Changing the ways of CPDD – College on Problems of Drug Dependence – June 12-16, #CPDD2016
Change is the ultimate law of life. Those that do not change and adapt, do not survive. In the life of scientific meetings, this means constantly improving the organisation of the events and tailoring them to the changing needs of the conference delegates. This year, the annual meeting of the College on Problems of Drug Dependence (CPDD) introduced several improvements and more are on the way in next years.
 photocredit: cpdd.org |
Bye Bye Tote Bags
Many of us were used to the traditional design of the CPDD tote bags. Each year had a different colour. For years when conference visited a warm region, such as Phoenix, AR, the tote bag included a special layer for keeping the contents cool. The non-bag policy brought the desired recognition of sustainability and (un-)expected diversity among the conference bags – everyone was different.
Bye Bye Printed Programs
For years, the conference book was a comprehensive bible for the conference week. Everybody read it and most followed it. Although the College printed a limited number of copies, this year, the e-programs drained participants smartphones’ batteries. What more, they offered note-taking and photograph uploading that many appreciated. Welcome to the digital age.
Hello Mentors
Since the early days, the senior delegates offered mentorship to junior delegates. Mostly informal. Following the new trends adopted at other conferences, such as AHSR or NAPCRG, the CPDD sent out emails to all Members in Training (MIT), offering to match them with a potential mentor (mentor bios included). If both parties agreed, the match-maker introduced them via email. I have learned a lot from my mentor. Especially that the decision makers may not read addiction journals, also that the team identity strengthens sense of ownership among team members and that the road to the research success can be long and winding. Let’s hope that the beneficial mentoring program continues in future.
Hello Shorter Conference
With the increasing demands on scientists’ workloads, there is a chance that the upcoming conferences will be shorter.
See also my previous blog posts about CPDD from the previous years:
2015: Getting the most out of the Conference of the College on Problems of Drugs Dependence #CPDD2015
2014: 76th Annual Conference of College on Problems of Drug Dependence: Decide to be fearless& fabulous
2013: My itinerary for the Conference – College on Problems of Drug Dependence, San Diego, June 15-20
AMERSA 39th Annual National Conference
November 5th, the national conference of the Association for Medical Education and Research in Addiction – AMERSA 39th – took place in Washington, DC. With 75% of the 225 delegates being new to the conference, the conference dynamics enlivened. As a rather small association with only 1 FTE, it is doing great in attracting so many new delegates. To see what lectures they got to hear, read my notes from the Keynote speeches below.
www.amersa.org
There is no room for prosecutors in the delivery room
Dr Paltrow questioned who gets the rights when it comes to pregnant drug users. While the laws in many US states try to protect the unborn child, in reality it is the judge, the county and the attorney who gets the rights. Is this the protection of the unborn or of the system? Dr Paltrow’s mother smoked during pregnancy:
“Maybe if my mom wasn’t smoking throughout her pregnancy, I might have been a for-profit lawyer.”
To reduce the stigmatisation of pregnant women with substance use disorders, make sure to “use the word use” – not Abuse, neither drug-dependent newborn. If you are asked to drug test when you shouldn’t, it is a moral obligation to do civil disobedience. The medical education should include teaching the risks that clinicians carry when they report pregnant women who use drugs.
What is appropriate counselling?
Dr Carroll posed some really important questions, such as – How do we really get to good long-term outcomes? Is Medical Management (MM approach) that good? The intensity of MM done in trials is probably not scalable in clinical practice. We shouldn’t give up on the research evaluating psychosocial treatments. Let’s give the therapies a fighting chance, shall we? We’ve just gotta find a way to do better as therapists. Many trials report that people do not finish the treatment. We have to reach to underserved and vulnerable populations. We have to realise that people in buprenorphine treatment are different – they don’t seek counselling. CBT (Cognitive Behavioural Therapy) retains people in treatment 3x better than treatment as usual. Usual treatment does not teach people skills.
Betty Ford Award Plenary Session at the AMERSA 39th Annual National Conference
How AMERSA was saved? When Betty Ford learned in 1985 that the association is near extinction due to only $200 left in the kitty, she offered a $10.000 cheque from the royalties of her new biography and personal account. This year, Dr Caetano received award named after her. His Border project, and two other projects, found how the Mexican Americans and the Puerto Ricans drank much more than the other groups of US Hispanics. Women of this origin drank the most of all national groups in this country.
“No matter what is the dimension of drinking, the diversity is there.”
If you’re in Miami, it’s not gonna be helpful to know the national data. The local authorities need to know.
If you enjoyed reading about this year’s conference, you may like to read my notes from the previous year, 38th meeting in San Francisco, CA, November 4th, 2014.
Addiction Health Services Research Conference 2015 | #AHSR2015
The healthcare landscape is changing. The delegates at the 2015 Addiction Health Services Research conference met to exchange ideas about how to navigate this change. Here, I note my thoughts from my favourite keynotes.
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| Photocredit: http://www.uclaisap.org/ahsr |
Pre-conference workshop on Wednesday, October 14th about publishing in addiction health services research was facilitated by Deborah Garnick, Carmen Masson, Mark McGovern, Richard Saitz, Jeffrey Samet and James Sorensen (chair).
Garnick asked why is publishing not a linear process. It’s really about management. It’s also about making people read review and suggest references. If you’re looking at tenure and professorship, you want to be thinking of the top journals. Some aspects change, others not. The peer review started in 1930-40s with the Journal of the American Medical Association. Publishing is a marketing activity. It’s also a group activity and an individual activity at the same time: somebody needs to sit down and write. Publishing is somewhat like a puzzle; it’s fun to try to figure out how to sell the paper.
Masson talked about writing seminars. Why do early-stage investigators get little training in writing? She answered her talk using the recent paper by Guydish et al: Scientific Writing Seminar for Early-stage Investigators in Substance Abuse Research. For future research about writing groups, we need to develop an outcome measure for evaluating such groups first.
McGovern covered working with journal editors. How to deal with conflicting advice from peer reviewers? Chose the one you like. How to make better reviewers? [LINK MY 50 SHADES]. Get your junior researchers to co-review with you as the senior reviewer. Or apply for the JSAT editorial fellowship.
Saitz about responding to revision requests: Editors are people too! Do everything possible to make it as easy as possible. The editors and reviewers are right probably half of the time. The opposite of easy for editors is annoying. They may be doing the editing at night, in their spare time. When you revise your paper, some fatal flaws of your paper may come to light. Universal Rejection is the most prestigious journal in the world because it accepts 0% of their submissions. Read more about dealing with rejection in my recent blog.
Samet talked about open access journals and journal selection. In ISAJE, 38 journals meet their criteria of doing things right. Of those, 10 are open access journals. Only 3 of them have an impact factor. It takes time to publish enough papers for the impact factor to be assigned to the journal. Beware predatoryjournals!
Lawrence Palinkas kicked off the conference on Thursday morning, October 15th with a keynote describing implementation science as a tool for navigating a changing healthcare landscape. Practitioners don’t have enough time, resources and training to Evidence-based practice (EBP). They don’t have access to and time for reading the scientific journals. Is the art of medicine lost in all this EBP? EBP is a manualised way to treat a patient. Clinicians often don’t like rigidity and single-focus of EBP that makes it hard to use. Many have seen an answer to all these problems in the implementation science. In the old days, the process of dissemination was through company reps, now modern and online strategies are used for reviews of EBP. He then went on to describe the implementation science in his own research. First was a randomised trial of a multidimensional treatment foster care. The early adopters of EBP utilise the relationship within their networks for information and advice. The follow-on study found that those who use research evidence more also do more EBP. Where did they get information about EBP? At conferences, from internet searches and from people they trusted. The third study found a modular approach to dissemination of EBP effective in reducing the internalising behaviour of children. Clinicians favoured this approach. It allowed for a cultural exchange. Both clinicians and researchers were flexible with the application of the EBP into routine care, i.e., they went out for a lunch together and talked about how and whether the EBP could be changed. Modules gave them more license to negotiate application. If you are going to navigate the changing landscape successfully, you need to focus on the social networks, their use of research, their interactions with researchers and their decisions whether or not to implement EBP.
In the panel discussion on Thursday, October 15th after lunch, the speakers navigated the changing healthcare landscape via experiences from the field of addiction health services. They were Thomas E. Freese (Moderator), Clayton Chau, H. Westley Clark, Vitka Eisen, Tami Mark and David Pating.
Chau said that sometimes even the clinicians have a hard time navigating the system of care. There are multiple case managers helping to navigate the system, but who’s coordinating the case managers? It is us who crazy system for people to navigate and blame the patient if they can’t navigate it.
Clark felt that, as an African American, integration is fun. 19 million people with addictions in States do not perceive the need for treatment. We think they need treatment. Who’s right? How can the system respond to the needs of the SafetyNet populations?
Eisen achieved the recovery through SafetyNet organisation that she became a CEO of 30 years later. Clients don’t fail treatment; treatment fails clients if they don’t improve. The payment is a huge issue. If we want to achieve some kind of parity in outcomes, we need some kind of parity in salaries.
Mark talked from a perspective of an economist. Buprenorphine is replacing prescription opioids in the so called ‘pill mills’ and becoming more and more prescribed; this raises questions in insurance companies.
Pating highlighted four different trends that are associated with the Medicaid expansion. In the last 2 years, they’re seeing 700000 more people. The workforce is challenged. Do we need a nIAtx or a totally different, new problem? Quality of care is another issue. The expansion was a leap of faith. We don’t know whether integration is effective. What is integration and how do we know that we’re integrated. Lastly, even though California expanded, there are still many people out of treatment.
Have you attended any of the Plenary sessions at the AHSR Conference on Friday? Post your thoughts below.
Getting the most out of the Conference of the College on Problems of Drugs Dependence #CPDD2015
June 15, 2015 – The conference of the College of Problems on Drugs Dependence took place in Phoenix, Arizona. When I learned that my paper was accepted, I decided to make the most out of the conference. I wanted to network. I found a blog by NICOLA KOPER especially helpful. She described how networking at conferences has resulted in more than one seminal and persistent research collaboration, and in joint publications. Koper also offered four tips on how you can make the most of conferences and use them to elevate the quality of your research programme. Here’s how I used them to make the most out of my conference.
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| Photocredit: cpdd.org |
Make the rounds at meals
Talk to the person before and after you in the coffee line. Talk to people you don’t know, make photos with them. But remember that some conferences have a policy of no photography of presentations or data allowed.
Lunch early and create more time for standing by your poster. But stay out late, people will remember you.
Go on the field trips
Field trips are gold mines for networking, if you can do them. Re-discover your interest. Engage playfulness. Enjoy the process. Connect with your curiosity.
Spend time with your students
They’ll appreciate it. This tip is more applicable for senior investigators. Other senior tasks are to attend steering committee meetings and to prepare talks or presentations.
Go to lots of talks
Talk to the speakers after their talks. Before the conference, prepare a list of people + match ideas or questions that you can ask.
Remember to balance the talks with quality networking time. How to (create the opportunities for) meeting people? Dance, don’t fight it.
Hang around; position yourself strategically so that you get a maximum exposure to random bystanders. Leave your bag in your room. Retreat and be quiet. Tiredness as well as weather affects us all. Take time to rest. If the climate differs from your home-country greatly, come early, adapt, adjust and fly.
Aim for at least one quality conversation per day. You can’t talk to 1000 attendees every day, but you can probably manage to talk to one of them every day. Pre-conference meetings are good for this too. Smaller audiences create more opportunities for mingling.
Go mall. You will meet more people than if you rush through the hotel. Opportunistic networking is equally helpful as targeted networking for creating new relationships.
Use discussions with your friends as spring boards for approaching new people and groups.
Three things are certain in life: Death, Taxes and Late-comers.
Stand by your poster for as long as possible. The late-comers have typically more time to talk to you.
If giving a talk yourself, remember how you present yourself. What words do you use to describe your samples? Scientists are people too; they used stigmatizing language, such as, alcoholics, in their award speeches.
Also, check out Jennifer Polk’s recent blog on UniversityAffairs: Conferences are for networking (@fromphdtolife).
New paper out now: Psychosocial Interventions for Alcohol use among problem drug users
May 18th: Many people in methadone treatment receive it through their primary care provider. As many also drink alcohol excessively, there is a need to address alcohol use to improve health outcomes for these individuals. We examined problem alcohol use and its treatment among people attending primary care for methadone maintenance treatment, using baseline data from a feasibility study of an evidence-based complex intervention to improve care.
What have we found: Clinical records indicated that 24 patients (19%) were screened for problem alcohol use in the 12 months prior to data collection, with problem alcohol use identified in 14 (58% of those screened, 11% of the full sample). Of those who screened positive for problem alcohol use, five received a brief intervention by a GP, and none were referred to specialist treatment.
Scores on the Alcohol Use Disorders Identification Test (AUDIT) revealed the prevalence of hazardous, harmful and dependent drinking to be 25% (n=26), 6% (n=6), and 16% (n=17) respectively.
Only 12 (11.3%) AUDIT questionnaires concurred with corresponding clinical records that a patient had any/ no problem alcohol use. Regular use of primary care was evident, as 25% had attended their GP more than 12 times during the past three months.
What does this mean: Comparing clinical records with patients’ experience of SBIRT can shed light on the process of care. Alcohol screening of people who attend primary care for substance use treatment is not routinely conducted. Interventions that enhance the care of problem alcohol use among this high-risk group are a priority.
To read the full article, go to the website of the Journal of Dual Diagnosis: http://www.tandfonline.com/doi/full/10.1080/15504263.2015.1027630#.VVtIBpO6eJY
Cite as: Klimas, J., Henihan, AM., McCombe, G., Swan, D., Anderson, R., Bury, G., Dunne, C., Keenan, E., Saunders, J., Shorter, GW., Smyth, B., Cullen, W. (2015) Psychosocial INTerventions for Alcohol use among problem drug users (PINTA): Baseline feasibility data. Journal of Dual Diagnosis 11(2):96-106
Cite as: Klimas, J., Henihan, AM., McCombe, G., Swan, D., Anderson, R., Bury, G., Dunne, C., Keenan, E., Saunders, J., Shorter, GW., Smyth, B., Cullen, W. (2015) Psychosocial INTerventions for Alcohol use among problem drug users (PINTA): Baseline feasibility data. Journal of Dual Diagnosis 11(2):96-106