History of Addiction Medicine

Patients with substance use disorders (SUD) are frequently encountered in emergency medicine (EM). Addiction medicine is a field that focuses on the diagnosis, prevention, and treatment of SUDs, combining various disciplines to treat conditions related to substances like alcohol, opioids, and stimulants. Addiction medicine expertise is particularly vital in EM due to the high incidence of SUDs seen in emergency departments (EDs) and the significant morbidity and mortality associated with these diseases.

EDs may be the first or only point of contact for individuals facing acute crises related to substance use, such as overdoses, withdrawal, or complications from chronic use. EM physicians are uniquely positioned to address these issues in critical moments by managing acute intoxication, initiating medication for addiction treatment (MAT), harm reduction counseling, and connecting patients with follow-up for further care. Incorporating addiction medicine in the ED can improve patient outcomes, reduce hospital admissions, and address the broader public health challenges posed by substance use.

Training in addiction medicine after EM residency prepares physicians for careers in a variety of inpatient and outpatient addiction treatment settings. This specialty also provides unique skills to establish a niche within EM.

History of the Specialty

Addiction medicine is a subspecialty under the American Board of Preventive Medicine (ABPM). It was previously recognized as a "self-designated" specialty but became a board-certified specialty under ABPM in 2017. Addiction medicine certification is open to any specialty. There is a separate certification pathway for addiction psychiatry that is only available to psychiatrists through the American Board of Psychiatry and Neurology.

While most addiction medicine fellowship programs are affiliated with family medicine, internal medicine, or psychiatry residencies, there are a small number of emergency medicine-based programs.