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California Society of Addiction Medicine A History It is important for our members to see how CSAM was based on passion and to see how much can happen when passion is activated. May 1, 2022 DRAFT /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 1 of 160

Even left side Inside front cover Page 2 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

How to use this book We have organized this “book” to be an easily readable, visually attractive, graphically interesting online digital magazine designed for CSAM members. Its pages give core information and the high points with links to references and additional material for those who want to pursue more detail. These are the themes we highlight We know that § CSAM history, timeline and milestones in an organization it is the § CSAM’s unique place in the development of addiction medicine personalities that in California and in the nation make all the difference. § CSAM achievements in improving the quality and accessibility of addiction treatment in California We’ve designed this history to introduce § The people who were the major players in the organization’s you to the people achievements and the personalities who § The historically important clinical, social and political matters made and are that were important in shaping CSAM’s activities making CSAM We invite your comments and suggestions for subsequent additions to this volume. The CSAM Historians Monika Koch, MD David Pating, MD Donal Wesson, MD Gail Jara California Society of Addiction Medicine One Capitol Mall, Suite 800 Sacramento, CA 95814 415/764-4855 FAX: 415/764-4915 www.csam-asam.org © 2020 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 3 of 160

California Society of Addiction Medicine -- A History Table of Contents HOW TO USE THIS BOOK .................................................................................................................................3 INTRODUCTION...................................................................................................................................................7 CSAM’S MISSION .................................................................................................................................................8 THE WORLD INTO WHICH CSAM WAS BORN ...........................................................................................9 HOW CSAM WAS CREATED – 1972-1974 ......................................................................................................13 A LOOK BACK, DECADE BY DECADE.........................................................................................................15 1970S – THE FORMATIVE YEARS.........................................................................................................................15 1980S – THE DECADE OF TURNING POINTS .........................................................................................................16 Certification Timeline ....................................................................................................................................17 1983 – Two Kroc Ranch meetings: .................................................................................................................21 1990S – MORE “FIRSTS”......................................................................................................................................26 2000 - ANOTHER DECADE OF “FIRSTS” ..............................................................................................................27 2010 ....................................................................................................................................................................31 2020 ....................................................................................................................................................................33 OUR PRESIDENTS..............................................................................................................................................34 1973 Charles Becker (served 4 years) ...........................................................................................................35 1977 Vernelle Fox ..........................................................................................................................................36 1980 David Smith ...........................................................................................................................................37 1983 Max Schneider, MD ..............................................................................................................................42 1985 Jess Bromley, MD .................................................................................................................................43 1986 Anthony Radcliffe, MD..........................................................................................................................45 1988 Garrett O'Connor, MD..........................................................................................................................47 1989 P. Joseph Frawley, MD.........................................................................................................................48 1991 Kevin Olden, MD ..................................................................................................................................49 1993 Richard Sandor, MD .............................................................................................................................51 1995 William Brostoff, MD ...........................................................................................................................53 1997 Gail Shultz .............................................................................................................................................55 1999 Peter Banys, MD ...................................................................................................................................56 2001 Gary Jaeger, MD ..................................................................................................................................58 2003 Donald Kurth, MD ................................................................................................................................60 2005 David Pating, MD .................................................................................................................................63 2007 Judith Martin, MD ................................................................................................................................65 2009 Timmen Cermak, MD ............................................................................................................................70 2011 Jeffery Wilkins, MD...............................................................................................................................71 2013 Itai Danovitch, MD ...............................................................................................................................73 2015 Monika Koch, MD .................................................................................................................................76 2017 David Kan, MD .....................................................................................................................................78 2019 Anthony Albanese, MD..........................................................................................................................80 2021 Karen Miotto, MD .................................................................................................................................83 CSAM MEMBERS WHO MADE A DIFFERENCE........................................................................................85 Josette Mondanaro 1980................................................................................................................................85 Joseph Zuska ..................................................................................................................................................85 John Chappel .................................................................................................................................................85 Joe Cruse 1983...............................................................................................................................................85 Don Wesson 1972...........................................................................................................................................85 Ray Anderson .................................................................................................................................................85 Mel Pohl .........................................................................................................................................................85 John McCarthy 1995......................................................................................................................................85 Page 4 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

Christy Waters................................................................................................................................................85 Deb Stephenson ..............................................................................................................................................85 Lyman Boynton...............................................................................................................................................85 Barry Rosen....................................................................................................................................................85 Don Wesson....................................................................................................................................................85 Don Gragg .....................................................................................................................................................87 George Lundberg, MD ...................................................................................................................................90 Steven J. Eickelberg, MD ...............................................................................................................................92 Walter Ling, MD ............................................................................................................................................94 Donald Wesson, MD ......................................................................................................................................96 Westley Clark, MD, JD, MPH........................................................................................................................99 THREADS THROUGH CSAM’S HISTORY..................................................................................................101 HOW RECOVERING PHYSCIANS EXPERIENCED CSAM......................................................................................101 CSAM’S VIEW OF AT SPIRITUALITY .................................................................................................................101 CSAM STAFF OVER THE YEARS.................................................................................................................102 Kerry Parker, MPA, CAE.............................................................................................................................103 Michael Barack, CCMEP.............................................................................................................................105 ASAM ...................................................................................................................................................................106 Notes from ASAM History ............................................................................................................................106 Jim Callahan ................................................................................................................................................106 Penny Mills, MBA ........................................................................................................................................107 LEADERSHIP RETREATS ..............................................................................................................................111 EXECUTIVE COUNCIL RETREATS BEFORE 2000 ................................................................................................111 LEADERSHIP DEVELOPMENT RETREATS 2005 FORWARD..................................................................................112 CSAM NEWSLETTER......................................................................................................................................118 MERF ...................................................................................................................................................................121 MERF DINNERS …… .......................................................................................................................................124 THE VERNELLE FOX AWARD .....................................................................................................................125 THE COMMUNITY SERVICE AWARD .......................................................................................................130 CSAM BOARD ...................................................................................................................................................132 CSAM COMMITTEES......................................................................................................................................134 COMMITTEE ON EDUCATION – ESTABLISHED 1974...........................................................................................134 Committee on Education – 2013 -2020........................................................................................................137 REVIEW COURSES AND STATE OF THE ART CONFERENCES...............................................................................139 COMMITTEE ON PHYSICIAN WELLBEING – ESTABLISHED 1975 ........................................................................140 LIAISON COMMITTEE TO DIVERSION – ESTABLISHED 1982 ..............................................................................141 COMMITTEE ON OPIOIDS – ESTABLISHED 1995.................................................................................................142 COMMITTEE ON PUBLIC POLICY – ESTABLISHED 1999 .....................................................................................145 COMMITTEE ON INTEGRATION AND ACCESS TO CARE – ESTABLISHED 2017 ....................................................148 COMMITTEE ON COMMUNICATIONS – ESTABLISHED 2017................................................................................149 CSAM NEWSLETTER......................................................................................................................................150 Editors ..........................................................................................................................................................150 What the Newsletters Looked Like Over Time -- Design and Redesign.......................................................151 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 5 of 160

We are THE CALIFORNIA SOCIETY OF ADDICTION MEDICINE SPEAKING OUT—THE VOICE OF TREATMENT EDUCATING Accredited provider of Continuing Medical Education (CME), as recognized Consumer Guide & Scorecard: Health Insurance Coverage in California for with commendation by the Institute of Medical Quality (IMQ) Substance Use Disorders & Mental Health, a comprehensive review of health plans to provide consumers help in choosing health care coverage, Addiction Medicine State of the Art Conference including mental health and substance abuse treatment services. The Scorecard also brought about requests for three other reports released Essentials of Addiction Medicine this year for Minimum Insurance Benefits for Patients with Alcohol Use Disorders, Tobacco/Nicotine, and Opioid Use Disorders, again he led an Addiction Medicine Review Course and Exam Track Preparation expert panel to bring CSAM’s recommendations to a state platform in Webinars CME courses available on-line (cme.cme.csam-asam.org) order to affect change — and change is happening as a result. ADVOCACY leadership Guideline for Physicians Working in California Opioid Treatment Programs Each year, CSAM researches and takes positions on over 40 California legislative bills OUR VISION YOUTH FIRST: Reconstructing Drug Policy, Regulating Marijuana, and and initiatives and CSAM physicians testify frequently at state hearings on various Increasing Access to Treatment in California treatment-related bills. To be a thriving state chapter, with growing membership, impactful education, effective Blueprint for Addiction Treatment in California Actively involved in State of California Advisory Boards and Commissions advocacy for members and their patients, Cannabis Policy Statement Representation on the Mental Health Services Oversight and Accountability Commission upwards leadership to our national organization (Prop 63) (ASAM), and a track record of contributing to the CSAM has issued three papers on Minimum Insurance Benefits for Patients with 1.) Opioid Use Disorder; 2.) Alcohol Use Disorder; and 3.) Nicotine and Collaboration with the CA Medical Association, the CA Hospital Association, and the CA establishment of access to high quality Tobacco Use Disorder Psychiatric Association on matters involving the treatment of substance use disorders addiction treatment in California. NETWORKING WITH COLLEAGUES Our Policy Goals: • Inform consumers about effective and appropriate levels of evidence-based CSAM Community Consult Groups meet CSAM COMMUNITY CONSULT GROUPS regularly to discuss clinical issues and share treatment for Substance Use Disorders (SUD) knowledge across specialties and practice TRIPLE C GROUP INFO AT CSAM-ASAM.ORG/TRIPLEC • Inform insurers regarding the efficacy of SUD treatment settings. • Create a statewide Physician Health Program LOCAL GROUPS FOR CASE CONSULTATION AND CLINICAL DISCUSSION • Provide medical treatment (by physicians) in residential treatment facilities Biennial Leadership Development • Dedicate taxes from tobacco and alcohol sales to prevention and treatment by Retreat to develop the skills and abilities of CSAM’s future physician leaders engaging with allies to more strictly regulating tobacco • Engage in overdose prevention efforts TRAINING IN THE TREATMENT OF ADDICTION • Promote harm reduction efforts • Advocate for parity / reimbursement for SUD treatment on par with reimbursement Bringing addiction training into primary care residency training programs for other medical conditions through hundreds of scholarships • Maximize access to treatment and integration of drug treatment, mental health, social awarded over a span of 20 years by the Medical Education and Research welfare, and court resources Foundation (MERF) • Improve licensing requirements for drug counselors Mentoring and conference For more information: www.csam-asam.org | E-mail: [email protected] scholarships for primary care Scholars Attending CSAM Conference physicians to expand MAT Supporting establishment of ABAM-accredited Addiction Medicine Fellowships CSAM is a professional society representing physicians dedicated to increasing access and improving the quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addictions. Page 6 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

Introduction CSAM members and prospective members An organization should know how and why it was should have ready founded, how it has evolved over time, and its access to CSAM’s contribution to the changing social and political history to understand context in which it exists, in other words, it how and why it has should know its history. been successful. CSAM has evolved since 1972 and its history is rapidly exceeding living memory of the many of the principals who have contributed to its development. Evidence of its many accomplishments spans many documents, none of which, by itself, provides a detailed or comprehensive overview. CSAM should create way to communicate its history to its incoming leaders and to its members. CSAM has contributed greatly to the evolution of addiction medicine in California and nationally. To continue to build on these accomplishments and to guide future development, CSAM leaders, members, and prospective members need to have ready access to its history and documentation to understand how it has been successful. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 7 of 160

CSAM’s Mission The mission of the California Society of Addiction Medicine (CSAM) is to advance the treatment of addiction through education of physicians, physicians-in-training, and other health professionals. Additionally, the Society promotes research, prevention, and implementation of evidence-based treatment. CSAM is the largest state chapter of the American Society of Addiction Medicine (ASAM). It has a growing membership, impactful education, and effective advocacy for members and their patients, upwards leadership in influential state and national roles, and a track record of contributing to the establishment of access to high-quality addiction treatment in California. January 2018 Page 8 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

The World into Which CSAM Was Born In 1972, most physicians had not received much, or any, education about alcoholism, drug dependence or the medical manifestations and clinical course of the patient with such a diagnosis, and those physicians who were treating alcoholic and drug dependent patients were not held in high regard in the medical community. Arthur Bolter, MD, a pediatrician, medical director of Project Eden, a drug treatment program in Hayward, became involved in the addiction field in the 1960s when he was called about kids who were passing out at local schools.* San Francisco was at that time the center of a youth drug culture and in the throes of a major heroin epidemic that was spreading to nearby communities such as the one where Bolter practiced. He discussed what he was seeing with Jess Bromley, MD, an internist in nearby San Leandro, who shared his interest. They both knew that there was no place physicians could identify themselves as being interested in treating problems of drug use and addiction. For years, the stereotype was that 'drunks were treating drunks,' with questionable means and outcomes. “We thought physicians who were treating what others saw as a 'loathsome' problem should get some respect!” said Bolter. While there were knowledgeable and experienced physicians and drug treatment programs, the quality varied widely. Some physicians and some programs were making a good faith effort to treat these patients but were not skilled or knowledgeable about alcohol or drug treatment. Some caused or enabled their patients’ addiction. Some claimed expertise but in fact their treatment approaches were based on the personality and/or charisma of the treating physician. There were also a few rogue physicians who were using their medical license, in effect, to deal drugs. But mostly, physicians were not interested. Bromley, Bolter and Lundberg and others all agreed that there needed to be a way to recognize physicians with real expertise. One of the driving motivations in the formation of a specialty society was to bring a level of professionalism to the physicians who were treating alcoholism and other addiction. The Society’s first members came from a Steering Committee appointed by the CMA Committee on Alcoholism and Other Drug Dependence. That group of 5, following specific criteria, selected and invited those who would become charter members. After that, the acceptance of new members followed this process: applicant members Establishing criteria were recommended by a member or a physician from the applicant’s for membrship in practice setting; applicants submitted an application along with letters of the new Society recommendation from two physicians who knew their practice; names of brought a level of professionalism we applicant members were published twice in the newsletter; applicants were wanted. accepted as full members by action of the governing body (then called the Executive Council.) George Lundberg, who was later to become the editor of the Journal of the Medical Association, describes it this way: “I was interested in researching adverse reactions provoked by drugs. It soon became perfectly obvious to me that the main problems were caused by the intentional recreational use of drugs, rather than adverse reactions. So, I shifted my focus. And at that time, medical schools were not teaching much about substance abuse and physicians in practice were also not doing much and were even running away from such /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 9 of 160

problems. We started putting on programs on substance abuse for parents, employers, teachers and so on, and got a big crowd from all those groups. But when we put on programs for physicians, nobody would come!\" \"About this time, there was an incident which really sparked the movement to change the law,\" Bromley reported in an article in CSAM News. \"In Riverside County, two CMA members - I believe they were a psychiatrist and a general practitioner - were quietly, even surreptitiously admitting heroin addicts to a local hospital to manage their withdrawal. Treating addicts in a community hospital was unheard of then. As we were told about it, the wife of the local chief of police was admitted to that hospital for some routine surgery and became enraged when she learned that there were addicts in the same place. Her husband got involved and the docs were charged with violation of the law\". Until 1971, California law prohibited treatment of opioid addiction outside a state or federal facility, a city or county jail, or a facility licensed by the state to provide methadone. “David Smith, MD, founder of the then-new Haight Ashbury Free Medical Clinic, clearly recalls this incident as well. ‘I was sitting in our detox clinic when Jess Bromley called and told me two doctors had just been arrested for doing what I was doing every day. That really got my attention.’\" In 1971, Bromley, then a member of the House of Delegates of the California Medical Association, asked CMA to sponsor a bill to change the restriction on treatment of addicts. The resulting 1972 change in California law allowed physicians to provide treatment in settings such as their office practices, and with medications, as long as the medications did not include the administration of any “narcotic drug.” Bromley went on to use his position within the medical community and within the CMA to call attention to the factors that put physicians at a disadvantage and to marshall the resources from within the CMA to form the kind of separate specialty society that he envisioned. According to Bromley, when the California Society of Addiction Medicine was founded in 1972, there were two forces pushing us to get organized: (1) the need to get the treatment of addiction into the medical mainstream, and (2) a need to change California laws that kept us from doing that. The past is never dead. It's not even past. --William Faulkner Frequently quoted by ASAM and CSAM historians like David Smth Page 10 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

For a full history of major events that shaped the world into which CSAM was born, click on this Link. This is the link to the Wesson history Open Ward Management https://csam-asam.org/members/group.aspx?id=224790 This is the Jack Gordon article From “Adolescnt Heroin Abuse in San Francisco” Ramer, Barry S.; Smith, David E.; Gay, George R. The International Journal of the Addictions, 7(3), pp. 461-465, 1972 * “In 1967 the abuse of drugs exploded out of the urban ghetto into the suburban areas. By 1968 in the San Francisco area high school students were overdosing in class at an alarming rate. …” from “Out-Patient Clinical Experience in a Community Drug Abuse Program with Phencyclidine Abuse” Bolter, A., Heminger, A., Martin G., Fry, M. in Clinical Toxicology 9(4),pp.593-600 (1976) There was another medical group focused on similar clinical issues, but it did not relate to what was happening in California. The group that eventually grew into the American Society on Addiction Medicine started in 1954 as the New York City Medical Society on Alcoholism with meetings in Dr. Ruth Fox’s living room. By 1972, it had expanded to be the American Society on Alcoholism [AMSA] and had affiliated itself with the Naional Council on Alcoholism. It remained primarily an east coast entity, with members from the clinical and research world that was focused on the treatment of alcoholism. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 11 of 160

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How CSAM Was Created – 1972-1974 The previous section reviews WHY a formation of a professional organization was needed. This section reviews HOW the society was founded and how it evolved. Photo of Formation of the California Society for the Treatment of Alcoholism and Other Jess Drug Dependencies started in the late 1960s/early 1970s with the vision of Jess Bromley – then chief of staff at San Leandro Memorial Hospital. He wanted to mainstream the care of the patients he and some colleagues were seeing. He began to gather those colleagues together and talk about the need for CME, peers, and professionalism. He began to describe a medical specialty society. April 1972 Gail Jara, who had worked th Dr. Bromley in San Leandro, joined the CMA staff. Among the CMA Committees she was assigned to staff were the Committee on Dangerous Drugs (Bromley was a member) and the Committee on Alcoholism, then two separate committees. Between April and October 1972, the two Committees met several times. They planned a pilot program of physician education in the treatment of drug dependent patients and submitted a request for federal funding to finance the program. They also proposed that CMA form the kind of medical specialty society that Bromley envisioned. October 27, 1972 action of the CMA Coucil: “Voted to approve the proposal that the Committee on Dangerous Drugs and the Committee on Alcoholism initiate the formation of a professional society in California for the treatment of drug dependence, including alcoholism, and further approve the proposal that California Medical Association solicit and receive a seed money grant to be used for the implementation of this proposal.” April 23, 1973 The first meeting of the 11-person Steering Committee that had been named by the two CMA committees. [Link to a copy of the minutes of that meeting.] September 12, 1973 The Steering Committee accepted bylaws for the new organization and began plans for the First Annual Meeting. [Link to a copy of the minutes of that meeting.] March 1974 Organizational Issue of the Newsletter listing the 54 charter members who had been chosen by the Steering Committee and invited to become the first members. [Link to a copy of that issue of the newsletter.] March 3, 1974 First Annual Meeting of the Members at the Hilton Hotel, San Francisco. Twenty-five members were present. [Link to a copy of the minutes of that meeting.] /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 13 of 160

April 3, 1974 First meeting of the governing body of the California Society for the Treatment of Alcoholism and Other Drug Dependencies, then called the Executive Council. [Link to a copy of the minutes of that meeting.] Page 14 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

A Look Back, Decade by Decade 1970s – the Formative Years 1971 Jess Bromley got CMA to sponsor a bill (ABxxx) to modify California’s Health & Safety Code restriction on what a physician could do in treatment of what the law then termed an “addict.” 1972 passage of the bill that added Section 11217.5 to California’s Health and Safety Code: “1Authorized treatment by licensed physician and surgeon” establishing that a physician may treat a patient for opioid dependence in his/her office practice, but not with opioids…. Jess Bromley brought the need for this change in legislation to the Califoria Medical Association and worked with CMA to get this passed. 1974 First annual meeting 1974 Accreditation awarded to the California Society 1974 First issue of the newsletter [Link to a copy of that issue of the newsletter.] 1979 Executive Council voted to form a medical education and reserch foundation (a 501(c)(3) corporation to put the society in a better position to achieve and promote its educational goals. 1 Notwithstanding the provisions of Section 11217, a licensed physician and surgeon may treat an addict for addiction in any office or medical facility which, in the professional judgment of such physician and surgeon, is medically proper for the rehabilitation and treatment of such addict. Such licensed physician and surgeon may administer to an addict, under his direct care, those medications and therapeutic agents which, in the judgment of such physician and surgeon, are medically necessary, provided that nothing in this section shall authorize the administration of any narcotic drug. (Added by Stats. 1972, Ch. 1407.) /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 15 of 160

1980s – the Decade of Turning Points Turning Points 1980 Diversion Program for Physicians opens after passage of § CDRH legislation AB1146 in 1979. requies medical director to have traiing 1980 passage of AB3218 to “define… a new type of health facility and experience, to be known as a ‘chemical dependency recovery hospital.’ creating the need for a (CDRH)” Subsequent implementing regulations [filed 12-24- certification in 82 that establish the standards required for licensure of a addiction medicine hospital in California: Title 22 Article 5 Section 79309 “Medical Director. The medical director as well as the § Medical Board of designated alternate shall be a physician with training and California’s Diversion experience in the care and treatment of chemical Program for Physicians dependencies.” opened 1981 Incorporation of the Medical Education and Research § MERF was founded Foundation (MERF) as a sister organization to CSAM § First CSAM 1982 Requirements were made final in regulation for the Certification in licensure of the new chemical dependence recovery hospital: Addiction Medicine Title 22 Article 5 Section 79309 “Medical Director. The medical director as well as the designated alternate shall be a § Kroc Ranch Unity physician with training and experience in the care and Meetings treatment of chemical dependencies.” § CSAM urges ASAM to 1983 CSAM announced the first certification in addiction assume the role of one medicine based on the document CSAM developed, “How to national medical Identify a Physician Recognized for Expertise in Diagnosis society in addiction and Treatment of medicine and CSAM Alcoholism and Other members vote to Drug Dependencies.” become a state chapter of ASAM Page 16 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

Certification Timeline 1980 – AB3218 passes creating a new category of hospital license – CDRH/CDRS 1982 – California Department of Health Care Services issues regulations governing how the Department will determine licensure for the new category of hospital require. One requirement is that the medical director of such a hospital or service “have training and experience in the care and treatment of chemical dependencies.” 1982 – CSAM announces a certification process that will identify physicians who have the required training and experience, giving the California Department of Health Care Services Licensing and Certification Division an external standard the surveyors could use to determine whether a physician had the required training and experience. 1983 – two Kroc Ranch meetings (February 7-8 and October3-5) 1983 – CSAM offers first Review Course (October 20-22) and exam (November) and awards 101 certificates 1984 – CSAM offers second Review Course and exam and awards 82 certificates 1985 – CSAM Executive Council votes to make available the exam it gave in 1983 and 1984 for use by AMSA if reciprocity is granted and if the requriements for sitting for the AMSA exam are comparable to the requirements for sitting for the CSAM exam 1985 – no exam this year because this is the transition year, moving the project to AMSA 1985 – Because there is no exam, and therefore no immediate need for a Review Course, CSAM designs a new 3-day conference: Chemical Dependence: Cooperation and Conflict between Fee for Service Treatment and the 12 Step Programs. 1986 – first AMSA exam; both AMSA and CSAM offer Review Courses 1987 – Second ASAM exam 1988 – third ASAM exam 160/Users/user/G1o9og8le9D–riven([email protected])/*aCrSAbMecHaisutosrye/*sAectSioAnsMlayoduet/scecitdioenss latyoouot sfafemprleth5-e1-2e2x.daocmx evePryage 17 of other year; not annually

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1983 first review course in October of 1983 in preparation for the first certification examination in November /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 19 of 160

1983 the first examination given in November of 1983. 101 physicians certified by CSAM It is important for our Jess Bromley presents the certificate to younger members to see G. Douglas Tabott from Georgia how CSAM was based on passion and to see how much can happen when passion is activated, and people are willing to put in the sweat effort to achieve goals in our field. . Page 20 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

1983 – Two Kroc Ranch meetings: The first years of 1980s saw major milestones in the development of the specialty of addiction medicine: CSAM’s first certification program – the first in the nation -- and the effort to unify the physicin societies into one national organization. The certification project began with CSAM in 1981. The unity movement toward bringing together one national organization began with the new American Academy of Addictionology (Doug Talbott in Georgia), CSAM (Jess Bromley and CSAM and CMA in California), the American Medical Association (Manny Steindler of AMA) and the American Medical Society on Alcoholism. What are now called “the Unity meetings” were held at the Kroc Ranch on February 7-8, 1983 and October 2-5, 1983 and resulted in the other organizations making formal requests to AMSA to refashion itself into the one national society that was needed. AMSA accepted that role and changed its name to the American Society on the Treatment of Alcoholism and Other Drug Dependencies in 1985. The Kroc Ranch meetings that resulted in one national society occurred in the same months of1983 that the California Socety for the Treatment of Alcoholism and Other Drug Dependencies announced and held the first certification project. Project announced First Kroc Ranch meeting – February 7-8 Application deadline First Kroc Ranch meeting – October 2-5 First Review Course – October 20-22 First Examination administered – Noember 19 First certificates awarded -- Second Review Course Second Examination administered Certificates awarded to the second group /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 21 of 160

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1984 Second CSAM certification exam – 82 physicians certified by CSAM Pictured here are nineteen of the 82 physicians certified by CSAM in 1984 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 23 of 160

1985 – CSAM transferred the certification to ASAM, giving all the elements of the project to ASAM at no cost; ASAM hired CSAM to implement ASAM certification 1985 in place of a 3-day Review Course, like the ones the Calfornia Society offered in 1983 and 1984, CSTAODD offered “Chemical Dependence: Cooperation and Conflict between Fee for Service Treatment and the 12 Step Programs” – a first of iis kind CME look at the role of AA and the 12 Step Programs from the point of view of those providing treatment for addiction 1986 – first national certification program offered by AMSAODD; first AMSAODD Review Course and Examination 1987 CSAM began a series of prescribing practices courses designed for those whose prescribing had come to the attention of the licensing agency, then named the Board of Medical Quality Assurance (and called “Bum Qua”) 1987 The CSAM Executive Council decided to apply to be recognized as a state chapter of the then-named AMSAODD. 1988 Revised Mission Statement adopted by the (then named) Executive Council: 1988 Revised Mission Statement At any given time, the California Society identifies the issue which is, in its opinion, of greatest central importance to the development of the field of addiction medicine. Previously, that has been eliciting consensus on what defines a physician specialist in this field, creating the certification examination, and seeking national acceptance for and implementation of certification. Currently the mission of the California Society is to set the standards for treatment of the diseases of chemical dependence. n January 31, 1988 Page 24 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

1988 CSAM annual awards dinner always included entertainment, and this year there was a Jess Bromley Look Alike Contest 1989 CSAM became a state chapter of ASAM and changed its name from California Society for the Treatment of Alcoholism and Other Drug Dependencies to California Society of Addiction Medicine 1989 is the first year that the CSAM annual meeting of its members will be held in conjunction with the fall conference (either the State of the Art Coderence or the Review Course.) Previously, since 1973, the CME program and the annual meeting of the members had been held in the spring in conjunction with the California Medical Association’s Annual Scietific Assembly. Beginning in 1983, there was an annual Review Course or State of the Art Course in the fall each year in addition to the program held in the spring at the CMA meeting. 1989 CSAM offers a course designed as the State of the Art in Addiction Medicine – the first in what would become a tradition, being offered in alternate years with a Review Course /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 25 of 160

1990s – More “Firsts” 19xx First Executive Council retreat weekend 1994 Unified membership with ASAM began. In order to be a member of CSAM, you had to join ASAM first. 1995 CSAM named the Committee on Treatment of Opioid Dependence 1998 CSAM published the Guideline for Physicians Working in California Opioid Treatment Programs. A first …. The document was updated in 2008 and again in 2019. 1999 CSAM offers the first CME program on use of buprenorphine in preparation for the expected 2000 FDA action to allow its use in office-based treatment: Buprenorphine in Pharmacotherapy of Opioid Addiction: Implementation in Office- based Practice, and publishes the guideline document Buprenorphine in Pharmacotherapy of Opioid Addiction: Iplementation in Office-based Medical Practice. Translating the experience of Clinical Trials into Clinical Practice (CSAM prepareing its members for what they should know about what is coming.) 1999 State of the Art Course Gail Shultz, Bill Brostoff, Peter Banys, George Woody, Gary Jaeger Page 26 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

2000 - Another Decade of “Firsts” 2000 Kerry Parker is named Executive Director after the December 31, 1999 retirement of Gail Jara. 2000 Proposition 36 (Treatment vs. Incarceration): CSAM joined a number of health care and substance abuse treatment associations to advocate for passage of Proposition 36. CSAM President Peter Banys, MD provided a supporting argument that stated CSAM’s position on the California voter pamphlet. David Breithaupt, Kerry Parker, Peter Banys, Name Name, Gary Jaeger, David Smith, Ernie Vasti /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 27 of 160

2001? First MERF dinner 2001 State of the Art Conference included a Spiritualty is the ever-present potential preconference workshop “Down to Earth for connectedness with sources of Spirituality: Practical Applications in power inside, outside and between Addiction Medicine.” ourselves that can be activated, or Link to Garrett’s overview description of the brought into being, in relationships or workshop and the definition of spirituality. elsewhere through courage, empathy, compassion and a ready access to feelings. 2003 CSAM received the Samuel R. Sherman Award for innovation in Continuing Medical Education (CME) planning and performance improvement, awarded by the Institute of Medical Quality of the California Medical Association (CMA). It was the CMA’s Award and recognition for innovation and excellence in CME. 2005 First CSAM Leadership Development Retreat With David Pating, Kerry Parker organized the first CSAM Leadership Development Retreat. The first was at the Asilomar Conference Grounds in Pacific Grove, CA. After that, biennial CSAM Leadership Development Retreats continued to provide a forum that reflects the values and interests of CSAM members, helps participants understand how to work effectively in hierarchical systems, improves each participant’s communications skills, and enhances individual leadership abilities through increased knowledge and understanding of organizational structures and interpersonal relations. 2009 Page 28 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

CSAM members attending the 2010 ASAM conference in San Francisco Seated Page 29 of 160 xx Tim Cermak Karen Miotto Max Schneider Gail Jara Standing Jeff Wilkins Lori Karan Xx David Mee-Lee Dan Glatt Xx David Gastfriend Angie Chen xx Xx Xx /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

Glen Taylor Page 30 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

2010 2011: Youth First Cannabis Report: CSAM adopted Youth First: Reconstructing Drug Policy, Regulating Marijuana, and Increasing Access to Treatment in California. The report was designed to reduce the harm to young Californians from marijuana use and from ineffective and punitive regulations, and to address the serious treatment needs of those adolescents who become harmfully involved with marijuana 2014 Institute of Medical Quality (IMQ) Commendation: Scorecard ? As an accredited provider of Continuing Medical Education, CSAM received six-year re-accreditation with commendation from the Institute for Medical Quality (IMQ). Six-year accreditation is the highest accreditation awarded by the IMQ and is awarded to only a small percentage of CME providers. 2015 California Health Insurance Scorecard: CSAM published: Consumer Guide & Scorecard: Health Insurance Coverage in California for Substance Use Disorders & Mental Health, a comprehensive review of health plans to help consumers choose health care coverage, including mental health and substance abuse treatment services. 2016 White Paper Reports on Insurance Benefits: Following on the heels of the 2014 Consumer Guide in an effort to further address the wide gap between minimum standards and what is provided by insurance coverage, CSAM adopted a series of three reports on insurance benefits for patients with Opioid Use Disorder, Alcohol Use Disorder, and Nicotine and Tobacco Use Disorder. 2019 Kerry Parker, CAE, CSAM’s Executive Director of 20 years, retired. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 31 of 160

2019 Strategic Plan Page 32 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

2020 Kimberley Andosca [brief bio] CSAM began 2020 with new executive staff, Kimbrley Andosca and the Advocacy and Management Group (AMG) with offices near the capitol in Sacrmento. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 33 of 160

Our Presidents 1. 1973 Charles Becker (served 4 years) [LINK TO PAGE ABOUT HIM] 2. 1977 Vernelle Fox (served 3 years) [LINK TO PAGE ABOUT HER] 3. 1980 David Smith (served 3 years) [LINK TO PAGE ABOUT HIM] 4. 1983 Max Schneider, MD [LINK TO PAGE ABOUT HIM] 5. 1985 Jess Bromley, MD [LINK TO PAGE ABOUT HIM] 6. 1986 Anthony Radcliffe, MD [LINK TO PAGE ABOUT HIM] 7. 1988 Garrett O'Connor, MD [LINK TO PAGE ABOUT HIM] 8. 1989 P. Joseph Frawley, MD [LINK TO PAGE ABOUT HIM] 9. 1991 Kevin Olden, MD [LINK TO PAGE ABOUT HIM] 10. 1993 Richard Sandor, MD [LINK TO PAGE ABOUT HIM] 11. 1995 William Brostoff, MD [LINK TO PAGE ABOUT HIM] 12. 1997 Gail Shultz, MD [LINK TO PAGE ABOUT HIM] 13. 1999 Peter Banys, MD [LINK TO PAGE ABOUT HIM] 14. 2001 Gary Jaeger, MD [LINK TO PAGE ABOUT HIM] 15. 2003 Donald Kurth, MD [LINK TO PAGE ABOUT HIM] 16. 2005 David Pating, MD [LINK TO PAGE ABOUT HIM] 17. 2007 Judith Martin, MD [LINK TO PAGE ABOUT HER] 18. 2009 Timmen Cermak, MD [LINK TO PAGE ABOUT HIM] 19. 2011 Jeffery Wilkins, MD [LINK TO PAGE ABOUT HIM] 20. 2013 Itai Danovitch, MD [LINK TO PAGE ABOUT HIM] 21. 2015 Monika Koch, MD [LINK TO PAGE ABOUT HER] 22. 2017 David Kan, MD [LINK TO PAGE ABOUT HIM] 23. 2019 Anthoy Albanse, MD 24. 2021 Karen Miotto, MD Page 34 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

1973 Charles Becker (served 4 years) I was an internist doing clinical pharmacology and toxicology at UCSF. I recognized that there was no teaching about chemical dependency in the medical school, while that was the root of so many of the problems we saw in the clinics. I was tring to bring my interests into the mainstream and felt that the best way to do that was with chemical dependency. I was lucky that there was this very good group of practicing physicians getting organized with in CMA. Gail Jara, there at CMA, helped us to formulate regular protocols and was an administrator who brough practice, research and teaching all together. Chuck Becker was Professor of Medicine I agreed to work with that group, which was at that and Pharmacology at UCSF time a Steering Committee, charied by Art Bolter, exploring whether to create an independent specialty society. The minutes of a meeting of that Steering Committee show their priority: “The consensus was that the steering committee should continue to create the society if it would deal with the real problems and practical issues of interest.” I was pleased to take on the role of the first President. There were a lot of factions early on, with the National Council on Alcoholism and AA groups wanting nothing to do ith heroin addicts and vice cersa. But we, within the new society, felt these were all part of the same problem. I’m not an alcoholic or drug addict, and early on some people wouldn’t listen to me because of that, while others wouldn’t because they thought I was! We had many discussions about how to deal with the image problem, and with the reluctance of physicians themselves to seek treatment because they knew their colleagues wouldn’t know how to help them. We thought that the development of recognized expertise was reason enough to start the new association. Editors’ note: This “interview” is taken from the article in CSAM News Fall 1993, Vol. 20, No 3, “CSAM Celebrates 20 Years” by Steve Heilig, MPH Link to “The Pharmacology of Antabuse” CSAMNews Vol. 1 No. 3 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 35 of 160

1977 Vernelle Fox Link to “The Best Prime Theripist for an Alcoholic is an Interdisciplinary Team”. A 1974 paper by Dr. Fox reprinted in CSAMNews Vol. 14 No. 2 Fall 1987 Page 36 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

1980 David Smith Which aspects of your practice led you to join CSAM? I met Jess Bromley. He was an Internist, then Chief of Staff at San Leandro Memorial Hospital, and a very charismatic leader in his community. He had a vision that was similar to mine about treating addiction and he could talk about the world as it should be. Jess Bromley “mainstreamed me” (showed me that addiction medicine can be mainstream). He wanted to found a medical specialty society for the physicians who were treating drug dependence – including alcoholism. He did not see a distinction. In our outpatient clinic, we started to treat David Smith is an pharmacologist , withdrawal syndromes with phenobarbital as we [brief bio] Lorem ipsum dolor sit amet, wanted a medication that was effective and a low consectetur adipiscing elit, sed do risk for diversion. Don Wesson and I published eiusmod tempor incididunt ut labore et papers on this topic2 and other doctors came to dolore magna aliqua. learn from us. We were a model for integrated outpatient multidisciplinary treatment that included addiction medicine treatment with no distinction between those who use alcohol and those who used other drugs.3 Jess wanted to make it feasible and accepted that physicians could provide appropriate treatment for addiction as part of their regular practice: a mainstreaming approach to treatment. His motivation increased when he learned that doctors were getting arrested for using our protocols. In those years, using phenobarbital for withdrawal symptoms technically violated the law which prohibited physicians from using scheduled medications for the treatment of addictions in their own private patients in their own offices. His first step was to work with California Medical Association to change California’s Health and Safety Code to allow a physician to “treat an addict for addiction in any office medically proper…”.4 He worked closely with CMA where he was a member of the CMA 2 Link to “Low Dose Benzodiazipine Withdrawal Syndrome: Receptor Site Mediated” CSAMNews Vol. 9 No. 1 January 1982 3 Over time there came to be > 40 similar clinics in the country. 4 4 Notwithstanding the provisions of Section 11217, a licensed physician and surgeon may treat an addict for addiction in any office or medical facility which, in the professional judgment of such physician and surgeon, is medically proper for the rehabilitation and treatment of such addict. Such licensed physician and surgeon may administer to an addict, under his direct /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 37 of 160

Committee on Dangerous Drugs to advocate for passage of that bill and when it passed in 1972, he took another step toward his vision by proposing that CMA support the creation of a specialty society for physicians treating addiction. That proposal grew into what is now CSAM. He had a vision of our field as becoming a specialty accepted by the mainstream medical profession. His vision also included seeing alcohol addiction as the same as drug addiction. That is why the organization was formed in 1972 with the unwieldly name of the California Society for the Treatment of Alcoholism and Other Drug Dependencies.5 The CMA accepted Bromley’s proposal, funded and staffed a Steering Committee to explore the creation of such a medical specialty society. In April of 1972, we had a meeting at Chuck Becker’s house in Tiburon. Jess Bromley was the leader and Gail Jara, who worked for CMA and had experience in organized medicine, worked on getting all the elements of a medical organizations, from regular meetings, a newsletter, CME programs, expanding memberships, showing us “this is how the big boys did it”. care, those medications and therapeutic agents which, in the judgment of such physician and surgeon, are medically necessary, provided that nothing in this section shall authorize the administration of any narcotic drug. (Added by Stats. 1972, Ch. 1407.) 5 Medicine’s viewpoint of treatment for alcoholism was very different, shaped by the East coast, where AA was founded in 1947. Alcoholism and the physician’s role in treatment of alcoholism was recognized, albeit informally, on the East Coast, when Ruth Fox, MD, gathered a group of physicians in her living room and formed the New York Medical Society on Alcoholism. It was about alcoholism. Drug treatment culture was very different, mostly started in the 1960’s, done in clinics like the Haight-Ashbury Free Medical Clinic clinic, and treatment providers felt that the addict has a right to treatment. Narcotics Anonymous (NA) based on the AA model did not develop until the 1960’s after people with drug addiction were rejected from AA meetings. Page 38 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

At the time, medicine’s viewpoint of treatment for alcoholism was very different from what we experience today. It was shaped by the East coast, where AA was founded in 1947. Alcoholism and the physician’s role in treatment of alcoholism was recognized, albeit informally, on the East Coast, when Ruth Fox, MD, gathered a group of physicians in her living room and formed the New York Medical Society on Alcoholism*. It was about alcoholism only. Drug treatment culture was very different, mostly started in the 1960’s, done in clinics like the Haight-Ashbury Free Medical Clinic, and locations where treatment providers felt that the addict had a right to treatment. Narcotics Anonymous (NA) based on the AA model did not develop until the 1960’s after people with drug addiction were rejected from AA meetings. *The New York Medical Society on Alcoholism became the American Medical Society on Alcoholism (AMSA) in 1970, then the American Medical Society on Alcoholism and Other Drug Dependencies (AMSAODD) in 1983, and with a name change, the American Society of Addiction Medicine in 1987. See the ASAM History. 1. What did CSAM do for you? What did you get out of CSAM – both for your practice and for you personally? I had come to medicine to have a mainstream career and financial security, then changed completely to start and work as addiction medicine provider in the HAFC and beyond, then via CSAM was able to get the field I chose to become a mainstream field. 2. About your time as President of CSAM 1980-1983-- your presidency a. The issue of the time At that time heroin and methamphetamine were very prominent. However “drug addiction” as a whole – that is anything other than alcoholism -- was more the issue rather than any specific drug. The issue of the time (1980-1983) was 1)the establishment of the first certification program for physicians to identify specialists in treatment of addition, and 2)the determination of whether certification would continue to be a state program or whether it would become a national service. b. What was the essential question facing CSAM when you took office as President? I wanted to assure that addiction medicine gets accepted into the medical specialties. This was important to the field, as “only the specialists stick with it” and I wanted to assure the field has dedicated providers and develops like other specialties. Gail was instrumental in making CSAM the leader in the addiction medicine specialist movement, with Tony Radcliffe she worked on addiction medicine courses, writing a body of knowledge, developing CME and eventually a certification. Jess started to get people together. With his charisma and the help and diligence of Gail Jara, he was able to get us to talk to each other, so a coalition was formed. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 39 of 160

In 1982, a meeting at the Kroc Ranch took place where we CSAM has always tried to found a national organization of addiction. It was been the creative not a good meeting, we could not agree on names as juice in addiction alcohol treatment providers were worried that adding drugs to the name would distract attention from the alcoholics. medicine In 1983 we met again after Gail had worked to convene more interested parties often through personal connections and friendships. She also got John Chappel as moderator and worked closely with Manny Steiner of the AMA. We were able to found the American Society for the treatment of alcoholism and other drug disorders, which later evolved into ASAM. At that first Kroc Ranch meeting, the main momentum for the treatment and inclusion of drug addictions into the name and focus of the society came from the California society. We had 4 areas in the country, the West Coast focusing on drug use, the Northeast Coast on alcoholism, the Midwest centered in Chicago, including both and the Southeast focusing on medical professionals with addictions. Page 40 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

3. What do you consider your major contributions to CSAM? I helped found CSAM and then represented it at ASAM and the AMA, always carrying the CSAM banner. Through CSAM drug addiction became recognized as addiction like alcoholism and eventually nicotine addiction. I was able to bring CSAM’s approach to the national society as ASAM president in the early 1990’s. At that time tobacco became recognized as additive substance despite much opposition by the tobacco lobby. George Lundberg was instrumental there and ASAM lobbied and advocated for this. Eventually ASAM received a letter from the president of the United States for its support of recognizing the addictive nature of nicotine. After my ASAM presidency I went back to my roots. When I started my work in addictions, I did not believe that addiction medicine could be a medical specialty, I also did not believe that ASAM would become an organization of national influence on politics, and both have happened. So now I am supporting CSAM and ASAM. I help when I can, e.g. in resolving conflicts between the organizations, when they come up. I believe both are most effective when they are together. I believe we should put principles before personalities. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 41 of 160

1983 Max Schneider, MD Max Schneider was a gastroenterologist who began is practice in Buffalo, NY. He dated his involvement with what became addiction medicine to the time when he was asked to cover the practice of a colleague– Melvin Block, MD – who provided treatment to many patients who were alcoholics. By the time he moved to California in 1964, he was already active in educating physicians about alcoholism and its treatment and already a member of the American Medical Society on Alcoholism (the earliest name of what is nowASAM). Max Schneider was an internist and He was a charter member of CSAM – one of the go-to gastroenterologist, practicing in Orange County. [brief bio] Lorem ipsum dolor clinicians and teachers, along with Vikki Fox and Joe Zuska, in Southern California. sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore He was president of CSAM in 1983 at the time of the et dolore magna aliqua. launch of the CSAM certification project and the Kroc Ranch unity efforts and president-elect and president of ASAM in the years 1983-1987 when he led the reorganization by which ASAM accepted the role of the one national organization to represent addiction medicine. He was a central participant in both Kroc Ranch meetings. He led CSAM through a time when, as he said, “there were oranges and lemons in the California Society after Kroc I. The oranges wanted to affiliate with the national effort, and the lemons wanted to leave things the way they were. The lemons looked on AMSA as northeast elitists.” He was a skilled and insightful statesman with a genial, personable, charming, and fun-loving approach to all matters. He was a teacher who wanted to reach all audieces, and contribute to treatment. He wrote and produced a series of short films, “Medical Aspects of …” that were used in treatment programs around the nation. He lectured in 49 states, three Canadian provinces, and six countries. He continued to teach until his death at age 92 in 2014. Page 42 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

1985 Jess Bromley, MD Jess Bromley was responsible for the creation of the California Society of Addiction Medicine. It was his vision for “what we should have.” “We” were the physicians who were treating alcoholic and drug dependent patients and responding to the emergence of “drugs” into their hometowns -- no matter whether the hometown was a suburban enclave like San Leandro or San Francisco’s Haight Ashbury. What they should have was continuing medical education, a peer community, a place in mainstream medicine with mainstream medicine’s standards, and a voice. Bromley was a general internist with a solo private practice in San Leandro, California – about 25 miles east of San Francisco. He was a medical politician, active in his county medical society and a delegate to the House of Delegates of the California Medical Association. He knew the system; he knew the pathways; he knew the ropes. He was a dynamic speaker, persuasive and succinct. He got your attention first with his physical presence; he stood at 6’5”. He was chief of staff at San Leandro Memorial Hospital in 1968-69 when Alameda County Healthcare Services was beginning to pay formal attention to the emergence of heroin use in the suburban areas in the San Francisco Bay Area and contacted Memorial Hospital about it. He had already been a pioneer and activist for standards of care for patients with cardiac disease. He had established the first Coronary Care Unit in the East Bay and organized the first structured hospital resuscitation response. So when he turned his attention to the treatment of drug use and addiction, taking action through his organizations was what came naturally to him. He first secured financial support from his hospital to build a community prevention approach that involved the schools, the police, the library, the PTA. He secured funds to open a teen drop in center. But his concern was broader and was focused also on medical care. In an interview about his work at that time, he said, “There seemed to be a lot of instant medical experts on drugs around. I quickly became convinced there were very few physicians really involved in drug treatment and ... I concluded what we really needed was to get organized and then to work toward establishing a new specialty.” Had a vision and held to it; took each step in the process to achieve it. He secured support from the California Medical Association for CME programs and then for the creation a medical specialty society. Articles of Incorporation were filed in July of 1973 for the California Society for the Treatment of Alcoholism and Other Drug Dependencies. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 43 of 160

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1986 Anthony Radcliffe, MD Thirty-six years ago, Tony Radcliffe asked us to … Tony Radcliffe was an internist with Kaiser in Fontana, [brief bio] Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 45 of 160

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1988 Garrett O'Connor, MD Garrett O’Connor is remembered as an intellectually gifted, outrageously humorous, courageous, kind and dedicated psychiatrist who, once sober from alcoholism, dedicated his life to teaching about alcoholism. He brought AA and the 12 Steps into CSAM’s educational curriculum with a focused clinical approach that we could understand, feel, and apply as a part of comprehensive evidence based protocols. He designed CSAM’s 1985 3-day conference “Conflift and Cooperation between Fee For Service Treatment and the 12 Steps. He was an organizational guru – a Tavastock student and teacher Spirituality Garrett O’Connor was a psychiatrist in Los Angeles [brief bio] Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 47 of 160

1989 P. Joseph Frawley, MD He was Treasurer for several years before being elected to the presidency. He was focused on outcome measurement and created and chaired the Treatmnt Outcome Committee in 1991. We have to measure what we do. You cannot improve what you don’t measure. Joe Frawley is an internist in Santa Barbara, [brief bio] Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Link to “Proposed Recommendations for Design of Treatment Efficacy Reserch with Emphasis on Outcome Measures” CSAM News Vol. 18 No. 1 Spring 1991 Page 48 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx

1991 Kevin Olden, MD What got you into this field? I chose Stanford’s Chemical Dependency Fellowship as a way to get to California after residency in NY. Once there I found patients with substance use disorders different and interesting and the work intellectually energizing. The fellowship included rotations through the inpatient detoxification unit, and we established a Chemical Dependency consult service. I found a void of information and science about treatment, and I became inspired by the opportunity to create and be a pioneer in this young field of addiction medicine. What is your recollection of your first patients with addiction? Kevin Olden is an internist and I remember being called by the house staff to see a gastroenterologist, [brief bio] patient with severe Delirium Tremens. The patient had Lorem ipsum dolor sit amet, very high pulse and blood pressure and was out of his consectetur adipiscing elit, sed do mind. I ordered 10 mg of Valium i.v. every 10 minutes, eius. and the resident raised hell with me. She was worried about overdose and killing the patient. I explained the pharmacology to her, and I persisted. Then the chief at the time (Tom Barefoot) accepted the patient to the ICU after I explained the risks of arrhythmia and aspiration as well as pharmacology of benzodiazepines and why I chose Valium over Librium. What were the challenges you faced in treatment of persons with addiction? The house staff in the hospital was very skeptical During my fellowship at Stanford, when I about my patients. They were not aware of was called to the Palo Alto VA, I felt like treatment options, and patients from the outpatient a missionary in a foreign land quoting clinics were almost never referred to treatment from the Bible (the medical literature) to programs. Inpatients in the detoxification unit were convince other physicians of the treated with a Librium protocol that was from the importance of science in addiction 1940s and inadequate. medicine. Which aspects of your practice led you to join CSAM? As I was the only physician at Stanford specializing in addiction, I felt it was important to connect with other physicians treating this population and working to assure scientifically sound and ethical treatment of our patients. In CSAM I found colleagues with similar interests and we could discuss cases. It was a place where patients with addictions were valued and treated with dignity. This was in contrast to some administrators’ approaches, where they were seen primarily as sources of money. How did you first learn about CSAM? As a Fellow I sought out the other physicians who were treating this population – Jack Gordon, Ray Anderson, Max Schneider. I went to meet Jess Bromley who had a private practice and also worked at a hospital in San Leandro. He was a big guy, 6’5”, 240 lbs, and a booming voice. He also was a brilliant medical politician and very charismatic. He was the founder of CSAM. He was very passionate about good treatment for our patients and very kind to me. So, I just joined CSAM as a Fellow in 1982. /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx Page 49 of 160

What are your first memories of CSAM – both before and after you joined? I remember particularly the medical director committee. It felt like a support group for physicians as often the addiction treatment units were being seen through 2 lenses: one was the view of physicians who cared about and treated the patients; the other was the lens of the administrators who saw treatment as a money maker. At the time the 28-day inpatient programs were paid for by the insurances usually without much scrutiny and were a substantial source of income for hospitals. It became a source of questions about the ethics involved. I remember going to one of the early annual conferences at the Betty Ford Center. When I asked one of the physicians about exchanging protocols for detoxifying alcoholics, he said that this was proprietary information and he could not share it. My jaw dropped as I had never seen medical knowledge seen as proprietary and I felt strongly that this was not ethical. It showed how the politics and money influenced our field of addiction medicine and also impeded progress in science of our field. I knew I was not What was the essential question facing CSAM when you took in Kansas office as President? anymore. There was a lot going on in our field at the time. For one thing, we had to find ways to work effectively with triple diagnosed patients (substance use disorder, psychiatric disorder and infectious disease – mostly AIDS), whose care was very challenging. Also, it was a time when a lot of ethical questions arose. The 28-day inpatient treatment industry was collapsing due to political factors and many medical directors lost their jobs. I recall it as a turbulent time. What do you consider your major contributions to CSAM? During my presidency, ASAM was asking CSAM to adopt unified membership. However, we objected to what we saw as substantially different practices within ASAM, and I believe my contributions to that delibertation were important in retaining the principles on which CSAM was originally founded. I resigned from the ASAM board in that process. Ultimately, we decided to vote against unified membership at the time. I spoke up against unethical practices in the field of addiction medicine when I saw them. I made a lot of enemies but also felt that I was changing attitudes that felt like “the Wild West of addiction medicine”. I insisted on scientific approaches in our field and in CSAM. What did CSAM do for you? What did you get out of CSAM – both for your practice and for you personally? I appreciated learning about different perspectives, for example from colleagues in different settings and from colleagues who were in recovery themselves. CSAM introduced me to the world of medical societies. I learned from masters like Jess Bromley about how to run a society, also aspects like the Robert’s Rules of Order to assure a board is run professionally. If you were writing the history of CSAM, what would be important to include? I think it is important to emphasize that physicians in addiction medicine live in a medical world and a political world. We need to focus on “Wissenschaft” (Science) as it creates value. Page 50 of 160 /Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 5-1-22.docx