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California Society of Addiction Medicine The Story of the First 50 Years: 1973 to 2023 CSAM members and prospective members should have ready access to CSAM’s history to understand how and why it has been successful. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 1 of Draft 6-15-22

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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 2 of

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 personalities § CSAM’s unique place in the development of addiction medicine that make all the in California and in the nation difference. § CSAM achievements in improving the quality and accessibility We’ve designed this of addiction treatment in California history to introduce you to the people and § The people who were the major players in the organization’s the personalities who achievements made and are making CSAM. § The historically important clinical, social and political matters that were important in shaping CSAM’s activities We invite your comments and suggestions for subsequent additions to this volume. The CSAM Historians Monika Koch, MD David Pating, MD Donald 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 © 2022 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 3 of

California Society of Addiction Medicine -- A History Table of Contents HOW TO USE THIS BOOK .................................................................................................................................3 INTRODUCTION...................................................................................................................................................8 THE WORLD INTO WHICH CSAM WAS BORN ...........................................................................................9 HOW CSAM WAS CREATED – 1972-1974 ......................................................................................................11 A LOOK BACK, DECADE BY DECADE.........................................................................................................13 1970S – THE FORMATIVE YEARS.........................................................................................................................14 1980S – THE DECADE OF TURNING POINTS .........................................................................................................15 Certification Timeline ....................................................................................................................................16 The Two Kroc Ranch Unity Meetings were both in 1983 ...............................................................................21 1990S – MORE “FIRSTS”......................................................................................................................................25 2000 - ANOTHER DECADE OF “FIRSTS”...............................................................................................................26 2010 ....................................................................................................................................................................29 2020 ....................................................................................................................................................................31 OUR PRESIDENTS..............................................................................................................................................32 1973 Charles Becker, MD (served 4 years) ..................................................................................................33 1977 Vernelle Fox, MD..................................................................................................................................34 1980 David Smith, MD...................................................................................................................................36 1983 Max Schneider, MD ..............................................................................................................................40 1985 Jess Bromley, MD .................................................................................................................................42 1986 Anthony Radcliffe, MD..........................................................................................................................44 1988 Garrett O'Connor, MD..........................................................................................................................46 1989 P. Joseph Frawley, MD.........................................................................................................................47 1991 Kevin Olden, MD ..................................................................................................................................48 1993 Richard Sandor, MD .............................................................................................................................50 1995 William Brostoff, MD ...........................................................................................................................52 1997 Gail Shultz, MD.....................................................................................................................................55 1999 Peter Banys, MD ...................................................................................................................................56 2001 Gary Jaeger, MD ..................................................................................................................................58 2003 Donald Kurth, MD ................................................................................................................................60 2005 David Pating, MD .................................................................................................................................62 2007 Judith Martin, MD ................................................................................................................................65 2009 Timmen Cermak, MD ............................................................................................................................70 2011 Jeffery Wilkins, MD...............................................................................................................................72 2013 Itai Danovitch, MD ...............................................................................................................................74 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 4 of

2015 Monika Koch, MD .................................................................................................................................78 2017 David Kan, MD .....................................................................................................................................80 2019 Anthony Albanese, MD..........................................................................................................................82 2021 Karen Miotto, MD .................................................................................................................................84 CSAM MEMBERS WHO MADE A DIFFERENCE........................................................................................86 Josette Mondanaro 1980................................................................................................................................86 Joseph Zuska ..................................................................................................................................................86 John Chappel .................................................................................................................................................86 Joe Cruse 1983...............................................................................................................................................86 Ray Anderson .................................................................................................................................................86 Mel Pohl .........................................................................................................................................................86 John McCarthy 1995......................................................................................................................................86 Christy Waters................................................................................................................................................86 Deb Stephenson ..............................................................................................................................................86 Lyman Boynton...............................................................................................................................................86 Barry Rosen....................................................................................................................................................86 Don Gragg, MD .............................................................................................................................................88 George Lundberg, MD ...................................................................................................................................90 Steven J. Eickelberg, MD ...............................................................................................................................92 Walter Ling, MD ............................................................................................................................................94 Donald Wesson, MD ......................................................................................................................................96 Westley Clark, MD, JD, MPH......................................................................................................................100 THREADS THROUGH CSAM’S HISTORY..................................................................................................102 HOW RECOVERING PHYSICANS EXPERIENCED CSAM......................................................................................102 CSAM’S VIEW OF SPIRITUALITY ......................................................................................................................103 CSAM STAFF OVER THE YEARS.................................................................................................................104 Gail Jara ......................................................................................................................................................104 Kerry Parker, MPA, CAE.............................................................................................................................106 Michael Barack, CCMEP.............................................................................................................................108 ASAM ...................................................................................................................................................................110 ASAM HISTORY 1947.......................................................................................................................................110 James Callahan, PhD...................................................................................................................................111 Penny Mills, MBA ........................................................................................................................................114 LEADERSHIP RETREATS ..............................................................................................................................117 EXECUTIVE COUNCIL RETREATS BEFORE 2000 ................................................................................................117 LEADERSHIP DEVELOPMENT RETREATS 2005 FORWARD..................................................................................118 CSAM NEWSLETTER......................................................................................................................................127 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 5 of

MERF ...................................................................................................................................................................130 THE VERNELLE FOX AWARD .....................................................................................................................134 THE COMMUNITY SERVICE AWARD .......................................................................................................138 CSAM BOARD ...................................................................................................................................................140 CSAM COMMITTEES......................................................................................................................................142 COMMITTEE ON EDUCATION – ESTABLISHED 1974...........................................................................................142 Committee on Education – 2013 -2020........................................................................................................146 REVIEW COURSES AND STATE OF THE ART CONFERENCES...............................................................................148 COMMITTEE ON PHYSICIAN WELLBEING – ESTABLISHED 1 ..............................................................................150 LIAISON COMMITTEE TO DIVERSION – ESTABLISHED 1982 ..............................................................................151 COMMITTEE ON MEDICAL DIRECTORS ..............................................................................................................152 COMMITTEE ON THE TREATMENT OF OPIOID DEPENDENCE ..............................................................................153 COMMITTEE ON PUBLIC POLICY – ESTABLISHED 1999 .....................................................................................156 COMMITTEE ON INTEGRATION AND ACCESS TO CARE – ESTABLISHED 2015 ....................................................158 COMMITTEE ON COMMUNICATIONS – ESTABLISHED 2017................................................................................159 CSAM NEWSLETTER......................................................................................................................................160 Editors ..........................................................................................................................................................160 What the Newsletters Looked Like Over Time -- Design and Redesign.......................................................161 NOTE FROM THE CSAM BOARD TO THE READER ..............................................................................................170 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 6 of

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. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 7 of

Introduction An organization should know how and why it was founded, how it has evolved over time, and its contribution to the changing social and political context in which it exists; in other words, it should know its history. 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. With this project, CSAM is creating a 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 in the nation. 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, with the documentation, to understand how it has been successful. The American Society of Addiction Medicine has published its history, titled “Treat Addiction • Save Lives.” In 1941when Ruth Fox, a New York psychiatrist, become interested in “a fairly new organization committed to helping those with … alcohol use disorder” – Alcoholics Anonymous, she attended an AA meeting where Marty Mann spoke. The rest, as they say, is history. What Ruth Fox was to ASAM, Jess Bromley was to CSAM – the founding parent. Bromley was a San Leandro internist whose vision has grown into the organization you see today. And that is the story this CSAM history attempts to tell. In ASAM’s publication1, the role of CSAM in forming one national medical specialty society and in establishing the specialty of addiction medicine is chronicled in great detail in the first half of the book. 1 “Treat Addiction • Save Lives” was created by Historical Research Associates, Inc. https://hrassoc.com/ and published by the American Society of Addiction Medicine, Rockville, MD. It is 264-pages, heavily referenced, with every assertion documented. It is available from the ASAM website https://www.asam.org/ 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 8 of

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 Establishing criteria patients’ addiction. Some claimed expertise but in fact their for membership in treatment approaches were based on the personality and/or the new Society brought a level of charisma of the treating physician. There were also a few rogue professionalism we physicians who were using their medical license, in effect, to deal wanted. 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 were recommended by a member or a physician from the applicant’s practice setting; applicants submitted an application along with letters of recommendation from two physicians who knew their practice; names of applicant members were published twice in the newsletter; applicants were accepted as full members by action of the governing body (then called the Executive Council.) 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 9 of

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 problems. We started putting on programs on substance abuse for parents, employers, teachers and so on, and got The past is never dead. a big crowd from all those groups. But when we put on programs for physicians, nobody would come!\" It's not even past. \"About this time, there was an incident which really --William Faulkner sparked the movement to change the law,\" Bromley reported in an article in CSAM News. \"In Riverside Frequently quoted by ASAM and CSAM historians like David Smith 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. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 10 of

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 Jess Formation of the California Society for the Treatment of Alcoholism and Other 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 with Dr. Bromley in San Leandro, joined the staff of the California Medical Association. Among the CMA Committees she was assigned 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. And they proposed that CMA form the kind of medical specialty society that Bromley envisioned. October 27, 1972 action of the CMA Council: “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.] 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 11 of

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.] 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.] 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 12 of

A Look Back, Decade by Decade 1970s – the Formative Years 1980s – a Decade of Turning Points 1990s – More Firsts 2000 – Transition 2010 -- 2020 -- 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 13 of

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: “2Authorized 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 California 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 research foundation (a 501(c)(3) corporation to put the society in a better position to achieve and promote its educational goals. 2 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.) 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 14 of

1980s – the Decade of Turning Points Turning Points —All of this happened 1980 Diversion Program for Physicians opens after passage in the 1980s of AB1146 in 1979. Medical Board of California’s Diversion 1980 passage of AB3218 to “define… a new type of health Program for Physicians opened January 1, facility to be known as a ‘chemical dependency recovery 1980 hospital.’ (CDRH)” Subsequent implementing regulations [filed 12-24-82 that establish the standards CDRH legislation requies medical required for licensure of a hospital in California: Title 22 director to have traiing and experience, Article 5 Section 79309 “Medical Director. The medical creating the need for a certification in director as well as the designated alternate shall be a addiction medicine 1981 physician with training and experience in the care and treatment of chemical dependencies.” MERF was founded 1981 Incorporation of the Medical Education and Research Kroc Ranch Unity Meetings February and Foundation (MERF) as a sister organization to CSAM October 1983 1982 Requirements were made final in regulation for the First CSAM Certification in Addiction licensure of the new chemical dependence recovery Medicine November 1983 hospital: Title 22 Article 5 Section 79309 “Medical Director. The medical director as well as the designated CSAM urges ASAM to assume the role alternate shall be a physician with training and of one national medical society in experience in the care and treatment of chemical addiction medicine and CSAM members dependencies.” vote to become a state chapter of ASAM 1983 CSAM announced the first certification in addiction medicine based on the document CSAM developed, “How to Identify a Physician Recognized for Expertise in Diagnosis and Treatment of Alcoholism and Other Drug Dependencies.” 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 15 of

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 170/Users/user/G1o9og8le9D–riven([email protected])/*aCrSAbMecHaisutosrye/*sAectSioAnsMlayoduet/scecitdioensslatyoouot sfafemprleth8-e24e-2x2.adomcx evPeargye 16 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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 18 of

1983 the first certificates were awarded 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 Talbott 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. . 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 19 of

1984 Second CSAM certification exam – 82 physicians certified by CSAM Pictured here are nineteen of the 82 physicians certified by CSAM in 1984 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 20 of

The Two Kroc Ranch Unity Meetings were both in 1983 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 Society 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 Second 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 Certification project given to the national organization == AMSA First AMSA Certification 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 21 of

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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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 23 of

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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 24 of

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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 25 of

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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 26 of

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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 27 of

CSAM members attending the 2010 ASAM conference in San Francisco Seated 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 Glen Taylor 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 28 of

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: 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. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 29 of

2019 Strategic Plan 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 30 of

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. March 15, 2020 – COVID-19 shut down September 2020 -- First virtual State of the Art Conference – first translation of a CSAM conference into a virtual platform – no mean feat. 2021 – virtual during the COVID-19 pandemic 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 31 of

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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 32 of

1973 Charles Becker, MD (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. I agreed to work with that group, which was at that 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 Chuck Becker was Professor of Medicine consensus was that the steering committee should and Pharmacology at UCSF 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. 3 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 33 of

1977 Vernelle Fox, MD Vikki Fox was from Georgia, and you could hear the slightly different cadence and vowel sounds in her lectures. In Atlanta she had established a new innovative treatment program and she would travel to take part in the meetings of the New York City Medical Society on Alcoholism that Ruth Fox, MD, organized and held in her living room. It was the group that would grow into ASAM. She moved to California in the early 1970s and in Long Beach started the first multidisciplinary alcoholism treatment program with a treatment team of doctors, nurses and others, showing how to detox with dignity. She taught that the best primary therapist for an alcoholic is an interdisciplinary team. She welcomed visiting physicians who wanted to observe and learn her approaches. Tony Radcliffe talked about those experiences, remembering the time she reprimanded him when he showed off his knowledge to a nurse. Fox told him, “Don’t ever embarrass any of my staff with your brilliance again. Teams are like family and as an invited member of this family you don’t insult your cousins.” She served as Chief of Alcoholism Services at Long Beach General Hospital from 1971 to 1979. Her writing and teaching raised the level of the work in terms of both scientific and ethical standards. It is no accident that CSAM’s annual award is named in her honor. At the Society’s Tenth Annual Meeting in 1984, she was recognized with an award that would afterwards be named for her and become the society’s highest honor: the Vernelle Fox Award. 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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 34 of

The California Society for the Treatment of Alcoholism and Other Drug Dependncies presents this award to Vernelle Fox, MD for Ø Distinguished contributions to the understanding and acceptance of alcoholism and drug dependence as medical diseases Ø Innumerable hours of teaching Ø The enthusiasm brought to the field Ø The courage to be unique With this presentation, the California Society establishes The Vernelle Fox Award to be given annually in recognition of noteworthy contributions to the field and designates Vernelle Fox as the model against which all future recipients of the award shall be measured. Presented at the Tenth Annual Meeting of the Society On the 12th day of March 1983 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 35 of

1980 David Smith, MD 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. David Smith is an pharmacologist , In our outpatient clinic, we started to treat [brief bio] Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do withdrawal syndromes with phenobarbital as we eiusmod tempor incididunt ut labore et wanted a medication that was effective and a low dolore magna aliqua. risk for diversion. Don Wesson and I published papers on this topic and other doctors came to 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. Jess wanted to make it feasible and accepted that This is the section of H&S that was added n physicians could provide appropriate treatment for 1972 addiction as part of their regular practice: a mainstreaming approach to treatment. His motivation increased when he Notwithstanding the provisions of Section learned that doctors were getting arrested for using our 11217, a licensed physician and surgeon may protocols. In those years, using phenobarbital for treat an addict for addiction in any office or withdrawal symptoms technically violated the law which medical facility which, in the professional prohibited physicians from using scheduled medications judgment of such physician and surgeon, is for the treatment of addictions in their own private patients medically proper for the rehabilitation and in their own offices. treatment of such addict. Such licensed physician and surgeon may administer to an His first step was to work with California Medical addict, under his direct care, those medications Association to change California’s Health and Safety and therapeutic agents which, in the judgment Code to allow a physician to “treat an addict for addiction of such physician and surgeon, are medically in any office medically proper…”. He worked closely with necessary, provided that nothing in this section CMA where he was a member of the CMA Committee on shall authorize the administration of any Dangerous Drugs to advocate for passage of that bill and whennarictopticadsrsuge.d in 1972, he took another step toward his vision by proposing that CMA sup(Apdoderdt bthyeStactsr.e1a9t7i2o,nCho. f14a07.) specialty society for physicians treating addiction. That proposal grew into what is now CSAM. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 36 of

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. 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 City 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 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”. 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? 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 37 of

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. In 1982, a meeting at the Kroc Ranch took place where we tried to CSAM has always found a national organization of addiction. It was not a good been the creative meeting, we could not agree on names as alcohol treatment juice in addiction providers were worried that adding drugs to the name would medicine distract attention from the alcoholics. 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. 3. What do you consider your major Photo AMA House 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. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 38 of

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. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 39 of

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. He was a charter member of CSAM – one of the go-to clinicians and teachers, along with Vikki Fox and Joe Max Schneider was an internist and Zuska, in Southern California. gastroenterologist, practicing in Orange He was president of CSAM in 1983 at the exact time County. of the launch of the CSAM certification project and he was a central participant in both Kroc Ranch meetings and the steps to unite the different organizations into one national society. He was president-elect and president of the American Medical Society on Alcoholism (AMSA) when the unity efforts succeeded in moving AMSA to become the American Medical Society on Alcoholism and Other Drug Dependencies (AMSAODD). He led the reorganization by which AMSA accepted the role of the one national organization to represent addiction medicine. ‘… there were oranges and He led CSAM through that same time when, as he said, “there lemons in the California were oranges and lemons in the California Society after Kroc I. The oranges wanted to affiliate with the national effort, and Society after Kroc I.” the lemons wanted to leave things the way they were. The lemons looked on AMSA as northeast elitists.” 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 40 of

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. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 41 of

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 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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 42 of

California Society for the Treatment of Alcoholism and Other Drug Dependencies. The first annual meeting was held in 1974. He did not become the first president of the new society; he served on the Executive Council in other roles until 1985. He went on to active roles with AMSAODD – most notably as the representative to the AMA Specialty Delegation in the AMA House of Delegates Steindler Callahan Name Smith Miller 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 43 of

1986 Anthony Radcliffe, MD Thirty-six years ago, Tony Radcliffe asked us to … “For us, things were very collegial, and it seemed we could always call each other and talk. We were busy trying to do what nobody else seemed to want to do.” 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. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 44 of

170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 45 of

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 “Conflict 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 He is remembered as an intellectually gifted, outrageously dolor sit amet, consectetur adipiscing humorous, multi-talented, courageous, kind, and dedicated elit, sed do eiusmod tempor incididunt ut physician who, once in recovery from alcoholism, dedicated labore et dolore magna aliqua. his life to preventing the harm being done to patients by physicians who lack the knowledge, skill, and training to recognize and treat addiction. 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 46 of

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 Research with Emphasis on Outcome Measures” CSAM News Vol. 18 No. 1 Spring 1991 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 47 of

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. Kevin Olden is an internist and What is your recollection of your first patients gastroenterologist, [brief bio] Lorem with addiction? ipsum dolor sit amet I remember being called by the house staff to see a patient with severe Delirium Tremens. The patient had very high pulse and blood pressure and was out of his mind. I ordered 10 mg of Valium i.v. every 10 minutes, and the resident raised hell with me. She was worried about overdose and killing the patient. I explained the pharmacology to her, explaining the risks of arrhythmia and aspiration as well as pharmacology of benzodiazepines. 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 a missionary in a foreign land quoting outpatient clinics were almost never referred to from the Bible (the medical literature). treatment programs. Inpatients in the detoxification unit were treated with a Librium protocol that was from the 1940s and inadequate. 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 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 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 48 of

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. 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. Often, at that time, the addiction treatment units were being seen through two lenses: one was the view of the 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, at one of the early conferences at the Betty Ford Center, asking one of the physicians about exchanging protocols for detoxifying alcoholics. He said that it 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 me how the politics and money influenced our field of addiction medicine and also impeded progress in the 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 deliberation were important in retaining the principles on which CSAM was originally founded. I resigned from the ASAM board in that process. And CSAM decided to vote against unified I think it is important to membership at the time. emphasize that physicians in I spoke up against unethical practices in of addiction medicine addiction medicine live in a when I saw them. I made a lot of enemies but also felt that I was medical world and a political changing attitudes. I insisted on scientific approaches in our field world. We need to focus on and in CSAM. “wissenschaft” – the German term for systematic pursuit What did CSAM do for you? What did you get out of CSAM – of knowledge, learning, and both for your practice and for you personally? scholarship. 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. . 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 49 of

1993 Richard Sandor, MD Rich Sandor is 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. NOTE ABOUT A LANDMARK EVENT OR SITUATION DURING HIS PRESIDENCY Link to “Spirituality and Addiction Medicine: Does Spirituality Have a Place in the Practice of Addiction Medicine?” by Richard S. Sandor, MD CSAMNews Vol. 19. No. 3 Winter 1992 170/Users/user/Google Drive ([email protected])/*CSAM History/*sections layout/sections layout sample 8-24-22.docx Page 50 of