Med School/Year Graduated: A.T. Still University at Kirksville, 2013
Years in Practice: 5
Have you or your loved ones been affected by addiction? What inspired you to specialize in addiction medicine?
No person in my immediate family has faced substance or alcohol use, thankfully, but during my [early medical] training, I noticed there was a general lack of knowledge on how to treat substance use disorders, leading to many cases where it… had significant impact on the health of our patients. When I finally saw a primary care doctor trained in addiction and the incredible change that patients displayed, [it] ultimately ignited the sparks of my career.
Your training is in family medicine. Other addiction specialists come up through psychiatry and internal medicine. How do these different root specialties affect treatment, if at all?
Regardless of primary specialty, all addiction physicians are trained in the socio/psycho/biology treatment of addiction. The nuances between specialties might lead a FM or IM doc to do more primary care in their cases, whereas a psychiatrist would be better equipped to manage more complex co-occurring disorders. But you can’t go wrong seeing any addiction physician, regardless of their primary specialty.
Which other medical specialists and professionals do you work with to help your patients?
Substance use disorders affect all organ systems. We collaborate regularly with primary care, surgical specialties, transplant and obstetrics. I commonly tell our fellows and residents the most important tool in medicine is the telephone – communication allows us to educate, coordinate, destigmatize and advocate for appropriate care for the vulnerable population we serve.
Do you believe the root causes of addiction are biological, societal, a combination or something else?
Addiction is a chronic complex disorder of the brain’s reward system and related neuro-circuitry. About half of the risk to develop an addiction is genetic. Environment, psychologic trauma and societal determinants of health also play a role. This informs treatment, which can include longitudinal biologic, social and psychologic remedies.
“Motivational interviewing” is an interest of yours. Can you explain what that is?
Motivational interviewing is a communication style we use with people who are ambivalent about change, including persons with substance and alcohol use and substance use disorder. It is an active listening and guiding style of interviewing that acknowledges autonomy and evokes the patient’s own desires to change compared to the more traditional paternalistic doctor-patient relationship.
You have four children. How will you discuss substance use and addiction with them as they age?
Having a strong open relationship with parents is one of the most influential things in a child’s life and can be protective against using and misusing substances and alcohol. My spouse and I are direct and honest about the usage of medication and drugs… prescribed or not. And also, with their effects and risks. We try to avoid fear-based discussion to avoid stigma. We use first-person lexicon… for instance, the “person chooses to smoke” instead of “that smoker.” We have discussed these things early and try to foster a relationship where they know they can come to us with questions without harsh judgement. It’s too late by the time they reach 12, so talk to your kids early. Don’t focus on fearmongering and risks. Also, one talk will not be enough. Create a space where kids come to you for questions, and teach them life skills, self-efficacy, stress reduction, drug resistance skills and building personal responsibility. This is a longitudinal conversation, not a one and done talk.
You love to hike and camp. Favorite spots in Arizona to enjoy the great outdoors?
Sedona, Grand Canyon, Oak Creek Canyon.
Name the best depiction of your field in TV or film that you’ve ever seen.
The way addiction is portrayed in the media does more harm than good most of the time. Depictions of substance use disorder and treatment trend toward the extreme. Addiction and drug use is often glamorized without any consequence, or the character is seen as severely flawed. Portrayals of addiction treatment do not depict what actual evidence-based treatment is like, which perpetuates stigma and discrimination. When addiction onscreen looks extreme, viewers with milder, albeit impactful, substance use disorders may not identify with having an addiction or that treatment is available and works.
What are you watching on Netflix these days?
I’m a fantasy and sci-fi nut, so I’ve been watching Star Trek: Discovery, The Book of Boba Fett and The Wheel of Time.
“If I wasn’t a doctor, I’d be…”
An ecologist. The interaction between animals and plants with the environment has always intrigued me, and [it] was my favorite undergraduate class.