Provider Perspective: Anika Alvanzo

Providing support and care for society’s most vulnerable and stigmatized is one of the most valuable things a provider can do. 

In the case of Anika Alvanzo, MD, MS, who serves as the Eastern Region Medical Director for Pyramid Healthcare, she intends to make a difference in the lives of those with substance use disorder. 

An internal medicine-trained addiction medicine physician, Alvanzo aims to improve the quality of treatment for individuals with substance use disorder and decrease the stigma associated with the condition. Working to improve the overall health and quality of life for these individuals, Alvanzo’s work is an invaluable contribution towards efforts to build a healthier Maryland.

Read the Q&A below to see how her work brings the state of Maryland alive!

What inspired you to engage with patients who have substance use disorder?
“After my first year of medical school, I became interested in violence against women and the impact of that on the health of women. I was in the primary care track of my residency, so I had completely planned to be a primary care physician.

One of my attending physicians knew that I had this interest in violence against women, and she connected me with a researcher who was doing addiction research in the OB/GYN clinic, and she allowed me to add a violence measure to her screening battery. It was [through] analyzing that data that I saw the relationship between the experiences of violence and trauma and substance use and addiction.

And that’s actually how I got interested in substance use. I did maybe four years of internal medicine and then transitioned exclusively to addiction medicine and really looking at the intersection between trauma and addiction, and then also looking at health inequities in the area of addiction.”

What is one of the most significant things that you’ve learned through this work?
“People with addiction are no different than you or me. There are a number of things that may contribute to someone developing a substance use disorder, whether there’s a genetic predisposition, environmental experiences, or particularly traumatic experiences they may have had that have contributed to it.

But at the end of the day, they’re people just like you and me. They’re somebody’s son, somebody’s daughter, somebody’s mother, sister, or brother– and just like in other areas of medicine where we are striving to have optimal quality, the same thing should be true for the treatment of people with addiction.”

How have the past couple of years, especially the pandemic, changed the scope of your work?
“I think it has actually sped up innovation in the area of addiction medicine, particularly in the area of telehealth and alternative delivery models for delivering addiction treatment. It has shown us that it’s time for our methadone regulation to change, that we can change methadone regulation and relax some of the restrictions without negative outcomes. And that we can actually improve outcomes for some patients. I think the pandemic has also put a brighter lens on the already existing health inequities in our country and in addiction treatment. 

I think for me, one of the other things the pandemic did is get me thinking more about the intersectionality of some of the disparities. In this world– in this field– you cannot come away without a profound understanding of the impact of the social determinants of health on one’s outcomes.”

What do you enjoy most about working in this field? What is the biggest barrier you face? 
“My favorite aspect is the interaction with patients. That is the most rewarding aspect of it– the interaction with patients, the opportunity to participate in their treatment and in their recovery in whatever way that looks like to them.

Stigma, and how it is applied in multiple domains, continues to be the biggest barrier. There continues to be stigma in the healthcare profession, even in the addiction treatment area in terms of stigma against medications and what we know are evidence-based treatments. There’s stigma in the criminal legal system in terms of how [they deal with] people with substance use disorder. There’s stigma in families and communities and [sometimes] that contributes to potentially worsening outcomes for some patients. 

The more we do to eradicate that and to educate people about addiction, the more we can ultimately hope to reduce some of those fears.”

How else do you stay involved in this field?
“I’m very active in the American Society of Addiction Medicine (ASAM). I’m on the board of ASAM. I also chair the ASAM Annual Conference Program Planning Committee. I’ve worked on the committee that is writing the racial justice statements, and then also with some other colleagues on a health equity module in addiction. 

The number of opportunities that I’ve gotten…has really given me a better understanding of policy and the importance of policy and legislation in the lives of our patients and in the lives of those who are treating them. It has also given me a better understanding of advocacy and the importance of advocacy. We often think of advocacy as national, but there are things we can do in our practice settings to be an advocate for our patients and for the other addiction providers.”

Anika Alvanzo, MD, MS, DFASAM, FACP is the Eastern Region Medical Director for Pyramid Healthcare, Inc., a physician consultant to the Behavioral Health Administration in the Maryland Department of Health, and the Managing Partner of Uzima Consulting Group, LLC, which provides addiction-related consultation, training, and expert witness testimony. Dr. Alvanzo is a graduate of the George Washington University School of Medicine and Health Sciences, holds a master’s degree in biostatistics from Virginia Commonwealth University, and is board certified in Internal Medicine and Addiction Medicine. She is a Distinguished Fellow of ASAM, a Past President of the Maryland-DC Society of Addiction Medicine, and currently serves as Chair of the ASAM Annual Conference Program Planning Committee and Region V Director for the ASAM Board of Directors.

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