To: California Society of Addiction Medicine 

74 New Montgomery Street, Suite 230 

San Francisco, CA 94105

American Society of Addiction Medicine 

4601 North Park Avenue Suite 101

 Chevy Chase, MD 20815

[Ed note: written c. 2003.]

Colleagues,

As I contemplated whether or not to renew this year with the not unsubstantial dues, I asked myself “Why should I?” Over the years since I joined the organization I have tried to raise the possibility of a harm-reduction option for the treatment of alcoholism. Notwithstanding my repeated and persistent entreaties, I have been repeatedly denied any opportunity for a collegial and professional forum. I have even offered to make my patients available for questioning and review. Nothing. Lame excuses —not ready yet.

Forays into spiritualism with self-styled practition- ers responding to the “spiritual needs” of addicts was particularly disturbing. Somehow I don’t remember any training in medical school in theological studies. The blurring of boundaries and confusion of identity diminishes, attenuates medical leadership, and reduces professional credibility to cultism.  Medical Review Officers conducting forensic examinations are not engaged in a medical activity. Endorsing their enforcement of corporate authority diminishes medical leadership and reduces ASAM/CSAM to shills and trough feeders. The societies support the federal government’s irrational drug-war policy while prominent addiction specialists seek to maximize their share of court referrals.

I officially give up on ASAM/CSAM and any possibility of a magical ethical transformation. I have been denied the opportunity to present a viable, effective, and medically appropriate intervention: cannabis as a substitute for alcohol and other addictive substances.

Retrospectively, I wonder why I waited so long to quit. I can no longer maintain my wishful thinking that somehow ASAM/CSAM could be fair, objective, professionally and medically correct.

I shall not be renewing my membership.

Tod H. Mikuriya, M.D.

Member since 1974

Certified by ASAM 1986

MRO Certified by ASAM 1992