Learn the latest on excessive alcohol use, opioid use disorder

This month's issue addresses alcohol use and misuse, prescribing buprenorphine, and improving health care's response to future pandemics.

Even before 2020, alcohol use and misuse in the U.S. were increasing, and the COVID-19 pandemic didn't help matters. Research using data from 2015-2019 found that nearly 90,000 deaths each year in those ages 20 to 64 could be attributed to excess alcohol consumption, and newer research indicates that alcohol-related deaths jumped 25.5% between 2019 and 2020, with no real end in sight. Internal medicine physicians can help stem this tide by screening patients regularly for problematic alcohol use and working with them on appropriate interventions, experts said. Even if a patient isn't ready to stop drinking, helping them cut down is a step in the right direction.

Another area where primary care physicians can play a vital role is in prescribing buprenorphine for opioid use disorder, but until recently, they needed special training to do so. The X waiver mandated that physicians complete eight hours of training to prescribe the drug and limited the number of individual patients they could then treat. As of this year, though, the federal government has "X'ed the X waiver," meaning that only a standard DEA registration number, which most internal medicine physicians already have, is now needed. Addiction medicine specialists call this an important step forward but note that more stringent requirements at the state level may continue to hamper access.

COVID-19 taught the U.S. health care system some hard lessons, including the limits of its infrastructure. Those working in infectious disease and public health have begun applying that new knowledge to prepare for, and perhaps avert, the next pandemic. Improved data tracking and real-time linkage to clinical practice, more attention to addressing disparities, and enhanced training will be key. Read our story on these ongoing efforts, including a new joint fellowship pilot by the CDC's Epidemic Intelligence Service and the Infectious Diseases Society of America that's beginning to accept applications this month.

Elsewhere in this issue, a story covers ACP's and Annals of Internal Medicine's 12th Virtual Forum, "Firearm Injury: An Escalating Health Crisis," where experts discussed the effects of gun violence on physicians and their patients and offered advice and resources for dealing with this urgent public health issue. And among other stories, one offers a preview of Internal Medicine Meeting 2023, which will be held in person and virtually in San Diego in April, while ACP President Ryan D. Mire, MD, MACP, reminds his colleagues why the words they use with patients matter.

Are you attending the annual meeting this year? Our team will be there to bring you up-to-date coverage. Drop us a line at to let us know what stories you'd like to see.


Jennifer Kearney-Strouse
Executive Editor