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ASAM, FSPHP and altering the diagnostic criteria
« on: August 06, 2011, 04:18:10 PM »
Fellows of ASAM – FASAM certification

Members of the American Society of Addiction Medicine (ASAM) can be recognized by the letters “FASAM” as part of their professional credential, with the “F” designating “Fellow of.”   ASAM supports research that furthers their financial goals and expands use of the ASAM principles of addiction treatment.  The ASAM wanted to create a new “Board” specialty in order to control federal grant funds and other public financing.   American Society of Addiction Medicine certification (FASAM) is not equivalent to medical board certification. On their website the ASAM admits that its “examination is not a Board examination. ASAM is not a member of the Board of American Board of Medical Specialties, and ASAM Certification does not confer board Certification. "  

The American Society of Addiction Medicine (ASAM) is has never been recognized by the American Board of Medical Specialties (ABMS) as a board specialty. There are professional organizations which provide “Board Specialty” training in medicine and psychiatry.  These organizations have clear and stringent guidelines as to who earns the honor and professional status as a “boarded” expert. Credentialing in these specialties as an MD is a challenging process that weeds out those without adequate clinical or academic skills. These ABMS recognized medical specialties include: pediatrics, geriatrics, surgery, psychiatry, neurology, internal medicine, urology, cardiology, anesthesiology, gastroenterology, emergency medicine, radiology, respiratory medicine, endocrinology and many others.

The field of psychology also defines strict guidelines for board certification.  The American Board of Professional Psychology was incorporated in 1947 with the support of the American Psychological Association. The ABPP is a unitary governing body of separately incorporated specialty examining boards which assures the establishment, implementation, and maintenance of specialty standards and examinations by its member boards. Through its Central Office, a wide range of administrative support services are provided to ABPP Boards, Board-certified specialists, and the public.  Specialization in a defined area within the practice of psychology connotes competency acquired through an organized sequence of formal education, training, and experience.  In order to qualify as a specialty affiliated with the ABPP, a specialty must be represented by an examining board which is stable, national in scope, and reflects the current development of the specialty.  A specialty board is accepted for affiliation following an intensive self-study and a favorable review by the ABPP affirming that the standards for affiliation have been met. These standards include a thorough description of the area of practice and the pattern of competencies required therein as well as requirements for education, training, experience, research basis of the specialty, practice guidelines, and a demonstrated capacity to examine candidates for the specialty on a national level.

In contrast to these accepted board credentials, ASAM certification   requires only a medical degree, a valid license to practice medicine, completion of a residency training program 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.  ASAM does not require any specific formal training or experience in the diagnosis and treatment of physical or mental illness.  But regardless of the lack of training in these fields, the state physician health programs have extended their outreach into areas in which they have no professional qualifications.  In most of today's state physician health programs, "Regardless of setting or duration, essentially all treatment provided to these physicians (95%) was 12-step oriented."    In these programs, ASAM practitioners routinely impose their spiritually-based 12-step abstinence recovery program.  This system is imposed on medical professionals through threats to remove medical licenses or curtail practice or hospital privileges.

Creating a new “Board” Specialty

The Diagnostic and Statistical Manual of Mental Disorders (DSM)   is published by the American Psychiatric Association (APA) and provides diagnostic criteria for mental disorders.  The ASAM refuses to acknowledge the DSM-IV-TR criteria for various addictive disorders.  Instead, the ASAM has its own criteria which were defined by its own doctors with addiction histories.   Dr. George Talbott was a primary contributor to the ASAM manual on addiction.  This book is used by ASAM doctors to diagnosis people with "addiction".   The vast majority of ASAM fellows also still believe that the only effective treatment for addiction must be based in the 12-steps of recovery expounded by the A.A. program.

Based on the new diagnostic manual defined by the ASAM members, the organization started their own credentialing program, called the graduates trained in their revised diagnostic approach “Fellows,” and designated them as experts.  The ASAM now seeks to “grandfather” their “FASAM” members as equivalent to boarded experts in behavioral medicine without the required strenuous “residency” training currently necessary to obtain a doctor certification as a “boarded” expert.  With stains caused by addictive behavior permanently erased from the doctor's record without unbiased evaluation, he or she can move easily into a position of national political influence and privilege. Such placements can permit a grateful recipient to return favors to sponsors.

It must be remembered that funding for the state PHP is provided in part by medical malpractice insurance companies.  The state PHP is not designed to help targeted doctors recover and go back to practice, nor are they designed to protect vulnerable populations from abuse, neglect and medical fraud. The state PHP is designed to make money for its constituents, to protect large hospital and medical corporations from medical malpractice lawsuits.  The state PHP will readily sacrifice an “uncooperative” or whistleblower's career for corporate profits. “Disruptive” professionals threaten cash flow.

The Federation of State Medical Boards

In May 1993, Federation of State Medical Boards   (FSMB) President Hormoz Rassekh, MD, established a special Ad Hoc committee on "physician impairment" in order to develop medical board strategies for identifying, evaluating, regulating, and managing "impaired" licensees.  In 1995 the FSMB stated this policy, "After discussion of several forms of physician impairment, the committee elected to focus primarily on chemical dependency, because of its prevalence."

ASAM has with political support managed to establish forty-six physician health programs in the U.S.A., with 42 of them being members of the FSPHP.    ASAM continues to promote the A.A. 12-step model of substance abuse treatment and maintain that impaired physicians be cured by religious belief.  Although originally started as simply chemical dependency treatment programs, these programs now extend into areas of medicine and psychology for which the ASAM doctors are not professionally trained or qualified.  According to the ASAM, the “impaired physician” is suffering from an illness which only a spiritual experience will conquer.  ASAM believes that these “impairments” need lifelong monitoring and are to be treated by surrendering one's "will and life over to the care of God" and completely immersing the individual in some variation of A.A.'s spiritually-based 12-step program.

Establishment of state Physicians Health Program (PHP)

The state Physicians Health Programs contract with medical associations, in each state, to provide “monitoring” services of licensed professionals reported to be “impaired.”  The cost is paid from both the state health department funding and federal funds, as well as financial support from malpractice insurance companies and large medical corporations.   The state PHP, a non- government entity (NGO) over which the state health department has very limited supervisory oversight, has been given almost police-like prerogative to revoke the license of any medical professional they choose to target.  In addition, the PHP has been granted, by most of the state legislatures, a quasi-governmental immunity from legal liability for damages suffered by injured persons. Medical professionals unwittingly sign a contract for this NGO to "monitor" them if deemed necessary when they apply for professional licensure now. The FSPHP is the umbrella organization of all the state PHPs.

The Federation of State Physicians Health Programs

The Federation of State Physicians Health Programs (FSPHP)   arose from state chapters of the American Society of Addiction Medicine (ASAM).   For example, Washington Physicians Health Program is the former Washington state chapter of the American Society of Addiction Medicine.  The FSPHP was originally established in order to monitor physicians with addictive problems in diversion programs.  But over the years the FSPHP expanded its outreach to include any “impairment” or “suspected impairment.”  In 2008 ASAM president Dr. Louis E. Baxter, Sr. MD (addiction psychiatrist FSPHP president 2009-2011) proclaimed that Physicians Health Programs (PHP) now includes, "To provide a means to identify, evaluate, and treat physicians who have diseases of impairment."    The use of the wording diseases of impairment is not coincidental as it is the language used in the legislation that provides governmental authority for the PHP’s existence and also its funding through the state departments of health.  This expanded mission now includes not only drug addiction and alcoholism, but also mental health issues such as disruptive behavior, psychiatric disorders, psychosexual disorders and even physical diseases and metabolic disorders.  In this mission creep volunteers and paid “agents” of the PHP now feel they are authorized by the state medical board to address as diverse problems as grief, sexual assault, domestic violence, child abuse, divorce, child custody, bulimia, asthma, diabetes and hypertension.  But these volunteers and “agents” may not have any professional qualifications to handle these issues and they are supervised by the PHP director who is only qualified in “addiction medicine”.  The PHPs are run by supervisory committees made up of addiction specialists and people “in recovery” who are not physicians at all.  Staffs of the PHPs are often recovered addicts who have Chemical Dependency Counselor (CDC) credentials or some other similar training which was gained while they were “recovering” from their own addiction.   True to the vision of Bill Wilson, co-founder of the A.A. or 12-step program, the ASAM and the FSPHP is run by addiction peers who supervise the “peer mentoring”.

Surprising to most doctors is that the Federation of State Physicians Health Programs has a state “Physicians Health Program” in almost every state.  This program is a non-governmental organization (NGO) with tax-exempt status and incorporated to limit legal liability for their board of directors. The state Physicians Health Program (PHP) has become the primary investigator of any medical professional suspected of impairment or labeled a "disruptive doctor."  Persons placing complaints against a doctors license are allowed to do it anonymously under the federal Health Care Quality Improvement Act (HCQIA) and do not even have to legally state what they allege is even true. There is no standard for admission of evidence.  Fabricated and false statements can be placed in the doctor’s professional record without any transparency and no due process.  This HCQIA legislation, originally intended to provide an avenue for patients to provide complaint information about doctors to state medical boards and federal agencies, has now had unintended consequences and instead protects hospital administrations from malpractice liability.  This immunity granted to “Good Samaritans” who come forward with complaints under HCQIA regarding medical care has been subverted by those wishing to hide malpractice and medical fraud.

Under the Health Care Quality Improvement Act (HCQIA) there has emerged a covert ability to impact or revoke a medical professional’s license without requirement of standard, valid legal evidence or court procedures.  Thus, doctors, nurses, pharmacists, chiropractors, dentists, and even veterinarians are now subject to control by this organization, the grandchild of ASAM.  Its practices bear uncanny resemblance to the operational ways of Straight Inc. and The SEED rehabilitation centers.   The same web of patient abuse behind closed doors has now gained official sanction as a governing agency watchdog with coercive control over medical professionals’ licenses through "monitoring" and investigation.

Doctors who lost their medical license for participation in abusive schemes sought a way to be reinstated as employable professionals.  They were invited to be doctors performing research in newly established, funded residential treatment centers for substance abuse, where it was possible to use drugs on captive patients without proper informed consent.  Who would believe or be concerned about “addicted” patients?  A collaboration formed that would benefit the pharmaceutical industry by targeting populations of “human subjects” who were controllable and who could be given their experimental drugs within locked facilities.  

In return for facilitating the pharmaceutical industry’s corporate goals, there would be political influence exerted to soften certain legislative language to permit ASAM doctors to regain their medical license and to erase the records of their own addictive behaviors and/or criminal activity.  The ASAM leaders strategically analyzed how to circumvent the medical quality control system that prevented them from expunging untoward behavior from their records.

It would be beneficial to infiltrate and eventually take control of the official systems that had developed to protect patient safety and medical integrity.  
The ASAM addicted doctors now had established a system for “monitoring” professionals accused or suspected of substance abuse or other addictive behaviors (i.e., sex, gambling).  Through the Federation of State Physicians Health Programs they attempted to gain a controlling access to professionals in every state.  Through contracts made with the state departments of health, they established themselves as the only capable competitor for state funds related to medical licensing fees that were designated to ensure quality professional performance.  

With generous outside funding from non-disclosed sources, ASAM doctors were able to effectively underbid others for these substance abuse treatment monitoring functions.  Thus, doctors who had been so impaired that their medical privileges were revoked or curtailed were now permitted to monitor every licensed medical professional within the U.S.A.  An aggressive and expensive advertising campaign through medical and nursing association journals presented the newly established Physicians Health Programs (PHP) as advocates for “impaired professionals.”  Everyone in the medical field was encouraged to report other doctors, nurses, dentists, chiropractors, pharmacists and other related professionals who might need to be “monitored” by the PHP.  Strategic marketing to allied professionals such as non-medically trained assistants, office managers, and paraprofessional staff to report “suspects” allowed the ASAM to target selected doctors and other healthcare professionals and force their participation in an unregulated monitoring system.  There were no protections against gossip, rumor or fabrications against licensed medical professionals.  Private investigators could be hired to probe the personal lives and background of professionals, without their credentials or methods scrutinized for aberrant purposes.  

Anyone with criminal interests could make a complaint against a doctor or other professional and expect to have the PHP take action.  This could neutralize or eliminate a competitor or whistleblower.  The ASAM embraced not only substance abuse problems (i.e., alcoholics and drug addicts) but also "sex addicts" and compulsive gamblers as members of their growing non-profit organization. Expunged histories provide no warning to patients about a past sexual-compulsive history.  Expanded focus of the PHP program also considers eating disorders and smoking as “addictions” that may warrant monitoring.

The ASAM and the Federation of State Physicians Health Programs   politically worked to change legislative law in each state to facilitate their control over the investigation into any quality control issues related to doctors or other licensed medical professionals. These legislative changes were achieved with no media attention, and few professionals knew these changes occurred.  Thus, legislation was passed to strengthen the authority of ASAM doctors while limiting legal liability by grant of quasi-governmental status and resultant governmental immunity.
Presenting themselves as experts on the treatment of addictions, the ASAM doctors offered educational programs to train others to view “problem” doctors through the lens of ASAM principles, based on the Dr. Ruth Fox tradition of abusive and coercive control.  They could protect their own addicted or criminally involved members and remove the medical license from anyone who could report their criminal behavior.  

The ASAM started another organization which prevents licensed medical professionals from ability to access their own medical credentialing verification documents.  The PHP requires that individual state licensing boards refuse to accept records that document professional credentials without applicants sending requests for credential verification to an independent incorporated centralized agency that the ASAM corruptly controls.  This prevents whistleblowers from seeking a professional license in any U.S.A. state and eliminates a doctor’s ability to go abroad with a clean record and obtain a license to practice.  It ends a professional career.  

ASAM and FSPHP control over professional licensing is not vulnerable to law enforcement scrutiny and is not under the control of any government body.  This is unrecognized power with no government supervision or accountability as an NGO incorporated to limit liability but operate as a non-profit to reap advantage of US tax laws.  The state boards of medicine do not control what transpires behind the closed doors of this ingenious monopoly.  

The U.S.A. Congress cannot pierce the covert halls of this power.  Even the FBI is stymied by the provisions of HIPPA regulation that were enacted to protect patients’ confidentiality, and which require a high burden of proof to obtain a legal subpoena.   ASAM doctors have created a system they control and in which they can hide whatever criminal activity is necessary to further financial goals.   Money laundering is possible with much less risk within the medical community collaborating with corrupted interests within the FSPHP and associated interests.  It is possible to threaten or professionally destroy any whistleblower naïve enough to report their criminal activity.  The FSPHP has the power and ability to force residential or outpatient “treatment” on whistleblower opponents under the auspices of the substance abuse treatment legislation and the mental health legislation at the state and local level.  Fewer medical professionals, psychologists and therapists are courageous enough to risk loss of their professional licenses if they report as “mandated reporters.”  Yet, they are required to do so by law. Unfortunately, many do not learn about this treachery until they report and are then brutally attacked from unanticipated directions.  

If law enforcement wants to prevent medical fraud, the ASAM and FSPHP corrupted system of power and control must be dismantled. It is necessary to ensure quality in our healthcare delivery systems.  That responsibility must be returned to properly elected and/or appointed officials collaborating with medical professionals in systems that are sufficiently transparent to assure that professionals with integrity and consumers are protected.

Because reports of abusive practices by the State physician health programs have leaked out,  media attention, state legislative actions, court decisions and voiced concerns of Congress have lead to the removal of PHP programs from many states including: CA, MN, NV, TX, WI, and OR.

The Association for Behavioral Health and Wellness

The American Board of Addiction Medicine was created by Association for Behavioral Health and Wellness (ABHW).  The new American Board of Addiction Medicine (ABAM) "specialty" criteria was written by the ABHW. The goal of the AMBHA [formerly the American Managed Behavioral Healthcare Association (AMBHA)] was to make money on substance abuse treatment and mental health services.  Their CEO, Pamela Greenberg, became chairman of the newly formed ABHW board.  Ms. Greenberg is also the senior vice president in the Stephens Inc. company of Dallas, TX, which supplies financial services to health insurance companies.  The goal of this alliance is to make money for the financial investors (Stephens Group LLC).  Those making management decisions are not trained in medicine or psychology; they are trained in financial assessment, risk management, cost-benefit insurance statistical analysis, economics, public policy, survey research and other related fields. They are not medical professionals.  

The Association for Behavioral Health and Wellness (ABHW)   is organized and run by Pamela Greenberg to protect certain financial interests, such as medical malpractice and health insurance companies (Aetna, Value Options, Cenpatico, Magellan Health Services, Optum Health Services, Shaller Anderson Behavioral Health, MHN);  it also promotes the financial interests of major pharmaceutical companies ( Eli Lilly, AstraZeneca International, Bristol Myers, Reckitt Beckiser).  (ABHW mission statement)  

ASAM states their goal is to establish addiction medicine as a specialty recognized by professional organizations, governments, physicians, purchasers and consumers of health care services, and the general public. The American Managed Behavioral Healthcare Association (AMBHA) and the ASAM collaborated to promote the alternate “board specialty” under the American Board of Addiction Medicine and admission of those with the FASAM credentials to expert status without the need for the usual residency training. These alternately boarded "experts" in behavioral medicine would then be able to compete for federal funds on par with traditionally prepared professionals.  Enhanced opportunities to commit medical fraud, patient abuse and human rights violations are facilitated.  

American Board of Addiction Medicine

ASAM is currently attempting to receive medical specialty recognition for promoting A.A.'s spiritually based 12-step recovery model to the American Board of Medical Specialties (ABMS)   ABMS certifies all of the traditionally recognized medical specialties and subspecialties (Internal Medicine, General Surgery, Psychiatry, Emergency Medicine, Anesthesiology, Pediatrics, Radiology, etc.). The American Board of Medical Specialties (ABMS), a not-for-profit organization, assists 24 approved medical specialty boards in the development and use of standards in the ongoing evaluation and certification of physicians. ABMS, recognized as the “gold standard” in physician certification, believes higher standards for physicians means better care for patients.  As an integral part of their comprehensive strategy for employment of former “recovered” addicts and to enhance their attainment of positions of power and authority within the medical community, ASAM wanted to obtain specialty recognition by ABMS.  However, the requirement of residency training at a recognized institution of higher learning was preventing their “recovered” doctors from getting board certification.  Many of them had irregular work histories marred with periods of addictive behavior.  Thus when their professional records were reviewed, they did not stand up well to that scrutiny, in addition the requirement for medical residency training meant that they would need to maintain sobriety for that period of time while attending professional medical instruction, this proved too difficult for many in the ASAM program.  Thus doctors such as Dr. George Douglas Talbott MD, who had many years of difficulty as an alcoholic, wished to have themselves grandfathered into ABMS board certification through some agreement settlement rather than completing residency training at a medical school.  So ASAM sought to establish a new board that would then seek admission as an ABMS board certifying institution. In 2006 ASAM established the American Board of Addiction Medicine (ABAM).  According to the official ASAM/ABAM website:

"Grandfathering is the pathway to acquire ABMS certification in a new specialty or subspecialty, without having to complete all of the training requirements that will eventually be established, such as completion of an ACGME-accredited residency program...For ASAM and ABAM certified physicians who are not already Diplomats of an ABMS member board, ABAM will facilitate and advocate for the establishment of non-onerous pathways for eligibility for an ABMS-recognized Addiction Medicine examination."  

But grandfathering alone would not erase the criminal records of DUI, domestic violence, drug related criminal activity, gambling infractions, drug diversion, sexual crimes etc. that were part of the history of these “recovered” medical professionals.  Thus a pathway also to expunge their criminal records had to also be established in order for ASAM doctors to rise in positions of power, authority and influence.  This they planned to accomplish through their political contacts in the Drug Free America Foundation, the New Freedom Commission on Mental Health and various governmental boards and committees formed to determine national drug policy.
The Federation of State Physicians Health Programs (FSPHP) established a committee to monitor the addicted or corrupted ASAM members who wanted their medical license back.  This FSPHP monitoring committee was made up primarily of “recovered” addicts.  When it became politically expedient, the monitoring committee decided that those who had been previously monitored no longer needed oversight and the committee was discontinued.  This, coupled with legislative actions at the state level in several states, became a model that could be used to hide from public view the past criminal infractions and inappropriate behavior of ASAM members.  

Lack of adherence to accepted standards regarding DSM-IV-TR diagnostic criteria

Many state Physicians Health Program “agents” do not have any qualifications other than those to do substance abuse treatment “peer mentoring” through A.A. or 12-step programs.  PHP or ASAM medical professionals may have limited licensure, may be monitored themselves by state medical boards, and may not have access to a DEA controlled drug box because of previous drug infractions. Their scope of practice may have been curtailed by the state medical board to only include working with persons with addiction problems or doing workplace or workmen’s compensation evaluations.  

Because of their limited training and education and the limits set by the state medical boards that monitor their own scope of practice, ASAM fellows tend to view all physical and mental health problems as “co-occurring” and secondary in importance to addiction problems.  With disregard to professional standards of practice, “dual diagnosis” of psychiatric labels are freely applied to patients in spite of the fact that most ASAM fellows are not formally trained in the diagnosis and treatment of "mental disorders". (see the web advertisement for Pathway Family Center)   ASAM does not acknowledge that many psychiatric diagnoses are subjective, imprecise, and subject to change over time.   They apply their limited knowledge of the DSM-IV-TR without supervision or accountability to professional standards.  All patients are assumed to have a diagnosis of the disease of addiction – even when no evidence of addiction is present.  According to the A.A. or 12-step model, the patient is in that case just in denial.  This was true in the case of Dr. Leon Masters MD when he was threatened professionally and then falsely diagnosed as having an addiction problem, falsely imprisoned at Talbott Marsh Recovery Center in Atlanta GA and had his professional reputation as a doctor destroyed by then ASAM president George Douglas Talbott MD.

George Douglas Talbott MD wrote his own criteria of what constitutes addiction, based on the A.A. and 12-step model.   When examining this diagnostic protocol, it becomes evident that the symptoms described actually represent symptoms consistent with Post Traumatic Stress Disorder.  ASAM Fellows of the FSPHP base their diagnostic criteria for addiction on symptoms that the valid application of the criteria in the DSM-IV-TR might instead attribute to Post Traumatic Stress Disorder (Acute and Complex).  

The ASAM and the FSPHP never confer a diagnosis that does not include addiction as a co-occurring and predominant diagnosis. Charting two co-occurring diagnosis increases revenue with little increase time spent. PTSD is a diagnosis that has been historically best treated with psychotherapy.  Acute PTSD can be treated with Cognitive Behavioral Therapy (CBT) and the patient can recover to full function without further need for monitoring or further psychiatric treatment.  PTSD also has been proven to respond best to psychotherapy not medication, although some medications have shown to have limited application.  It is important to recognize the difference between PTSD, which is a psychiatric injury, and other clinical conditions of mental illness.  This is a legal as well as a medical concept with enormous implications.  For example, a sole diagnosis of PTSD would permit a sexual assault victim or domestic violence victim to testify in a court of law as a credible witness.

PTSD can be related to a child’s experience in a Straight-like copycat program.  Maia Szalavitz reported that psychiatrist Dr. Jay Kurdis recently provided expert testimony in the 2003 civil trial against Miller Newton (former Straight, Inc. National Director), which revealed that:

“Post-traumatic stress disorder (PTSD) can occur when someone is confronted by an overwhelmingly scary, actual real threat to life and limb, or to something as important as that, and in the face of that threat, [finds himself] helpless to do anything about it. The diagnosis was first introduced in relation to Vietnam veterans, some of whom had had terrifying combat or prisoner-of-war experiences that left them anxious, depressed, paranoid, overreactive to loud noises, and susceptible to vivid nightmares and flashbacks of the traumatic situation. Research shows that the longer that people feel helpless in frightening situations, and the less control they feel they have, the more likely they are to develop PTSD.”  

One of the hallmarks of all the Straights and Straight, Inc. descendant programs, such as Kids Helping Kids, KIDS of New Jersey (KIDS), etc. was that the whole program was deliberately designed to make participants feel powerless.

Altering the diagnostic criteria of the DSM-V

The American Psychiatric Association publishes an authoritative manual regarding diagnosis of mental disorders.  This manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM) is periodically updated to reflect the most recent findings in the field.  A newly revised first draft of the DSM-V or the fifth edition of the American Psychiatric Association's   (APA) DSM is due for publication in May 2013.  In this new DSM-V draft  it is suggested that "Eliminating the separate categories of Substance Abuse and Substance Dependence and replacing them with a single unified category of Substance Use Disorder" and instead "Labeling the overall section 'The Addiction and Related Disorders'.  This was a change in wording which the ASAM/ABAM heavily lobbied for as it would change the diagnosis of Substance Abuse (in the DSM-IV) to instead Substance Use Disorder under the section heading of addictive disorder.   This simple change would have the result of further legitimizing ASAM and their new ABAM specialty and expanding their scope of practice.   ASAM fellows support A.A. and 12-step program principles and maintain that addiction is a lifelong brain disorder requiring lifelong treatment.  This treatment bolstered with a DSM diagnosis is often mandated by court orders and censure by professional licensing boards. The financial benefits to the newly established ABAM would be enormous.

References and citations:

1.  American Society of Addiction Medicine,

2.   The ASAM certification process now included board certification by the ABAM.  In 2009, The American Society of Addiction Medicine (ASAM) transferred the certification examination to the American Board of Addiction Medicine (ABAM), and the next examination will be offered by ABAM on December 1, 2012 and in subsequent years.  A physician certified by ABAM is board certified. For More information please visit the ABAM Web site at

 3, DuPont RL, McLellan AT, White WL, Merlo LJ, Gold MS.  Setting the Standard for Recovery: Physicians' Health Programs, Journal of Substance Abuse Treatment.  2009;36:159-171.
4,  The Federation of State Medical Boards (FSMB) is a national non-profit organization representing the 70 medical and osteopathic boards of the United States and its territories. The FSMB leads by promoting excellence in medical practice, licensure, and regulation as the national resource and voice on behalf of state medical and osteopathic boards in their protection of the public.

5,  Federation of State Physicians Health Programs – State Listing

6,  Federation of State Physicians Health Programs Inc., 515 North State Street – Room 8584, Chicago, IL  60610,  Phone: 1.312.464.4574 Fax: 1.312.464.5841

7.  American Society of Addiction Medicine. 4601 N. Park Ave., Suite 101, Chevy Chase, MD  20815.

8.  2008 presentation on Physician Health Programs (PHP's) before the FSMB (Federation of State Medical Boards) at their 2008 annual meeting, given by 2009-2011 ASAM president “Physician Health Programs: How They Work,” FSPHP Dr. Louis E. Baxter, Sr., MD (an addiction psychiatrist), PHP missions now include, "To provide a means to identify, evaluate, and treat physicians who have diseases Conference 2008  

9.  The Association for Behavioral Health and Wellness (ABHW), formerly the American Managed Behavioral Healthcare Association (AMBHA),is an association of the nation’s leading behavioral health and wellness companies.,

10.  Association for Behavioral Health and Wellness (ABHW),,
  The American Board of Medical Specialties (ABMS), a not-for-profit organization, assists 24 approved medical specialty boards in the development and use of standards in the ongoing evaluation and certification of physicians. ABMS, recognized as the “gold standard” in physician certification, believes higher standards for physicians means better care for patients.

11.  ASAM website

12.   Pathway family Center listed in on the Dual-Diagnosis Drug-Rehab, National Family Center,  Pathway Family Center is located at 6405 Castleplace Court, Indianapolis, IN 46250   Pathway Family Center claims to do Primary Services Dual Diagnosis, Substance abuse treatment and drug rehab Type of Care  Dual Diagnosis Rehab , Residential short-term sober living drug treatment (30 days or less), Residential long-term drug rehab treatment sober living (more than 30 days), Outpatient drug rehab, Partial hospitalization drug program/substance abuse day treatment Services Provided Dual Diagnosis Treatment, Substance abuse treatment   Pathway Family Center dual diagnosis drug rehab with a primary focus on Substance abuse treatment and drug rehab. ... is&ID=4109

13,  Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision, American Psychiatric Association, pages xxxi, xxxii.   Limitations of the Categorical Approach:

        DSM-IV is a categorical classification that divides mental disorders into types based on criteria sets with defining features. This naming of categories is the traditional method of organizing and transmitting information in everyday life and has been the fundamental approach used in all systems of medical diagnosis. A categorical approach to classification works best when all members of a diagnostic class are homogeneous, when there are clear boundaries between classes, and when the different classes are mutually exclusive. Nonetheless, the limitations of the categorical classification system must be recognized.

        In DSM-IV, there is no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or from no mental disorder. There is also no assumption that all individuals described as having the same mental disorder are alike in all important ways. The clinician using DSM-IV should therefore consider that individuals sharing a diagnosis are likely to be heterogeneous even in regard to the defining features of the diagnosis and that boundary cases will be difficult to diagnose in any but a probabilistic fashion. This outlook allows greater flexibility in the use of the system, encourages more specific attention to boundary cases, and emphasizes the need to capture additional clinical information that goes beyond diagnosis. In recognition of the heterogeneity of clinical presentations, DSM-IV often includes polythetic criteria sets, in which the individual need only present with a subset of items from a longer list (e.g., the diagnosis of Borderline Personality Disorder requires only five out of nine items.)

14.  ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders (2nd ed., Revised). Chevy Chase, MD: American Society of Addiction Medicine

15,  Maia Szalavitz, Help at Any Cost: How The Troubled-Teen Industry Cons Parents and Hurts Kids (New York: The Penguin Group, 2006), p. 221.

16.  American Psychiatric Association

17.  The Federation of State Physician Advocacy Groups claims to be an informal group of concerned and dedicated medical and legal professionals who wish to remain anonymous, in order to reduce our exposure to retaliation or slander because of the controversial nature of our free speech.  The Federation of State Physician Advocacy Groups (FSPAG) was founded in late 2007 as an independent  physician-run alternative to the Federation of State Physician Health Programs (FSPHP).  The FSPHP is an independent nonprofit corporation which controls the vast majority of standard "Physician Health Programs" (PHP's) operated by medical licensing boards in all 50 states.  Also known as "diversion programs", PHP's were originally designed to provide a therapeutic avenue for physicians with "chemical dependency" (alcoholism and drug addictions) to access confidential treatment with protection from professional investigation and/or disciplinary action.  Many PHP's have gradually expanded their missions to include monitoring and treatment management for physicians with mental illness, and some are now expanding even further to encompass monitoring and treatment management for all physicians with possible "diseases of impairment" (defined as alcohol and drug use disorders, psychiatric disorders, disruptive disorders, psychosexual disorders, metabolic disorders, and physical disorders -- including diabetes, hypertension, and asthma). These increasingly broad missions have not changed the fact that the majority of state PHP's are still run by medical directors who are qualified only in "addiction medicine" and have supervisory committees largely staffed by addiction specialists and members of the general public who are "in recovery" from various addictions and who need not be physicians at all.

18.   Psychiatric Times
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