Addiction Psychiatry

Addiction psychiatry is a medical subspecialty within psychiatry that focuses on the evaluation, diagnosis, and treatment of people who are suffering from one or more disorders related to addiction. While focused mainly on alcohol, substance abuse and addiction, it also considers disorders involving legal and illegal drugs, gambling, sex, food, and other impulse-control disorders.

Addiction psychiatrists are trained substance abuse experts who are in a unique position to identify concurrent psychiatric and substance-use problems in individuals seeking treatment for either or both conditions. Given the reciprocal effect of psychiatric and substance use disorders, there is a critical need for specialists trained in the diagnosis and treatment of both conditions.

The increasing amount of scientific knowledge on the health effects and potential treatment of substance abuse has led to advancements in the field of addiction psychiatry. These advancements in understanding the neurobiology of rewarding behaviour allowed many opportunities for research in addiction psychiatry.

Addiction psychiatry is still an expanding field. Currently, there is a high demand for substance abuse experts in both the private and public sector.

What Is Addiction Psychiatry About?

Addiction psychiatry aims to treat individuals with addiction issues along with co-occurring psychiatric disorders, otherwise known as patients with dual diagnosis. Addiction psychiatrists treat a wide variety of patients of all ages with varying conditions. Each case of addiction is unique, and professionals recognise the numerous factors that tie into each individual’s struggle. For example, substance abuse often occurs among individuals dealing with mood disorders and other forms of social stress.

Addiction psychiatrists are able to recognise, diagnose, and treat the disorders, concurrently with the related substance abuse issues. Furthermore, addiction psychiatrists also recognise certain health effects from illicit drugs, in order to properly treat each individual.

Addiction psychiatry encompasses both medicine and psychotherapy, or professional therapeutic interaction, as a means of treating individuals. However, not all types of substance addiction contain approved medication for treatment. In a conventional addiction psychiatry session, addiction psychiatrists will gain a better understanding of their patient’s lifestyle, by gathering medical history and the patient’s mental health concerns.

Next, the psychiatrist will construct different possible solutions to the patient’s problem. If necessary, addiction psychiatrists will prescribe medication. Moreover, these experts recommend the benefits of 12-Step programmes, such as Narcotics Anonymous and Alcoholics Anonymous, and often encourage patients to seek external support.

Addiction psychiatry can also be a method of recovery for those who have attempted to cease their drug or alcohol abuse without prior success.

With the recent explosion in scientific knowledge in the area of substance abuse, growing sophistication in our understanding of the factors that contribute to substance use disorders has led to therapeutic strategies tailored to specific subgroups of substance abusers. Novel pharmacological strategies have been developed and are being implemented to target individuals for whom effective, attentional, or anxiety symptoms pose a particular risk of vulnerability to the development of substance abuse or dependence.

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Addiction Psychiatrists – Who Are They? What Do They Do?

Addiction psychiatrists are physicians, meaning they hold either an M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathic Medicine). They specialise in all the potential effects of addiction on the brain and body, working through evaluation, diagnosis, and the treatment of patients to help them heal. Since many addicts experience co-existing mental illnesses simultaneously, addiction psychiatrists must have a strong knowledge in all areas of psychiatry.

A combination of extensive medical preparation, coupled with a wide understanding of psychology and mental health, is what enables psychiatrists to excel in their field. Addiction psychiatrists hold even greater expertise in the areas of recovery, prevention, identification, and treatment of substance abuse.

In their day-to-day practice, addiction psychiatrists may be responsible for:

  • Counselling patients
  • Reviewing and updating patient records
  • Creating individual recovery/care plans, including for the prescription and administration of medication
  • Running and evaluating diagnostic and laboratory tests
  • Group therapy
  • Interventions/Working with the families of patients
  • Developing and conducting research

How Qualified Are Addiction Psychiatrists?

In order to become a certified addiction psychiatrist, one must first have completed medical school, and further, be certified as a general psychiatrist. Next, general psychiatrists must commit themselves to residency in addiction psychiatry setting. The addiction psychiatry residencies are one-year programmes set in a hospital or clinical setting, where general psychiatrists learn how to diagnose and treat substance use disorders, as well as potential coexisting psychiatric disorders. After completing one of these residency programmes, addiction psychiatrists are then capable of being hired in either a private or public setting.

The educational path of an addiction psychiatrist can be summarised as:

  • Earn a bachelor’s degree
  • Complete a medical school programme
  • Complete a residency
  • Secure a license 
  • Become board certified. In order to become board certified in psychiatry, medical doctors must meet all of the following requirements:
  • Graduate from an accredited medical school approved by the World Health Organization (WHO).
  • Hold an unrestricted license to practice in at least one US state.
  • Complete required training in the psychiatry speciality.
  • Test for, and pass, the exam for the psychiatry speciality.
  • Complete a Fellowship in addiction psychiatry
  • Pass the Subspecialty Exam in addiction psychiatry
  • Continuing education

Psychiatrists should be aware that board certification, which is necessary for legal practice, must be renewed every 10 years. Continued education is required in order to renew certification, and credits for the psychiatric field must meet specific standards. Psychiatrists must complete 30 continued medical education credits in their speciality each year.

A Career in Addiction Psychiatry

There are ample job opportunities in addiction psychiatry. There is a shortage of specialists in this field, in many clinical settings, and psychiatrists trained in the treatment of substance abuse will have a range of attractive choices for a practice setting.

The patient population is underserved, so there is an increase in mandates for addiction treatment from both county and municipal governments and third-party or private payers leading to a demand for credentialed addiction specialists. So, multiple opportunities exist in both the public and private sectors.

Addiction psychiatry provides career opportunities in all fields. Particularly promising are child psychiatry, consultation/liaison psychiatry, and forensic psychiatry.

For psychiatrists interested in research, the substance abuse field offers a wealth of unexplored areas. Early-career psychiatrists, entering the field of substance abuse, will have a wealth of opportunities for pursuing research funding. Clinical research in the field of addiction psychiatry has obtained increased governmental funding in the past several years. This trend shows every promise of continuing, therefore, research psychiatrists working in the field of addiction psychiatry are in a position to reap the benefits of this enhanced support.

Addiction psychiatry is a complex profession, which requires an exceptional skill set. Stimulating both the left and right sides of the brain, psychiatry combines math and science-based medicine with behaviours and emotional-focused mental health treatments. This physician speciality can be emotionally taxing at times, but for individuals who are passionate about treating addiction and co-occurring mental illnesses, addiction psychiatry can offer a challenging and fulfilling career.

The Importance of Addiction Psychiatry

Similar to the treatment of other psychiatric disorders, clinical intervention for substance use disorders are effective. This work offers clinicians the opportunity to help patients lead productive, happier lives. Such clinical service is tremendously gratifying and brings many rewards.

Overwhelming data shows that treatment for addiction promotes less substance use, better psychological and physical health, and improved social functioning. Every case of addiction eradicated is a reduction in the number of those predisposed to committing a crime. Cost-offset analyses show clear long-term economic benefits to providing addiction treatment. So, society also benefits.

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