Addiction medicine in the time of COVID-19: An overview of the 2020 Joint Scientific Annual Conference of the International Society of Addiction Medicine and Canadian Society of Addiction Medicine

Abstract

For years, Substance Abuse has annually published a communication regarding the annual conference of the International Society of Addiction Medicine (ISAM). These pieces have highlighted the important events of the conference and the work of the organization, as reflected in part by selected abstracts from the conference. This editorial communicates the events of the 2020 conference, the third to be held in conjunction with the Canadian Society of Addiction Medicine (CSAM) and the first virtual conference. The conference was attended by over 800 participants and covered a wide range of topics, including addiction medicine during the COVID-19 pandemic. Despite the challenges of not being able to meet physically in Victoria, British Columbia as had been planned, the virtual event provided an opportunity to share current information in order to help advance prevention, treatment, policy and public helath efforts relating to addressing addictions and helping those impacted by these often devastating conditions.

Keywords:

• Substance-related disorders
• addictive behaviors
• COVID-19
• policy
• treatment
• health disparities
• infectious diseases
• co-occurring disorders

The year 2020 brought many challenges, punctuated by the substantial impact of the COVID-19 pandemic. Among these challenges were quarantines, lockdowns, spatial distancing and travel restrictions that led, among many other things, to long-standing conferences being canceled, postponed or moved to digital platforms. The International Society of Addiction Medicine (ISAM) and the Canadian Society of Addiction Medicine (CSAM) collaborated to hold a joint scientific conference that had initially been scheduled to be held in Victoria within the province of British Columbia in Canada. Given the state of the pandemic and related travel restrictions, the conference was held virtually from November 12–14, 2020.

The journal Substance Abuse has a long-standing relationship with ISAM. Among these, ISAM conference proceedings and selected abstracts have been published in the journal for approximately 15 years.^1–10 The current manuscript seeks to continue this tradition with respect to the 2020 conference.

This event marked the third time that the ISAM and CSAM organizations held joint scientific meetings, with previous events having been held in 2009 (Calgary) and 2016 (Montreal). However, this event marked the first time the annual conferences (ISAM’s 22nd and CSAM’s 32nd) were held virtually. The conference Co-Chairs were Drs. Jennifer Brasch and Nady el-Guebaly. The Executive Committee also included Drs. Paul Sobey, Melanie Willows and David Martell. As with prior ISAM/CSAM conferences, the event was highly successful, attracting 844 attendees from 28 countries and 6 continents. Forty-nine sessions were live-streamed, and new research was communicated through 108 on-demand Research Brief presentations. The theme of the conference was aptly entitled, “The World of Addiction: Now and the Future.” Ten plenary speakers addressed topics ranging from cannabis legalization, co-occurring disorders, behavioral addictions, spirituality, youth addiction, neuroscience, prevention and treatment, including how neuroscience may inform treatment advances through such approaches as neuromodulation. Plenary speakers from the US National Institute on Drug Abuse (NIDA; Dr. Ivan Montoya) and World Health Organization (WHO; Dr. Vladimir Poznyak) provided current institutional insights relating to how addictions are being investigated and addressed globally. A full list of the plenary speakers and the titles of their presentations can be found in the program (see Supplementary Appendix 1).

As in prior years, the topics covered in the conference focused on specific substances including alcohol, tobacco, stimulants, benzodiazepines, cannabis and opioids. The last two substances were particularly emphasized in part given the increasing legalization of cannabis in North America and elsewhere, and the opioid epidemic that has led to numerous deaths globally. Potentially vulnerable groups were also a focus, with presentations considering the situations and needs of racial/ethnic minority groups, people with LBGTQ orientations, incarcerated individuals, vulnerably housed/homeless people and others who may be at elevated risk for addictions. In particular, there was an emphasis on addictions in youth and pregnant women, and these were considered from multidisciplinary, interdisciplinary and international perspectives. As in prior years, addiction-related concerns like infectious diseases and potential sequelae related to intravenous drug use (HIV/AIDS, hepatitis, skin infections, endocarditis) were addressed, with a focus on hepatitis C given the impact of the illness and recently available therapeutic agents that may help people with hepatitis C infections. A complete list of presentations is included in the program (Supplementary Appendix 1).

Among communicable diseases (and perhaps overall), COVID-19 was arguably the greatest focus of the conference. An international panel considered COVID-19 and addictions from a global perspective. Several symposia focused on COVID-19 including one on international efforts to advance telehealth efforts and another on how to care for and provide opioid agonist therapy in the setting of restrictions imposed by jurisdictions during the pandemic.

The conference also highlighted efforts of the ISAM Interest Groups, which have grown over the past several years. The Neuroscience Interest Group, which recently published a consensus article on how to integrate neuroscience into addiction treatment,¹¹ organized and presented a symposium on brain stimulation for addiction medicine. The Spirituality Interest Group, which recently generated a position statement on the role of spirituality in addiction medicine,¹² contributed a symposium on the evidence for spirituality in addiction medicine across cultures, including with respect to neurobiological and treatment considerations. The Policy and Practice Interest Group conducted a symposium on telehealth in addiction medicine, building off successful webinars^13–15 and surveys^16,17 that have focused on COVID-19, telehealth and other impacts of and responses to the pandemic. The Behavioral Addictions Interest Group generated 3 symposia that focused on neurobiology, treatment and COVID-19-related changes and responses. With respect to the last topic, problematic use of the internet (and specific forms thereof - gaming, gambling and pornography use) was highlighted. How such behaviors may have increased during the pandemic was considered, and the contents of a guidance on how best to prevent COVID-19-related problematic use of the internet were presented.¹⁸ Finally, the Philosophy, Anthropology and Human Sciences Interest Group organized a symposium on COVID-19's impacts on people with addiction. This symposium provided insights from social science and humanities perspectives on people with addictions during the pandemic, covering topics such as how structural racism in the United States has influenced drug war policies and health inequities (including in relation to COVID-19 death rates). These phenomena were considered with respect to transnational protests and demonstrations supporting Black lives.

Another focus of the conference was the next generation of addiction medicine practitioners and researchers. A symposium generated by early career investigators focused on the organization of a global network of early career addiction professionals (ISAM NeXT). This symposium discussed challenges and opportunities encountered by early career investigators, presenting data from a recently conducted survey. To promote the advancement of early career researchers, a professional development presentation entitled, “Communication in Medicine: Writing Abstracts and Grants for Successful Career Advancement” was included in a trainee track. To help the involvement of early career addiction professionals, awards to cover conference registration were provided. NIDA-supported Bursary awards were made to Drs. Duncan Hill (Scotland), Patrice Forget (Belgium), Champika Pattullo (Australia), Stephen Gilbert (United Kingdom), Anees Bahji (Canada), Gayatri Bhatia (India), Dario Gigena (Argentina), Preethy Kathiresan (India), Eric Peyron (France) and Kevin Sabet (USA). Their abstracts (and other selected ones) can be found in the supplemental materials (see Supplementary Appendix 2), with additional abstracts published elsewhere.^19,20

As the COVID-19 pandemic has led to many hardships, particularly for those individuals struggling with addictions, we are grateful that the 2020 annual conference was able to be held virtually. Holding a virtual as opposed to an in-person conferences has unique challenges. How does one manage differences in time zones for an international conference? How does one balance prerecorded versus live presentations, and how does one manage question and answer sessions after each? How does one manage technical concerns including access to the virtual spaces and navigation within them? These and other considerations were aptly handled through the joint efforts of AMP (hired as consultants to manage the virtual event), the organizing committees, and the conference attendees. As additional conferences in the future will undoubtedly need to be held virtually (for example, the 2021 ISAM conference), the experience gained during the 2020 event has been invaluable. However, perhaps most importantly, the successful virtual conference in 2020 contributed to us remaining connected and united during the COVID-19 pandemic in our efforts to advance addiction-related policies, prevention efforts, and treatments, keep informed of the latest addiction research and clinical developments, and improve public health efforts related to addictions.

Acknowledgments

We would like to acknowledge Marilyn Dorozio for her work on the ISAM/CSAM conference and assistance with the manuscript. We would like to acknowledge as well many others (including Jennifer Brasch conference co-chair, Becca Hebert, Tracy Howden, AMP (whose expertise helped to ensure a successful virtual experience at the conference) and others) for making the conference a success. None of the funding agencies had input into the design of the conference or content of the manuscript; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

Disclosure statement

Dr. Potenza has no conflicts of interest. Dr. Potenza discloses that he has consulted for and advised Rivermend Health, Game Day Data, Addiction Policy Forum, AXA, Idorsia and Opiant Therapeutics; received research support from the Mohegan Sun Casino, the Connecticut Council on Problem Gambling and the National Center for Responsible Gaming; consulted for or advised legal and gambling entities on issues related to impulse control and addictive behaviors; provided clinical care related to impulse-control and addictive behaviors; performed grant reviews; edited journals/journal sections; given academic lectures in grand rounds, CME events and other clinical/scientific venues; and generated books or chapters for publishers of mental health texts. Dr. el-Guebaly has no conflicts of interest. Dr. el-Guebaly discloses that he is Professor Emeritus, University of Calgary; Editor in Chief, The Canadian Journal of Addiction; Senior Editor, Textbook of Addiction Treatment: International Perspectives, 2nd ed., Springer Health, 2021; and Co-Chair, Organizing Committee, ISAM-CSAM Joint Scientific Annual Conference 2020.

Additional information

Funding

This article received support from the NIH/NIDA [grant R13 DA040431]. The ISAM/CSAM 2020 conference was supported by NIDA, WHO, the Royal College of Physicians and Surgeons and the Alberta Medical Association Section of Addiction Medicine. Conference support was also provided by Indivior Pharmaceuticals, Homewood Health, New West Recovery, Knights Therapeutics and Abbvie.