Edwin C. Chapman, Sr., M.D. has practiced in Washington, D.C. for 40 years specializing in Internal Medicine and Addiction Medicine. He currently as an adjunct assistant professor in the Howard University Department of Behavioral Health and Psychiatry and maintains an active practice in the community investigating the complex mix of addiction, under-treated mental illness, infectious diseases (AIDS & hepatitis C), criminal behavior, and chronic diseases in which patients have 20-25 years shorter life expectancies. Using an innovative "virtual office telemedicine design," he is addressing the needs of opioid addicted index patients and their entire families recognizing the impact of addiction as a "social determinant of health" and a factor leading to "toxic stress" in both family and community-wide settings. He continues that work, augmented by empirical observations, with the Howard University National Human Genome Center and Howard University School of Pharmacy currently investigating the generic and epigenetic factors impacting the metabolism of buprenorphine. In 2016 those initial efforts resulted in changes in dosing parameters and prior authorization recommendations for many Medicaid patients in the District of Columbia.