Bridging the Gap: Dual Fellowship Training in Addiction Medicine and Digestive Diseases

Addiction Prescription: A Bridge Between Addiction Medicine and Digestive Diseases

“…To the authors' knowledge, this is the only transplant hepatology fellowship in the US that has mandated an addiction medicine rotation. After witnessing the benefits that this exposure has for trainees and patients, we agree with Haque and Fiellin [4] regarding the importance of incorporating addiction education into digestive disease training, given the substantial overlap that exists between these two sub-specialties.…”

“…Although the pathophysiology of AUD is complex, involving genetic, psychosocial, and environmental factors, Haque and Fiellin [4], in a recent issue of Digestive Diseases and Sciences, highlight the substantial overlap that exists between gastroenterology/hepatology and addiction medicine in caring for patients with SUDs, which often account for and exacerbate many gastrointestinal and liver diseases (Fig. 1).…”

“…Further exacerbating the low rate of treatment by providers, Haque and Fiellin [4] report that only 35% of the patients referred to addiction medicine services receive ongoing treatment after their hospitalization. There are a multitude of factors underlying this observation, including the observation that patients may be hesitant towards treatment, the negative stigma associated with seeking and receiving treatment for SUDs, a lack of well-trained providers, deficiencies of insurance coverage, transportation, or time, and an underappreciation of the severity and chronicity of addiction as a disease [7].…”

“…2), that engages trainees in inpatient and outpatient Fig. 1 Impact of substance use disorders on digestive diseases, as highlighted by Haque and Fiellin [4]. This list is not exhaustive but illustrates the overlap that exists between these sub-specialties Fig.…”

“…After completing the executive fellowship, trainees report greater confidence and capability in more comprehensively assessing and treating patients with SUDs, especially in the context of solid organ transplant evaluation. Additionally, trainees report an improved approach towards AUD as a disease that benefits from treatment, similar many other medical conditions, which in turn reduces the stigma surrounding SUDs that Haque and Fiellin [4] appropriately emphasize. To the authors' knowledge, this is the only transplant hepatology fellowship in the US that has mandated an addiction medicine rotation.…”