Improving DEIB in Addiction Medicine Training Through Interdisciplinary Collaboration and Program Evaluation.

Developing a diverse Addiction Medicine (AM) workforce will improve medical and public health responses to the increasing health risks created by substance use disorders (SUDs). A workforce that embraces diversity, equity, inclusion, and belonging (DEIB) principles may foster novel responses to address the disparities in treatment and outcomes experienced by Black, Indigenous, and People of Color (BIPOC) who are impacted by SUDs. However, experiences of bias and discrimination in the workplace and a lack of exposure to addiction-related content in educational settings limit opportunities to develop and retain a diverse workforce. In this commentary, we describe the creation of the Inclusion, Diversity, and Equity in Addiction medicine, Addiction research, and Addiction health professions (IDEAAA) initiative, a strategy to foster diversity in the field of addiction through efforts targeting learners at different stages of the biomedical education pipeline. Now in its second year, the IDEAAA Program is focused on programmatic evaluation through a qualitative interview study of AM training programs to improve the understanding of experiences of participants who are self-identified members of underrepresented groups (URGs). Interdisciplinary programs with multi-faceted approaches are a strategy to improve DEIB in the AM workforce; IDEAAA's design and methods can inform other AM programs who have the desire to improve DEIB through novel approaches.

An open label clinical trial of complement inhibition in multifocal motor neuropathy.

Human and animal studies on antibody-mediated neuropathy implicate complement in pathogenesis. In animal models complement inhibition is therapeutically beneficial. The monoclonal antibody, eculizumab (Soliris™, Alexion Pharmaceuticals, Cheshire, CT), prevents cleavage of C5 and thus inhibits terminal complement activation. In an open label study, 13 multifocal motor neuropathy patients received eculizumab for 14 weeks, 10 of whom were concomitantly receiving intravenous immunoglobulin. The primary outcome was safety of eculizumab, and the secondary outcomes included change in intravenous immunoglobulin (IVIg) dosing frequency, performance, and electrophysiological parameters. Adverse events were minor during the study. Nine of 10 patients on IVIg maintenance continued to require IVIg. IVIg dosing interval was not different between the run-in and the treatment period. There were improvements in patient-rated subjective scores and selected clinical and electrophysiological measurements. Overall, a small treatment effect occurred in some patients that appeared supplementary to and independent of the IVIg treatment effect, and occurred more frequently in patients with higher baseline motor function.