Disrupted Physician 101.1: The “Impaired Physician Movement” and the History of the American Society of Addiction Medicine (ASAM)

Disrupted Physician 101.1: The “Impaired Physician Movement” and the History of the American Society of Addiction Medicine (ASAM).

Henry David Thoreau

“With one arm around the shoulder of religion and the other around the shoulder of medicine, we might change the world.”—Twelve Steps and Twelve Traditions, AA World Services, Inc (1953).

In 1985 the British sociologist G. V. Stimson wrote:

“The impaired physician movement is characterized by a number of evangelical recovered alcoholic and addict physicians, whose recovery has been accompanied by an involvement in medical society and treatment programs. Their ability to make authoritative pronouncements on physician impairment is based on their own claim to insider’s knowledge.”

The American Society of Addiction Medicine’s mission is to “establish addiction medicine as a specialty recognized by professional organizations, governments, physicians, purchasers, and consumers of health care products, and the general public.”  

In this they have succeeded.images-4

And in the year 2014 Stimson’s characterization of the “impaired physician movement” remains as accurate and apt as it was in 1985. But the “number of evangelical recovered alcoholic and addict physicians” has increased dramatically  (outnumbering Addiction Psychiatry by 4:1)  and their involvement in  medical society and treatment programs” has been realized and enforced through the state Physician Health Programs and their “PHP-approved’ assessment and treatment centers.

Their “ability to make authoritative pronouncements on physician impairment…based on their own claim to insider’s knowledge”  has become public policy and sanctified by Regulatory Medicine -essentially the Word of the Lord.

And the 1953 Alcoholics Anonymous prophecy that “With one arm around the shoulder of religion and the other around the shoulder of medicine, we might change the world” is also coming to pass.

But the world is not changing for the better as that arm around the shoulder of religion has its fingers deep in the pockets of the multi-billion dollar drug and alcohol testing and assessment and treatment industries.  And the arm around the shoulder of medicine has its fingers clamped tightly around its throat; a stranglehold in full throttle suffocating the Profession of Medicine with no meaningful opposition I can see.

The Medical Profession, Moral Entrepreneurship, Moral Panics, and Social Control

The Medical Profession, Moral Entrepreneurship, Moral Panics, and Social Control.

As a society governed by organizations, associations,  institutions and regulatory bodies, the medical profession is not immune to “moral panics” and “moral crusades.”

A threat to patient care or the values of the profession can be identified and amplified.   A buildup of public concern fueled by media attention ensues creating a need for governing bodies to act. Medical Professionalism and the Public Health has been assailed.

Unbeknownst to the general population and most members of the medical profession at large, certain groups have gained tremendous sway within organizational and regulatory medicine. Through  moral entrepreneurship they have gained authority and become  the primary definers of the governance of the medical profession and the social control of  doctors.  To benefit their own interests they have fostered and fueled “moral panics.” Exhorting authorities to fight these  threats by any means necessary  they have successfully made and enforced rules and  regulations and introduced new self-serving definitions and tools that neither help doctors nor protect the public.

A paranoid is someone who knows a little of what’s going on.

“A paranoid is someone who knows a little of what’s going on”
–William S. Burroughs
In his 1969 novel The Wild Boys, William S. Burroughs writes “Under pretext of drug control suppressive police states have been set up throughout the Western world…. The police states maintain a democratic façade from behind which they denounce as criminals, perverts and drug addicts anyone who opposes the control machine.”

15 years earlier Dr. Ruth Fox formed the New York City Medical Society on Alcoholism. This organization subsequently became the American Medical Society on Alcoholism and eventually the American Society of Addiction Medicine (ASAM). The organizational goal of this group has always been to convince the medical establishment of the chronic relapsing brain disease model of alcoholism (and subsequently all addictions) and that 12-step spiritual recovery as defined by Bill Wilson and the Big Book as not only a valid medical treatment, but the one and only treatment.

The American Medical Association had previously reviewed the Big Book in 1939 aptly finding it “a curious combination of organizing propaganda and religious exhortation” that “contains instructions as to how to intrigue the alcoholic addict into acceptance of divine guidance in place of alcohol.” The reviewer concludes that other that the “recognition of the seriousness of addiction to alcohol” the “book has no scientific merit of interest.”

Unable to successfully convince doctors of their ideology by swaying them intellectually due to an absence of any solid scientific methodology or genuine evidence-base, they decided on a more effective tactic.   By gaining political power, promoting themselves with propaganda, spreading misinformation, and suppressing truths that don’t fit in their world view, they created a faux “medical specialty” requiring not knowledge or competence just authoritative dogma and allegiance.

They have convinced medical societies, medical boards, regulatory agencies, parole boards and others to not only accept them as experts, but to write legislation in states to declare them “the” experts in addiction medicine. They did this with a torrent of strategic lobbying efforts on behalf of the 12-step addiction treatment industry towards the AMA (and indirectly through the FSPHP towards the AMA), ABMS, APA, FSMB, ABIM, JCAO, CSAT, consumer groups, presidential candidates, state medical societies, congress, corrections agencies, social service agencies, faith-based community centers, the media and many other targets.

By proclaiming themselves “experts” and  bestowing phony “Board Certification” not recognized by the American Board of Medical Specialties, (ABMS) they have created the myth of expertise at the expense of real experts. And in doing so they have effectively lobotomized evidence-based thought and critical thinking.


This group has essentially created a despotism in addiction medicine treatment. A no choice one-size-fits-all take-it-or-leave-it pretend panacea of what’s good for the goose is good for the gander.   They have additionally created a tyranny in regulatory medicine.   Unsupervised and opaque, they have gained stranglehold control over individual doctors and gained sway over the culture and practice of organized medicine.

They have influenced the DSM-V, are trying to gain control of MRO education and regulation, and pose a great danger to us all.  This front-group for AA and the 12-step drug testing industry is fulfilling Burrough’s prediction of a police state. As medical Robber Barons by imposition of force in numbers and money they have assumed unqualified authoritarian control and influence that is posed to create irremediable harm to both society and individual freedoms and liberty.

Alarmist call to arms about the dangers of drugs and hidden addicts protected by others and posing danger to create untrue hype is propaganda and misinformation to further the ASAM drug-testing 12-step inpatient rehab agenda and gain control.

Drug war sloganeering designed to get everyone aboard. Logical fallacy, deceptive facts, pseudoscience, and misinformation is obvious if anyone cares to look a little deeper. The conflicts-of-interest are immense. The ASAM is a front group for AA that uses ends-justifies-the-means coercion and deception to get public recognition of the righteousness of the twelve steps of recovery.

Neither doctors nor US citizens should be subject to the whims of a religion based political group composed of unqualified, inexperienced, paternalistic and biased individuals who are truncheons of dogmatic ideology and refuse to accept evidence based treatment, transparency, and accountability as important. These are self-proclaimed specialists–great pretenders. Fake it til u make it.

The problem is that regulatory agencies, politicians, medical boards, law enforcement and others have either bought into the lie or live in willful ignorance.   Blinkered, ambivalent or unconcerned, most people, including those in health-care, take them at face value resulting in the misperception that they are the experts.

Indeed, they are well on the way to becoming the only experts.  Within the next couple of years this will become a reality. The ASAM will eventually gain ABMS specialty certification and when this comes to fruition they will undeniably be the only recognized experts  in the field of Addiction Medicine.

The Addiction Psychiatry subspecialty (the only specialty currently recognized by the ABMS) has already been pushed into a corner and will most likely have to join in rather than fade away–similar to what happened to proctology as gastroenterology evolved as a specialty. That analogy doesn’t quite work however as gastroenterology swallowing proctology represents an advancement in science based on valid methodology and evidence base.  It represents evolution in medicine not monopolization in sales.

This situation is more like anti-vacciners proclaiming themselves immunologists and gaining enough support to run the real ones out. Pseudoscience, groupthink, deception, and coercion. A framework not built on the scientific method, evidence based decision making, autonomy and benevolence; but based unproven ideological dogma, righteous inflexible worldview, rigid rules, obedience, and control.

Drug testing of  physicians and others will be done by ASAM, FSPHP physicians. They will demand prohibition, testing and treatment at their facilities. Complete control. Absolute power.  . Even with 100% specificity and sensitivity there are valid arguments against this. But if you throw in the corruption and other issues that are obvious if one peers inside this Potemkin ASAM village, both medicine and society as we know it is going to be emasculated  by dabblers and clowns.  It will come in a whimper not a bang,  and by then it will be too late.

They have already taken over Physician Health Programs  (PHPs) by removing competent and virtuous doctors who did not conform to A.A. groupthink and held them under threats of litigation with “gag orders” not to speak of the abuse and crimes they witnessed.  Claiming success with these programs they now want to move outward and onward as “Professionals Health Programs.”  Any one with any sort of license will be at risk.

PHP’s function to monitor and control. . Mandating coercive 12-step ideology onto physicians is standard operating procedure. The marked rise in physician suicide over the past decade is directly correlated with the FSPHP (an arm of ASAM)  taking over state impaired physician programs. A front-group for a front-group unrecognized in the sea of acronyms involved.

And the “kill em all let God sort em out” logical fallacy of saving doctors and protecting patients is propaganda with no evidence base.

This system, that encourages referring doctors confidentially for evaluation, is a nearly foolproof means to silence any physician they feel the need to. An accusation of substance abuse is made relatively easy. Then recommend an evaluation to one of your own people who will confirm the problem and force the victim into a 5 -year monitoring program with mandatory adherence to the 12-step road to salvation.

The FSPHP colludes with a list of around two dozen inpatient drug treatment centers such as Hazelden, Talbott, Marworth, and Bradford where  co-conspirators will engage in “confirmatory bias” and “confirmatory distortion” to make the assessment fit the diagnosis.  This provides a nearly perfect system to remove any physician from practice.

The ASAM claims an 80% success rate with the PHPs. If you look at the data on which this is based , however, it is as illusory as they are—-sheer sloganeering and propaganda with no substance or soul.

The ASAM and FSPHP are gaining power and expanding in scope. They have effectively muscled forth the “war on drugs’ agenda to further their goals by establishing a system of coercion, control, secrecy, and misinformation.  With doctors the first wave was substance abusers, they then added any psychiatric diagnoses, and are now after the “disruptive physician.”  The next target is the “aging physician” who will inevitably be diagnosed with “character defects.”    And by calling this the “New Paradigm” of addiction medicine they want to expand their scope to other professions.

This is a system that oppresses physicians and is about to enter the domain of others including students.  It will impact individual freedom, destroy the Bill of Rights, erode freedom of religion, stifle freedom of speech, and take us back decades..

By convincing others of their expertise they have strategically placed themselves in a position of power that includes the ability to remove any doctor from practice.

And unless something is done soon, every physician in the US will be at risk of losing everything at the whim of of a 12-step front group that places ideology above evidence base and dogma above virtue.

Claiming success they now want to bring it to you.