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PLNDP Physician & Medical Student Associates
April 2001 Newsletter

From the PLNDP National Office

Dear Colleagues:

In this newsletter we inform you of our recent project activities and seek your advice and involvement. We hope that you will become active in our project. We know that the support and activity of the PLNDP Physician and Medical Student Associates are critical to implementing medical and public approaches in our national drug policy. To facilitate your involvement in the PLNDP mission, we have streamlined our website to allow better access to our free reports and encourage contacts with our Outreach Partners.  We have also purchased a domain name that we felt would be easy to remember and locate - We encourage you to visit our website and make use of the free educational resources.

Resources Available on our website include:
* PLNDP Consensus Statement
* PLNDP Position Paper on Drug Policy
* PLNDP Action Kit (with PowerPoint slides)
* Overview of PLNDP Research Reports and Video Reports-
     a)      Effectiveness of Treatment
     b)      Alternatives to Incarceration
* PLNDP "Physician Guide on How to Advocate for More Effective National  and State Drug Policies"

         David C. Lewis


Endorsement and Support for Our Consensus

To date, we have received endorsements from 23 state medical societies and numerous professional organizations, including the American Medical Association (see our website, , for a complete list of supporting organizations). NOTE: We are actively recruiting state medical societies and national professional organizations to endorse our consensus. If you are interested in helping with this effort, please contact the PLNDP National Office email or phone 401-444-1817.

Release and Distribution of the "PLNDP Position Paper on Drug Policy"

Last spring a copy of the "PLNDP Position Paper" was sent to each member of Congress with a cover letter signed by PLNDP members Dr. Edward Brandt Jr. and Dr. Philip Lee, in part stating that, "We are confident that a comprehensive approach that includes drug treatment, prevention measures, and criminal justice approaches - especially when they are integrated into multidisciplinary and collaborative efforts - will decrease the burden of America's drug crisis on individuals and communities."

In January 2001, the "PLNDP Position Paper" was sent to each governor by Governor John Rowland of Connecticut. Gov. Rowland noted that, "While expanding drug addiction treatment and prevention will result in some modest increases in health care costs, PLNDP research demonstrates that these costs will be more than offset by reductions in the number of drug abusers and the resulting social and economic costs." If you haven't seen the policy paper, you can download it from our website at within the RESOURCES section.

Briefing Sessions with Policy Makers

PLNDP has held several briefings on Capital Hill to discuss >addiction treatment and to outline the recommendations in the "PLNDP Position Paper on Drug Policy". One such briefing included the following speakers: Edward Brandt, Floyd Bloom, Judge Peggy Hora and Thomas McLellan. Capital Hill staff, as well as representatives from several national organizations, attended the briefing.

Another more recent session was held at the Hall of States cosponsored by the National Governors Association and the National Conference on State Legislatures. PLNDP member Dr. Edward N. Brandt, Jr., former Assistant Secretary for Health (Reagan Administration) led a panel discussion which included Dr. Hoover Adger, President of the National Association for Children of Alcoholics and former Senior Deputy Director of the Office of National Drug Control Policy, The Honorable Bill Schma, Circuit Court Judge, 9th Judicial Circuit, State of Michigan and Dr. Thomas McLellan, Professor of Psychiatry at the University of Pennsylvania. In a session well attended by governors' state representatives, panelists stressed the need to treat drug addiction as a disease and discussed the cost-effectiveness of substance abuse treatment when compared to incarceration.

In addition to formal briefing sessions, there have been numerous individual meetings with policy makers at both state and federal levels. We need PLNDP Associates to take our consensus and policy reports and meet with their local and state policy makers. If you want to become more active locally in advocating for a more public health oriented national drug policy, we have a guide to help you. It is entitled Physician's Guide on How to Advocate for More Effective National and State Drug Policies. This guide will be mailed to all PLNDP Associates in early April and will also be available on our website.

Educating the Public and Professionals


To date, we have produced three videos. More than 5,000 copies have been distributed nationwide of "Trial, Treatment, and Transformation" and "Drug Addiction: The Promise of Treatment." These videos have been distributed free of charge (with support from our foundation funders, the Robert Wood Johnson Foundation and John D. and Catherine T. MacArthur Foundation), and will be made available until foundation support runs out. The third video, "From Hopelessness to Healing," is intended for placement on cable television and has had an excellent response. Thus far, this video has been shown in many areas including Grand Rapids MI, Toledo OH, San Antonio TX, La Jolla CA, and New Haven CT. In addition to placing this video on local cable networks, we are trying to place it in the Community Video sections of Blockbuster and Hollywood Video stores nationwide. If you want to help place our video in your local cable television station or elsewhere, we have a VIDEO KIT to walk you through this process including sample letters and other materials. Contact the PLNDP office (email or call 401-444-1817) for more information.

Medical Journal Publications

Two articles in peer reviewed journals were directly connected with the PLNDP project. The first by A. Thomas McLellan, Ph.D., David C. Lewis, MD, Charles P. OBrien, MD, Ph.D., Herbert D. Kleber, MD is titled "Drug Dependence, A Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation." It is found in JAMA, 2000, 284: 1689-1695. This publication grew out of Dr McLellan's presentation to a panel of the PLNDP at our first research report briefing on the nature of addiction.

For a copy of this publication see:

The second publication by Norman G. Hoffmann, Ph.D., Albert J. Chang, BS and David C. Lewis, MD is entitled "Medical Student Attitudes Toward Drug Addiction Policy". This study explores the attitudes and perceptions of medical students concerning patients with addictions and policy issues related to drugs. Medical students expressed general support for treatment funding and related demand reduction strategies, but the strength of their support was influenced more by their political orientation than their perception of the effectiveness of the strategy.

This article was published in Volume 19, Number 3, 2000 of The Journal of Addictive Diseases. For a copy of the abstract of this publication see:

Focused Policy Meetings and Reports

Effective Medical Treatment of Heroin Addiction in Office-Based Practices with a Focus on Methadone Maintenance

On November 6, 2000 the PLNDP, under the guidance of PLNDP Chair Dr. June Osborn, initiated a meeting co-sponsored by PLNDP member Dr. Spencer Foreman, President, Montefiore Medical Center and Dr. Robert Newman, President, Continuum Health Partners, in cooperation with PLNDP member Dr. Jeremiah Barondess, President of the New York Academy of Medicine (NYAM). At this meeting held at NYAM, clinicians, researchers, and regulators presented their perspectives on the current status of the institution of office-based opioid treatment in the US. The discussion was lively and productive.

PLNDP feels it is time to review the policies that both support and retard expanding methadone maintenance treatment into medical practices beyond large clinic settings. The timeliness of such a discussion is enhanced by the probable introduction of buprenorphine as an opioid maintenance drug. A working draft of these discussions is being finalized and will be distributed to attendees and PLNDP core members within the next few weeks. Once the report is completed it will be posted on our website.

The Effect of Welfare to Work Programs and Medicaid Eligibility on the Access and Quality of Substance Abuse Treatment

Because of the high degree of enthusiasm for the format of the PLNDP-convened meeting on methadone treatment, we are now planning a similar format for facilitating a small group discussion and developing a summary report on the subject of Medicaid. We will be reviewing issues of access to and quality of substance abuse treatment for those involved with Welfare to Work and Medicaid programs, as well as those who are ineligible. PLNDP Member Dr. Edward Brandt, Jr. has agreed to chair this meeting.

Environmental Influences on Addiction

Because of the PLNDP's recognition of a need to expand research, PLNDP member Dr. Jeremiah Barondess, President of the New York Academy of Medicine, is spearheading a study on the relationship between environmental factors and drug use, harmful drug use and addiction. We are in the process of organizing a discussion among a group of epidemiologists to discuss the current research findings and needs in this area.

New Research/Policy Initiative

Adolescent Substance Abuse

The next PLNDP research and policy report will be focused on adolescents. A central focus of this report will be the availability and quality of substance abuse treatment and the relationship between adolescents and the juvenile justice system. We are in preliminary discussions and are developing a national advisory board for this report whose membership thus far includes: Drs. Hoover Adger, Kenneth Schonberg, Deborah Simkin, Susan Riggs, George Comerci, and Lew Lipsitt. The Board of Directors at the American Academy of Pediatrics has recently endorsed our consensus statement and supports this next phase of our work. AAP has asked Dr. George Comerci to be their representative on the PLNDP advisory committee for the adolescent project. Dr. Comerci is also a core member of the PLNDP and a member of the PLNDP Strategic Planning Committee. One activity potentially linked to the adolescent report is a children's initiative by the American Academy of Arts and Sciences, headed by PLNDP member Dr. Howard Hiatt to look at the juvenile justice system in relation to adolescents and substance abuse. If you have suggestions for topics and/or researchers that we should include, please notify us by email ( or call 401-444-1817.

PLNDP Outreach Partners Reports

In October 1999 the PLNDP National Office began to decentralize our operations by developing PLNDP Outreach Partners. Each of these organizations are asked to coordinate physician activities, link medical societies and PLNDP Associates, develop and disseminate educational materials for physicians and medical students and promote PLNDP policy initiatives. If you are interested in collaborating with or contacting a PLNDP Outreach Partner please email us at or call 401-444-1817. The following organizations are PLNDP Outreach Partners:

American Academy of Pediatrics
(Representative: Dr. George Comerci)

AAP has endorsed the PLNDP consensus and also agreed to work closely with us in the development of our upcoming research report focused on adolescents. For more information see the above summary under the heading of Adolescent Substance Abuse.

Join Together
(Representatives: David Rosenbloom & Barbara Hildt)

Join Together (JT) and PLNDP are looking to work more closely with communities. If you are interested in connecting with community coalitions concerning treatment and substance abuse issues, contact Barbara Hildt at

In October 2000, in coordination with PLNDP, Join Together kicked off a weekly electronic newsletter, PLNDP Direct. This weekly electronic newsletter reports on all of the major news, research and funding issues relating to drugs, alcohol, tobacco and guns, as well as highlights from PLNDP activities, events and educational resources. The newsletter gets published every day and is free. PLNDP Direct has its own subscriber list of physicians. If you haven't signed up please go to and click on SUBSCRIBE TO PLNDP DIRECT.

Join Together has recently completed a new resource guide for PLNDP Associates entitled"Physician's Guide on How to Advocate for More Effective National and State Drug Policies" which will be distributed to all PLNDP Physician and Medical Student Associates. This guide will be used in recruiting new physician associates and increasing awareness of available resources needed to advocate for a public health approach to national drug policy.

Join Together is also sponsoring a program called Demand Treatment. Demand Treatment is designed to mobilize communities across the country to increase brief interventions, screenings, referrals, and actual quality treatment at the local level. For more extensive information about Demand Treatment, consult the JT website (

American Society of Addiction Medicine
(Representative: James Callahan)

Part of ASAM's mission in this project is to connect PLNDP members with ASAM state chapters to further the goal of a more effective national drug policy. To learn more about ASAM and ASAM members in your community, contact Jim Callahan at

JT and ASAM have been collaboratively working on the issue of parity (insurance benefits for substance abuse and addiction equal to other chronic diseases). With the support provided by PLNDP, these two organizations have convened a working group that has attracted the attention of major national organizations and government officials around the issue of parity. This working group now calls itself "Coalition on Alcohol and Drug Addiction Treatment." Its focus is on achieving parity at a state level by concentrating its initiative on educating policymakers. This group proposes to target 7 states initially in this effort (AZ, CA, NY, HI, FL, IA and WI).

American Academy of Addiction Psychiatrists
(Representative: Dr. Stephen Dilts)

AAAP has been participating in various PLNDP activities including the PLNDP Strategic Planning Committee, the discussions in November's meeting on methadone maintenance and the parity discussions of the "Coalition on Alcohol and Drug Addiction Treatment". If you'd like to learn more about AAAP and ways to get involved contact Dr. Dilts or Jeanne Trumble with AAAP at

American College of Obstetrics and Gynecology
(Representative: Dr. Ronald Chez)

ACOG has recently endorsed the PLNDP consensus statement and implemented a CME learning module on substance abuse. Its target audience is the 40,000+ Fellows and Junior Fellows of ACOG. This work is being done with support from PLNDP. The training module consists of 60-70 slides with accompanying text, and will be distributed via CD. It will also be available to download from both the ACOG and PLNDP webpages. To learn more about this module and ACOG contact Dr. Chez at

American Medical Student Association
(Representative: Michael Mendoza)

Michael Mendoza has been working with Dr. Preston Reynolds, PLNDP member and Representative for SGIM, on a survey designed to assess medical students' perceptions of their teachers' attitudes towards patients with abuse and addiction problems. The final draft of the survey is very near completion. Michael is going to use the survey for a pilot study at the upcoming national AMSA meeting in late March 2001. If you are interested in getting involved with medical students' activities you can email

Society of General Internal Medicine
(Representative: Dr. Preston Reynolds)

Dr. Reynolds presented PLNDP's work to two groups at the annual SGIM meeting. She presented the PLNDP consensus statement to all members of the Health Policy Committee, which has agreed to present the statement to the SGIM Council for endorsement consideration. If you are interested in learning more about SGIM or ways to get involved contact Dr. Reynolds at:

PLNDP is also working with SGIM members to develop a supplement to the Journal of General Internal Medicine on substance abuse and current health policy issues surrounding substance abuse. The remaining sections of the supplement will be devoted to articles on the diagnosis of addiction disorders and effective addiction treatment. The deadline for submission of articles is June 1, 2001 (see JGIM's instructions for authors at:

Society of Teachers of Family Medicine 
(Representative: Dr. Richard Brown)

The Executive Board of the Society of Teachers of Family Medicine endorsed the PLNDP consensus statement at their May 2000 meeting. STFM's Executive Director has agreed to offer an information session on the consensus statement and supporting materials at the 2001 STFM National Meeting. To learn more about STFM and ways to get more involved, contact Dr. Brown at:

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