Editor’s Note: I have watched the American Society for Addiction Medicine (ASAM) grow for more than 40 years, from the time it was named “AMSA” for the American Medical Society on Alcoholism. This month is the fifth anniversary of its being under the direction of Penny Mills. You will see in this interview why she has had such a positive impact on this organization and why I have enjoyed working with her so much.
“When I came to ASAM, there wasn’t even a department dedicated to education,” says Penny S. Mills, executive vice president and CEO of the organization since July 2010. “I brought in a dedicated staff person, and we’ve centralized all of the educational offerings.”
During Mills’ tenure, the reach of the educational programs of the American Society of Addiction Medicine (ASAM) has more than doubled from 13 programs in 2010 to 51 in 2014. “There’s such a need for credible clinician education around addiction,” Mills says. “We continue to see the opportunity to grow educational activities.”
Growth seems to be one of the organization’s guiding principles under her leadership. Prior to joining ASAM, Mills held leadership positions with a range of health care organizations including the American College of Cardiology, where she held a senior position for 15 years.
She joined ASAM from Avalere Health, a leading advisory firm focusing on the intersection of health policy and business strategy. Mills holds a bachelor of arts in psychobiology from Oberlin College and an MBA and Sloan Certification in health services administration from Cornell University.
Recently, she talked with Modern Addiction Recovery about the opportunities and challenges facing ASAM and the addictions field in general.
Modern Addiction Recovery: Since you joined ASAM, the organization has grown significantly. Are there one or two accomplishments of which you are especially proud?
PM: The work of the Patient Advocacy Task Force has been valuable. ASAM commissioned a number of research reports on the barriers to obtaining medication to treat opioid addiction. The research was cited in several journals as well as in a Huffington Post piece on opioid addiction. It makes me very proud, on behalf of ASAM, that this research has been so widely documented and cited.
Along similar lines, the American Medical Association passed a policy opposing undue barriers to accessing medication and proposed a state bill to eliminate these barriers by not putting medications on formularies or limiting dosage amounts. AMA then created model state law, which ASAM supports, and we will work with our chapters in this effort to eliminate barriers to medication for the treatment of opioid use disorders.
MAR: ASAM members come from an unusually wide variety of primary specialties, which must create particular organizational challenges. What strategies have you found useful to try to resolve controversies and minimize divisiveness?
PM: Being a multi-specialty society is beneficial to ASAM. It brings in multiple perspectives so that when we deal with different issues, like treating patients with opioid use disorder, for example, we have obstetricians and gynecologists as members who can weigh in on the issue as well as ER professionals who’ve seen the negative impacts of the problem first-hand.
We have members who work in primary care practices and outpatient or inpatient facilities. We also opened up our membership to non-physicians. They all bring different perspectives, but I see this as healthy rather than being a source of conflict. However, we have to prioritize. The needs of one group might not be as critical as those of another group that week. The challenge is prioritizing everyone’s needs.
MAR: How would you say that ASAM is similar to other medical specialty societies, and in what ways is it different?
PM: Certainly there are a lot of similarities in terms of functions like continuing education, advocacy, chapters, and policy and guideline development. From my perspective, what is different about ASAM is that previously I never had any engagement with the criminal justice system. I never understood the difference between being in jail versus being in prison. It’s very important to understand these kinds of differences if you’re going to work with addiction specialists.
ASAM’s advocacy work has a social justice aspect as much as it does a government relations focus. The addiction field hasn’t had a political voice like AIDS or cancer. Many of the patients ASAM members treat don’t have advocates because of the stigma associated with addiction.
MAR: What do you think are the one or two most immediate issues for the addiction field to address?
PM: The opioid overdose epidemic tops the list. It’s everywhere. States have created task forces, and quite a few bills are working their way across the Hill right now (i.e. The Opioid Overdose Prevention Act). There are so many dimensions to the crisis.
Another immediate issue is the workforce. I don’t know that there will ever be enough specialists to treat addiction. To address workforce issues, we’ve developed education programs targeting primary care providers. They need to be educated, and we need to make it less difficult to treat patients. We need to tackle both of these issues.
MAR: Further down the road, what issues do you see “over the horizon” that will need to be addressed?
PM: One key issue that will need to be addressed is quality of care. How do you know what quality addiction treatment looks like? It takes a while to define quality metrics and determine how to implement those metrics and show improvement. The addiction field has a way to go in defining and measuring quality of care and clearly needs to catch up with other disciplines. There just aren’t good metrics right now.