominations Committee.  Activities not appearing on the website such as work groups, task forces and the History Project were not included. Below is the result:

We compared our member numbers with the California Health Care Foundation’s CA Health Care Almanac: A Quick Reference Guide March 20211¹ which has various breakouts of the racial/ethnic identification of active patient care physicians, California Med School graduates and total population in California in 2019 and 2020 (below):

Some of the numbers that break out:

23% of CSAM members “preferred not to answer” or gave no answer to their racial/cultural affiliation. This was a bit less than the 26% of ASAM physicians who answered the same in 2021.

Comparing all CSAM members with those listed on committees:
       White: 44% vs 52%, Asian 12% vs 11%, Hisp/Latino 8% vs 7%, AA 6% vs 2%,
       Other 6% vs 3%, AmInd/Alask Nat 1% vs 0%, Nat Hawaii/Other Pac Isl ~ 0.5% vs 0%,
       Prefer not to Answer 4% vs 7%

6% of Californians and members are African American, but 2% of committee members listed are.

39% of Californians are Latinx, 8% of members are and 7% of committee members listed are

32% of CA physicians active in-patient care are AA/PI, 12% of members are Asian and 11% of committee members listed are.

33% of CA physicians active in-patient care are White, 44% of members are White and 52% of committee members listed are.

Towards these ends and on behalf of the Membership Committee, I presented this data to the CSAM Board yearly kick-off meeting February 11, 2023, along with the recommendation that the Board reviews this and other data on culture/ ethnicity and develop a longitudinal action plan on diversity.

Since that time, there have been various developments:

The Inclusiveness and Social Justice Advisory Group has been created by our current President, Sharone Abramowitz, MD. This group has links to the Membership Committee through shared members.

Last Winter, MERF and the CSAM Membership Committee teamed up to submit a proof-of-concept paper to the California Health Care Foundation seeking funding to develop training for clinicians from race/ethnic groups underrepresented in medicine. Our request was not funded.

Last Spring, MERF and the CSAM Membership Committee teamed up to submit an application for a MAT Access Points grant to the Sierra Foundation (CA DPH SOR-3 funds) designed to promote addiction prevention and treatment for opioids and stimulants to communities of color in California. We offered to develop an 11-month training spanning 2023-24 for 16 California clinicians who either a) identified as an underrepresented medical minority or b) who work in the Tribal Health or Urban Native Indian Health Care systems in California. Our request was not funded.

From my seat on the ASAM Membership Counsel, I have been advocating for improvements in our ability to measure diversity among our membership. Since CSAM and ASAM require joint membership and membership/demographics are in ASAM’s platforms, by improving our ability to measure, we can improve tracking the diversity and identify gaps which need to be addressed. The next horizon for this is to look at sexual orientation, gender identity and expression (SOGI) numbers among membership which ASAM/CSAM has never tracked.

By: Randolph P Holmes MD, FAAFP, DFASAM, Government Affairs Committee Chair

The legislative session has now concluded here in California and Governor Newsom has either signed or vetoed all bills presented before him. CSAM’s Government Affairs Committee worked diligently to vet and review all the bills relevant to Substance Use Disorders/Addictions care. Two bills CSAM supported were signed into law:

• SB 326 & AB 351, both authorize a bond initiative to fund improvement of the mental health and SUD treatment system
• SB 872 authorizes mobile pharmacies to dispense medication for SUD’s

There were several fentanyl bills that were signed (and many that were not). One bill we supported and was signed was:

• AB 33 will create a fentanyl task force that has a representative of CSAM serving; another bill will create an overdose reporting system.

There were five (5) naloxone bills but only one was signed:

• SB 234 which requires Stadiums, concert venues and Amusement Parks to provide naloxone was signed. 
• SB 461 was amended to require Community colleges and CSUs to provide fentanyl test strips.

There were a number of bills that CSAM opposed that were vetoed:

•  SB 58 was one of these bills which would have legalized hallucinogens.

CSAM also supported a number of bills that were vetoed:

• AB 1288 and AB 1060, bills to drop Prior Authorization requirement by private insurers for medication to treat SUD’s and emergency mental health/SUD care but these were vetoed;
• CSAM supported AB 1207 which would have prohibited cannabis products from being produce in ways to attract children, but it was vetoed

CSAM was neutral of SB 43, which redefines the meaning of gravely disabled, and this bill was signed into law.

Lastly, CSAM continues to be involved in our efforts to re-start a Physician Wellness Program for physicians who experience issues with SUD’s or mental health problems. We are preparing comments on the state’s new proposed rules and regulations.

CSAM’s GA Committee welcomes any CSAM members who are interested in California policy issues to attend our monthly Zoom meeting as a guest. Getting involved with advocacy is a great way to advance treatment opportunities in our communities. We do not yet have our list of bills for the 2024 legislative session, but we expect more movement on fentanyl, naloxone, licensing of outpatient treatment programs, and building capacity for mental health/SUD treatment.

By: Farah Zaidi, MD, 2024 State of the Art Conference Committee Chair

On behalf of the California Society of Addiction Medicine (CSAM), I am excited to share some of the early planning highlights of the 2024 CSAM State of the Arts (SOA) Conference in August 2024, taking place in the beautiful city of San Francisco at the spectacular venue Hyatt Regency San Francisco.

I would like to begin by honoring and acknowledging the original people of this vibrant city: We are on the ancestral homeland of Ramaytush Ohlone peoples who are the original inhabitants of the San Francisco Peninsula. We wish to pay our respect to the Ancestors, Elders and Relatives of the Ramaytush Community as the first people of this land. We recognize that we benefit from living and working on their traditional homeland.

San Francisco Bay Area is the hub of innovation, technology, education, research, science, arts, cultural diversity and so much more. The Bay Area is also home to many prestigious Universities, as well as top notch Residency and Fellowship training programs of almost all specialties.

The theme of the 2024 SOA Conference is “Social and Commercial Determinants of Health (SDoH & CDoH)”. While there is increased awareness of SDoH, the understanding about the CDoH appears to be in its infancy and is evolving. The 2023 Lancet series on CDoH, defines CDoH as “the systems, practices, and pathways through which commercial actors drive health and equity.” Tobacco, alcohol, processed/ultra-processed foods and drinks, gaming and gambling are some of the well-known examples of CDoH with significant harmful impacts on public health.

Our expert faculty will highlight the trends, advances, and innovations in the treatment of addictions, as well as the intersectionality of social and commercial determinants with addictions, focusing on the impact of vulnerable and already marginalized communities at disproportionally high rates.

In addition to covering the State of the Art in treatment and research of the most prevalent of substance use disorders, we plan to explore the relationships of climate change and substance use disorders, the role of Artificial Intelligence (AI) in addictions treatment, the link between spirituality in trauma care and recovery, and specific treatment considerations in special populations including the Maternal-Fetal dyad, LGBTQ, Children & Adolescent and Geriatrics.

Our popular Board Exam Preparation Track will be offered again to those who are preparing for the American Board of Preventive Medicine, Addiction Medicine Subspecialty Board Exam in 2024. Our other Wednesday Pre-conference workshops will focus on psychedelics, the state of the art in opioid use disorder treatment, addressing our child and adolescent populations, while MERF (Medical Education Research Foundation) will offer its popular MI (Motivational Interviewing) workshop on Wednesday as well.

And last but not the least, MERF scholars and conference attendees will have an opportunity to share their research and other projects through multiple Poster Sessions over the course of conference.

In short, whether you are a late, mid or early career physician, a physician in training, a medical student, an associate member (i.e., advanced practice provider, therapist, medical assistant), a returning or a novice CSAM conference attendee, the CSAM 2024 SOA Conference promises to offer you a perfect blend of learning, networking, relaxing and sightseeing in San Francisco, one of the top tourist destinations of the United States.

Happy Holidays,

-Farah Zaidi, MD