Addiction

Addiction and Substance Misuse Psychiatric Care

Why Seek a Psychiatrist for Addiction Treatment?

Frequently, addiction is not a stand-alone concern, and just offering medicine intervention for addiction is not adequate for long-term relief.

Mental Health Condition How it Relates to Substance Use Integrated Treatment
Depression Self-medicating to improve or ignore mood Antidepressant + sobriety support + therapy
Anxiety Self-medication to calm or ignore worry, may have rebound anxiety Anxiety + sobriety support + therapy
ADHD Self-medicating to improve focus, energy, concentration; impulsive “change of status” use ADHD treatment + sobriety support
Bipolar Disorder Risk-taking in mania;
self-medicating to alleviate depression or “anxiety”		 Mood stabilizers + sobriety support
PTSD/Trauma Substances to numb trauma symptoms, irritability, depression, to improve sleep, to “check out” Trauma therapy +/- medicine
+ sobriety support
OCD Substances may temporarily reduce or improve intrusive thoughts OCD treatment + sobriety support
Insomnia Substances may temporarily improve sleep Insomnia treatment + identifying and addressing underlying causes + sobriety support
Social/performance anxiety Substances to “tolerate” anxiety related to social situations or
performance-related anxiety		 Treat anxiety with therapy +/-medicine + sobriety support

Integrated treatment matters. Without identifying and treating the co-occurring mental health illness(es), long term sobriety is challenging at best and realistically unlikely.

Our treatment strategies include:

  • Comprehensive psychiatric evaluation
  • Substance use history and patterns
  • Co-occurring mental health screening
  • Medical history and medicine review
  • Safety planning including withdrawal assessment
  • Support evaluation

Modalities may include:

  • Medication assisted therapy with:
    • Buprenorphine (suboxone, sublocade) for opioid use disorder
    • Naltrexone (Vivitrol) for alcohol or opioid use disorder
    • Acamprosate for alcohol use disorder
    • GLP-1 medicines (off label-Ozempic, Zepbound) when appropriate
  • Treating Co-Occuring Conditions:
    • Antidepressants and anti-anxiety medicines for depression, anxiety, PTSD, OCD
    • ADHD medicines when appropriate to facilitate and maintain recovery
    • Mood stabilizers for bipolar disorder and some types of PTSD
    • Sleep medicines for insomnia
  • Collaborative Care with:
    • Individual therapists
    • Support groups (AA, NA, SMART, Celebrate Recovery)
    • Intensive outpatient programs when warranted (IOP, PHP)
    • Primary care physicians and other specialists for overall health
    • Family members (with permission) for support establishment
  • Ongoing Support
    • Regular visits for medicine management
    • Crisis planning and intervention
    • Long-term relapse prevention strategies

If addiction concerns are chasing you, please consider reaching out and letting us partner with you on a path to genuine and lasting recovery.