5 Questions With…
Louis E. Baxter, Sr., M.D. Chief Executive Officer and Executive Medical Director of the Professional Assistance Program of New Jersey, Inc. (PAPNJ)
You are the founder, CEO, and Executive Medical Director of the Professional Assistance Program of New Jersey, Inc. Would you please give us a brief description of your organization’s work and how alcohol treatment is part of it?
The mission of the PAPNJ is to provide services to protect the safety and welfare of the citizens of New Jersey through education, identification, evaluation, treatment planning, and advocacy for licensed healthcare and other professionals in recovery from impairing medical conditions and illnesses. According to our estimates, there may be more than 20,000 impaired healthcare professionals in the state. The PAPNJ is the solely approved program in the state of New Jersey to manage physician and other healthcare professional impairment. The PAPNJ manages all manners of impairment, including drug, alcohol, psychiatric, and behavioral conditions. Alcohol use is involved in more than 70 percent of all our cases.
Over the course of your long career, you’ve seen many scientific advances in the alcohol research field. What developments in diagnosis and treatment of alcohol use disorder [AUD] do you find most significant?
I have been involved in drug and alcohol treatment for more than 30 years, and over that time there have been significant changes and developments in the diagnosis, treatment, and monitoring of AUD. Thanks to the efforts of the National Institute on Alcohol Abuse and Alcoholism [NIAAA] and other governmental research efforts, AUD has been proven to be a chronic medical brain disease that is influenced by genetic and environmental factors. The aforementioned has resulted in more accurate diagnosis and development of medications to assist in the treatment of AUD.
The finding that AUD is a chronic medical disease has led to the chronic medical model of treatment for AUD and co-occurring conditions. Specifically, we now understand that successful treatment and outcomes depend upon long-term rather than short-term management and that interventions are required. Recovery from AUD is a lifetime endeavor. The development of three FDA- [U.S. Food and Drug Administration] approved medications, i.e., disulfiram, naltrexone, and acamprosate, has allowed for individuals to obtain and maintain abstinence. Together, medications as well as behavioral therapies have significantly improved the outcomes of success for a large number of patients who are appropriately diagnosed, treated, and monitored.
February is Black History Month—what are your thoughts about improving alcohol-related health outcomes among African-American communities?
There is a tremendous opportunity to improve diagnosis and treatment outcomes for AUD among African Americans. This largely depends on enhanced education and application of evidence-based diagnostic and treatment approaches for this group of patients. Both patients and health practitioners need to be the targets of alcohol education.
Currently, the lack of alcohol education among patients and practitioners has led to this documented disparity of care and successful outcomes among African Americans and other minorities.
Black History Month is a perfect time to kick off more intense involvement of organizations, both public and private, in the African-American community to focus on getting the education, new interventions, and developments dispersed throughout places of worship and educational and medical training institutions. This effort would be vitally important in reducing the current healthcare disparities we see in the African-American community and other minority communities today.
This is NIAAA’s 50th anniversary year. As a member of the Institute’s National Advisory Council, how would you summarize NIAAA’s contributions to the alcohol research field over the last five decades?
As this is NIAAA’s 50th anniversary, it is important to review and highlight some of the Institute’s major accomplishments. NIAAA has established the recognition that alcohol and its use is a major cause of many health-related problems. Alcohol has been found to be a leading cause of morbidity and mortality in this nation. Alcohol use and misuse has in most cases been a confounding contributor to chronic and acute medical conditions. NIAAA has done wonders in terms of providing treatment information to patients and providers through its development of the NIAAA Alcohol Treatment Navigator.
Looking ahead, are there any alcohol research advancements on the horizon that particularly interest you?
Many alcohol research opportunities by NIAAA lie ahead that will improve our abilities as providers to diagnose, appropriately treat, and monitor AUD in the future. The effort to better screen and predict AUD is very promising in the genetics research supported by NIAAA. As we learn more about the neurobiology of addiction in general, and alcohol specifically, more targeted medications and counseling protocols can be developed to effectively treat and combat the ravages of alcohol misuse and AUD. These ongoing research initiatives will help in the screening and prevention of AUD, as well as diagnostic and treatment outcomes—endeavors that we do desperately need.