ASAM president also medical director for drug company

phrma2I missed this a while back. Turns out that ASAM’s president works for a buprenorphine manufacturer.

Stuart Gitlow, M.D., is the president of the American Society of Addiction Medicine (ASAM) and also medical director — as a consultant — for Orexo, which makes Zubsolv, a newly approved buprenorphine-naloxone medication (see ADAW, July 15).

The first public charge of a conflict of interest was made last month via Twitter by Mark Willenbring, M.D., former director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism. In the tweet, Willenbring suggested that ASAM should examine its policies about conflicts of interest. While the connection with Orexo doesn’t mean that Gitlow’s beliefs and statements about buprenorphine are incorrect, it does raise questions, said Willenbring, now in private practice in St. Paul, Minnesota, where he provides treatment for substance use disorders and is a strong proponent of medication-assisted treatment. “At the same time, how can someone who is employed by the drug company have any credibility when his financial interest is in selling the drug?” Willenbring told ADAW. “My concern is with the increasing public perception, especially in psychiatry and addiction treatment, that financial interests taint and discredit professional opinions.” Gitlow’s dual roles, said Willenbring, raise this question: “Is he speaking for ASAM as a professional or for the pharmaceutical company as a salesman?”

While I don’t follow ASAM closely, I’ve seen no evidence of Gitlow advocating for any policy that would not receive broad agreement among ASAM membership.

However, as ASAM engages in advocacy around prescribing limits for buprenorphine, is it a conflict that the organization’s president gets a paycheck from a manufacturer?

7 Comments

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7 responses to “ASAM president also medical director for drug company

  1. Stuart Gitlow

    Old news, now outdated, and with both sides fully explored in the article. The bottom line, of course, is that unless we’re retired, we all receive pay from somewhere. Some from clinic employment, some from treatment centers, some from insurance companies, and a diminishing number from private practice. Each such position carries potential conflicts. I’ve been fully transparent about my now past work for the pharmaceutical industry as well as about my work for the disability carrier industry, all of which was purposely set up as consultancies so that I am not obligated nor allowed to speak for any such firm. The potential conflict of interest has been fully addressed by the ASAM board – at my request – and while in such positions, I have recused myself from any issue for which the potential conflict could become an actual conflict.

    All that said, Willenbring’s charge that I had a financial interest in selling the drug (Zubsolv) proves only that he understands little about what a medical director at a pharmaceutical company does, particularly in a consultant role. I had no financial skin in that game and stood to gain or lose nothing from Orexo’s success or lack thereof. My consultancy with them revolved around my perspective as a private practice physician in the addiction field, something Willenbring could have learned had he bothered to ask before making statements about which he knew absolutely nothing.

    • Thanks for your reply. Would you say the ADAW article was fair?

      • Wow! Now I know why this guy is against marijuana. I just read his CNN article. Most ridiculous article I have read in a long time! I then decided to Google asam and big pharma and sure enough. This is why I do not trust most doctors. You should see the pill addicts in my town. Bad diet, lack of exercise & these doctors throw pills @ the problem. Most problems can be solved by exercise, healthy diet and natural remedies, whether herbal or acupuncture or other. But you don’t make a sale you don’t make a buck. Drug dealers!?! Guys like gitlow fear anything natural so that includes Marijuana. They only trust chemists in lab coats who are as isolated from reality and nature as they are. They only care about money because it keeps them in mansions in gated communities cut off from the real world. I was once pre med but couldn’t bring myself to sell my soul like this guy! All the doctors I was meeting were callous drunks! Thank you for your article. You should submit it to CNN.

  2. chuck gehrke

    The public and many physicians are troubled (very) by the very questionable activities and relationships of some physicians with pharmaceutical and medical device companies. It is really of little (if any) importance what the Board or any other body within the organization says about the situation. Medicine brought this on itself with poor oversight of these relationships in the past. So it needs to do whatever it takes to reestablish public trust. As things stand today, If someone wants to serve in a medical leadership role any and all situations which can be even remotely construed as a real, imagined, or perceived conflict of interest should be avoided. Charles F. Gehrke MD, FASAM, FACP

    • Yes, the reputation of the medical community has been damaged, which comes down to the trust of one’s doctor–something that once went unquestioned. The profession no longer enjoys that status at the same level. Thank you for the post.

    • Stuart Gitlow

      Dr. Gehrke: That would leave us in the unavoidable position of having almost no one who could hold a leadership position. The fact is that a majority of physicians today are employed by institutions of one sort or another and therefore will have real, imagined, or perceived conflicts of interest. A full time physician at Harvard would have conflicts. A full time employee of Hazelden would have conflicts. Each conflict must be worked through, must be transparent, and must be discussed if at issue for any given topic. But to say that none of these individuals could be among our leaders is to eliminate MOST of those who would be available. Please note as well that I was not employed by anyone and therefore have had no obligation whatsoever. You may still feel, of course, that there could be a conflict, and I agree with that perception and therefore recused myself from relevant topics of activity.