Addiction Medicine and Addiction Psychiatry in America: Commonalities in the Medical Treatment of Addiction
| Autor: | Christopher R. Freed |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Health (social science) Substance dependence Health Policy Addiction media_common.quotation_subject Alcoholics Anonymous Public Health Environmental and Occupational Health Addiction psychiatry medicine.disease Credentialing Mental illness Article Substance abuse Addiction medicine mental disorders medicine Psychology Psychiatry Law media_common |
| Zdroj: | Contemporary Drug Problems. 37:139-163 |
| ISSN: | 2163-1808 0091-4509 |
| DOI: | 10.1177/009145091003700107 |
| Popis: | Freed (2007) recently identified the widespread but inaccurate belief that most American physicians have expertise on addiction. In actuality, two competing medical disciplines treat addiction in the United States: addiction medicine and addiction psychiatry.Addiction medicine was born in 1954 when a New York City internist named Ruth Fox, whose husband died an alcoholic, and Marty Mann, the first woman to stay sober with the Alcoholics Anonymous twelve-step program of recovery, founded an organization of physicians interested in alcohol addiction called the New York City Medical Society on Alcoholism. The New York Society promoted the modern concept of alcoholism as an illness that Alcoholics Anonymous invented. Indeed, a number of physicians in the New York Society were themselves recovering alcoholics who turned to Alcoholics Anonymous for care (Freed, 2007; Galanter, 2005), a trend that continued in the 1970s and 1980s as doctors from American medicine's impaired physician movement (see, e.g., Steindler, 1984; Talbott, 1988) and self-described "addictionologists" (doctors in recovery who committed their medical careers to drug treatment) joined physicians with a strictly professional interest in drug abuse to help addiction medicine grow nationally. Today, the leading organization in addiction medicine, the American Society of Addiction Medicine (ASAM), has about 3,000 members, one third of whom are recovering alcoholics and addicts (Freed, 2007).Addiction psychiatry originated in 1985 when a small group of academic psychiatrists from the American Psychiatric Association founded their own organization of addiction specialists that today, with approximately 1,000 members, is called the American Academy of Addiction Psychiatry (AAAP). The psychiatrists argued that substance dependence was a mental illness which they could treat more effectively than ASAM physicians, especially doctors in recovery whose philosophy of care derived from their personal experience in Alcoholics Anonymous. In 1991, troubled that "within the treatment system, [physicians in recovery] . . . have supplanted psychiatrists on the front lines" (Group for the Advancement of Psychiatry Committee on Alcoholism and the Addictions, 1991:1292), the psychiatrists used their scholarship on drug abuse, the comorbidity literature that linked addiction and mental illness, and exclusive training programs in addiction psychiatry to persuade the American Board of Medical Specialties, the "gold standard" of physician credentialing, that they possessed specialized knowledge on addiction. Recognition from the American Board of Medical Specialties gave addiction psychiatrists the "right to responsibility" (Goode, 1960) for the medical treatment of addiction, especially since addiction medicine failed to attain comparable professional standing (Freed, 2007).'ASAM still seeks recognition for addiction medicine from the American Board of Medical Specialties (American Society of Addiction Medicine, 2006), a mission that suggests a substantive distinction between addiction medicine physicians and addiction psychiatrists. Similar to the belief that most physicians have expertise on addiction, this notion is also inaccurate. As this article shows, leading addiction medicine physicians and addiction psychiatrists agree on the definition of addiction and that drug treatment is an "art" which requires a multimethod approach. Despite this extensive accord, ASAM physicians and AAAP psychiatrists draw sharp distinctions between addiction medicine and addiction psychiatry to serve historical, economic, and professional interests, revealing the importance to both disciplines of recognition from the American Board of Medical Specialties and thus "jurisdiction" (Abbott, 1988) over the medical treatment of addiction.Data collection and analysisData for this article, part of a larger sociological and historical study on addiction medicine and addiction psychiatry, derive primarily from 17 interviews with addiction medicine physicians, addiction psychiatrists, and doctors certified in both medical disciplines. … |
| Databáze: | OpenAIRE |
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