What is an Addiction Psychiatrist?

Addiction PsychiatristAddiction psychiatrists are medical doctors with general psychiatry training, as well as additional training in diagnosing and treating people with addictions. The most common types of addiction include alcohol and drug addiction, including addiction to nicotine. But addiction psychiatrists may also treat people with other addictions, such as gambling or sex addiction. 

To treat addiction, addiction psychiatrists may prescribe medications and provide psychotherapy. In some cases, they may also admit people to the hospital or outpatient programs for treatment. They may also diagnose and treat people with other mental health issues, in addition to addiction. To become certified as addiction specialists, they usually complete a residency or fellowship in addiction medicine, following their general medical and psychiatry training. In the US, they can be board certified by the American Board of Addiction Medicine or the American Board of Psychology and Neurology.

People can become addicted to a variety of substances; possible dependencies that you might study as an addiction psychiatrist include drug, alcohol and nicotine addictions.

Drug and Alcohol AddictionsAddiction psychiatry deals with treatment methods for those living with drug and alcohol addiction. Treatment can be problematic, because when people are under the influence of drugs, their brain chemistry becomes altered. If you become an addiction psychiatry researcher, you'll attempt to find new molecular compounds that interact with natural chemicals in the brain to curb the cravings for particular drugs.

You'll also learn how patients can benefit from community-based groups like Alcoholics Anonymous. Addiction psychiatrists can treat both adolescents and adults, as well as people with health complications related to their addiction, such as HIV, hepatitis and infections. If you enter addiction psychiatry, you'll explore the reasons behind a person's substance abuse problem, such as depression, trauma, stress or strained family life. You'll also study the genetic components behind patients' predispositions to certain addictions.

Other Substance Abuse AddictionsAddiction psychiatrists don't just treat people's addictions to alcohol and illicit substances. New research is being conducted on medical and psychotherapy solutions for those looking to combat nicotine addiction. If you become an addiction psychiatrist, you might explore ways to prevent relapses after patients attempt to cut their nicotine consumption.

Another growing problem in the population is prescription drug addiction. Addiction psychiatrists must be wary of prescribing medications for these dependencies and instead look at other treatment options, such as counseling or behavior modification therapy.

What Treatments Do Psychiatrists Use?

Psychiatrists use a variety of treatments – including various forms of psychotherapy, medications, psychosocial interventions and other treatments (such as electroconvulsive therapy or ECT), depending on the needs of each patient.

Psychotherapy, sometimes called talk therapy, is a treatment that involves a talking relationship between a therapist and patient. It can be used to treat a broad variety of mental disorders and emotional difficulties. The goal of psychotherapy is to eliminate or control disabling or troubling symptoms so the patient can function better. Depending on the extent of the problem, treatment may take just a few sessions over a week or two or may take many sessions over a period of years. Psychotherapy can be done individually, as a couple, with a family, or in a group.

There are many forms of psychotherapy. There are psychotherapies that help patients change behaviors or thought patterns, psychotherapies that help patients explore the effect of past relationships and experiences on present behaviors, and psychotherapies that are tailored to help solve other problems in specific ways. Cognitive behavior therapy is a goal-oriented therapy focusing on problem solving. Psychoanalysis is an intensive form of individual psychotherapy which requires frequent sessions over several years.

Most medications are used by psychiatrists in much the same way that medications are used to treat high blood pressure or diabetes. After completing thorough evaluations, psychiatrists can prescribe medications to help treat mental disorders. Psychiatric medications can help correct imbalances in brain chemistry that are thought to be involved in some mental disorders. Patients on long-term medication treatment will need to meet with their psychiatrist periodically to monitor the effectiveness of the medication and any potential side effects.

Class of Medications

Antidepressants – used to treat depression, panic disorder, PTSD, anxiety, obsessive-compulsive disorder, borderline personality disorder and eating disorders.
Antipsychotic medications – used to treat psychotic symptoms (delusions and hallucinations), schizophrenia, bipolar disorder.
Sedatives and anxiolytics – used to treat anxiety and insomnia.
Hypnotics – used to induce and maintain sleep.
Mood stabilizers – used to treat bipolar disorder.
Stimulants – used to treat ADHD.
Psychiatrists often prescribe medications in combination with psychotherapy.

Other treatments are also sometimes used. Electroconvulsive therapy (ECT), a medical treatment that involves applying electrical currents to the brain, is used most often to treat severe depression that has not responded to other treatments. Deep brain stimulation (DBS), vagus nerve stimulation (VNS), and transcranial magnetic stimulation (TMS) are a few of the newer therapies being used to treat some mental disorders. Light therapy is used to treat seasonal depression.

What are the Requirements to Become an Addiction Psychiatrist?

Becoming an addiction psychiatrist takes many years of school. First you will need to attend and complete college, then medical school. Upon successful graduation from an accredited program, you will need to complete a residency in psychiatry. According to the American Psychiatric Association (APA), residents must complete 48 months (4 years) of psychiatric specific residency. After completing a residency in general psychiatry, you will need to complete one year of ACGME (Accreditation Council for Graduate Medical Education) accredited addiction psychiatry specific fellowship training.

New graduates must pass oral and written examinations for obtaining state medical license required to practice medicine, which can vary depending on the state in which you want to practice. It is wise to examine the requirements for your individual state while pursuing your education to make sure the classes and steps taken will help to support your career goals.

Certification in addiction psychiatry can be obtained through the American Board of Psychiatry and Neurology (ABPN), which is a branch of the American Board of Medical Specialties (ABMS). Only those who are board certified in general psychiatry will be considered for the sub-specialty certification in addiction psychiatry, upon meeting the educational, training, and other requirements.

Skills and Qualities
The skills that are valuable for those wishing to pursue addiction psychiatry includes both excellent written and verbal communication aptitude, as you will need to interact with a variety of individuals, from the clients themselves, to the family members and other medical professionals on the treatment team. Additionally, leadership and problem solving are essential in filling the role, as you will often be called upon to make big decisions that have the possibility of impacting another’s life. Being entrusted with such a responsibility requires clear thinking and keen analytical skills.

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