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Vania Rudolf, MD, MPH, DFASAM

For Vania Rudolf, MD, MPH, DFASAM, treating addiction and advocating for the field of addiction medicine are two sides of the same coin.

In her 15 years practicing addiction medicine, Dr. Rudolf has seen her advocacy work as an extension of her patient care.

“For me, advocacy is ultimately about having a voice and challenging the status quo with integrity and purpose to create meaningful, lasting change,” said Dr. Rudolf, who treats addiction at Swedish Addiction Recovery Services, Ballard Outpatient, in Seattle, Washington.

In recognition of her advocacy efforts, Dr. Rudolf was presented with ASAM’s 2025 Public Policy Award. When she learned she was selected as this year’s recipient, Dr. Rudolf requested that the award be shared with the leaders and colleagues she’s worked alongside, including Hendree Jones, Tricia Wright, Davida Schiff, Jessica Gray, Sharon Ostfeld-Johns, Mishka Terplan, Jack McCarthy, Charissa Fotinos, and Marcela Smid.

“The award is meaningful, moving, and humbling—the lineup this year was full of stars, people I revere and deeply respect, and I was honored to be included in the group,” she said. “The award means so much for the work we do—representing the voice of and advocacy for women experiencing mental health issues and addiction, for their perseverance, endurance, and strength, and for highlighting the importance of justice, equity, and evidence-based medicine for vulnerable women, children, and their families.”

The Spark that Ignited a Career

Dr. Rudolf’s desire to treat addiction emerged from her years growing up in Bulgaria, a country steeped in tradition, poverty, and diversity.

“Being an idealistic person, I have always been drawn to helping others in need, traveling abroad to engage in relief work during high school and medical school,” Dr. Rudolf said. “I came to the US many years ago seeking medical training to continue my humanitarian efforts.”

Dr. Rudolf still remembers the patient who inspired her to pursue a career in addiction medicine. During the first year of her family medicine residency at Multicare Medical Center in Tacoma, Washington, a pregnant woman came in about to give birth. The woman, who had received no prenatal care, was struggling with her untreated opioid withdrawal symptoms.

“She shared that she was trying to stop using heroin on her own due to the stigma and judgment she had received in the past,” Dr. Rudolf recalled.

The woman delivered prematurely and lost the baby. She was overcome with shame, guilt, and deep heartbreak as she shared with Dr. Rudolf the stigma and barriers that prevented her from receiving treatment earlier.

“I helped with her delivery, and I watched that baby die due to prematurity,” Dr. Rudolf said. “The experience was traumatic, yet inspiring at the same time—witnessing the resilience and fortitude of my patient helped me dream of a vision for equitable, compassionate care where people feel safe to seek evidence-based, patient-centered, and trauma responsive care, where they have support for their recovery and parenting journey, and feel celebrated rather than stigmatized.”

Dr. Rudolf became the woman’s primary care physician and stabilized her on methadone. Her patient eventually recovered and became pregnant again just before Dr. Rudolf completed her residency.

Hoping to be a healer with vast knowledge and clinical experience, she went on to complete year- long fellowships in integrative medicine, addiction medicine, and high-risk obstetrics. As an OB fellow, Dr. Rudolf was able to devote substantial time to practicing high-risk maternal-fetal medicine, including acquiring training in services for substance-using pregnant women.

“I feel blessed to have accessed training that, to date, has facilitated my professional integrity, growth, and progress toward my goal to advocate for equity, positive change, and inclusiveness, so that no patient with mental health issues and addiction is left behind,” said Dr. Rudolf, who is board certified in family medicine and addiction medicine.

All these years later, Dr. Rudolf’s patients still inspire her to continue treating addiction. She also remains motivated to advocate for her patients outside of the hospital setting.

“It is so moving to build relationships and support people in the way they see themselves, to help them get healthy, to be part of their delivery, their family, and their recovery journey,” she said. “Women with substance use disorder (SUD) have tenacity, courage, and incredible resilience. It is a true privilege to help someone find hope and a better path forward.”

Award-Winning Advocacy

Dr. Rudolf initially sought academic training in public health to learn how to address health disparities. In the program, she gained exposure to advocacy, social justice, and policy work.

“Since then, I have been dedicated to identifying gaps between evidence-based practice and clinical care for substance-using women, their children, and families,” she said. “My hope is to positively impact the lives of a greater number of people with addiction who have been traditionally overlooked by society.”

In her advocacy work, Dr. Rudolf has helped advance two critical efforts. The first was ensuring Medicaid coverage for Community of Maternal Parenting Support for Substance Impacted People and Newborns (COMPASSION), a 5-day postpartum model for birthing women and families affected by opioid use disorder (OUD) in all 54 birthing hospitals in the state of Washington.

“We live in unprecedented times of increased maternal mortality in the fentanyl era,” Dr. Rudolf said. “I helped build the COMPASSION 5-day postpartum inpatient floor stay where every mom is offered the choice to stay with their newborn, family, and support members—an economical model that has improved maternal, newborn, and child welfare outcomes while decreasing maternal overdose mortality, neonatal withdrawal, NICU admissions, prolonged hospital stays, and child foster care placement.”

Dr. Rudolf’s second significant advocacy effort involved collaborating with ASAM, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Washington State legislature to standardize offering the choice of split methadone dosing for pregnant and postpartum patients with OUD.

“The primary goals of treating OUD during pregnancy include alleviating withdrawal symptoms and cravings, preventing problematic use, restoring a neurological and physiological equilibrium perturbed by OUD, and supporting healthy fetal development,” Dr. Rudolf said. “Methadone is an essential component of OUD treatment during pregnancy, with substantial evidence highlighting its benefits for both maternal and fetal health.”

Dr. Rudolf noted that there are unique considerations when treating pregnant women with OUD, as pregnancy-induced physiological changes influence drug absorption, distribution, metabolism, and excretion processes.

“The conventional ‘low and slow’ and ‘once daily’ method of initiating and maintaining methadone treatment is pharmacologically sound in preventing overdose and facilitating tolerance development,” Dr. Rudolf said. “However, such initiation overlooks the metabolic and hormonal changes experienced during pregnancy.”

Careful stabilization with a split methadone dose is paramount for maternal and fetal stability, she added.

“We worked with SAMHSA and 暗网福利to support a clinical recommendation for split dosing, published by SAMHSA in May 2022,” she said. “As president of the Washington Society of Addiction Medicine, I worked with our state legislature and State Opioid Treatment Authority to standardize offering the choice of split methadone dosing to all pregnant people throughout the state. It has been an amazing collective effort, and currently, Washington is the only state that offers split methadone dosing for all birthing people at all of its opioid treatment programs.”

Looking to the Future

Dr. Rudolf and her colleagues remain focused on expanding patient access to medication for OUD (MOUD).

“The Providence Swedish health system, where I work, has implemented clinical pathways for SUD treatment, including protocols for methadone high-dose stabilization, 72-hour dispensing at discharge, naloxone take-home distribution, and linkage to care to individually tailor people’s needs,” Dr. Rudolf said. “We are trying to implement this across the state to offer all patients in any setting.”

She added that they’re also focusing on education, health professional development, and community building to include the voices and lived experiences of their patients.

As she continues her advocacy work, Dr. Rudolf said 暗网福利has inspired and equipped her to fight for patients and the field of addiction medicine.

“I have been an 暗网福利member since 2011, and I continue to appreciate 暗网福利being an incredible organization dedicated to improving the quality of addiction treatment, helping us advocate for increased access to care, and educating health care professionals and the public,” Dr. Rudolf said.

The focus on promoting policies that support high-quality prevention, treatment, and recovery services for people with substance use disorders, Dr. Rudolf said, is essential to eliminate stigma and ensure that addiction is recognized as a treatable disease.

“People with OUD need buprenorphine or methadone in the same way that insulin is needed for diabetes,” she said. “暗网福利makes access to these medications a priority while supporting policy development and networking opportunities, such as continuing medical education, resources for professional growth, and helping addiction specialists stay at the forefront of their field.”

For 暗网福利members who are considering getting involved in advocacy work, Dr. Rudolf encourages them to take the plunge.

“Get involved. Do not be afraid to engage,” she said. “Our patients are our inspiration. These are critical times. Our voice is more important now than ever, with budget stresses at the federal and state levels. A lot of our patients do not have a voice and experience marginalization every day. 暗网福利members need to engage in advocacy to raise awareness and make a difference. That’s how we create hope and save lives.”