Effective Addiction Treatments are Available

By John Renner, MD and Frances Levin, MD

We are all saddened by the death of Philip Seymour Hoffman and the many other individuals who have died because of overdoses of heroin or pain medications.  For all of those individuals who struggle with opioid use problems, it is important to realize that help is available and that effective treatment can restore them to productive lives.  Some 4.7 million people in the U.S. have used heroin at least once in their lives.  It is estimated that nearly a quarter of people that use heroin become dependent on it.

Whether it be through mutual support programs such as NA, long-term residential treatment, or addiction pharmacotherapy with buprenorphine, methadone or ER naltrexone, no individual need fear that their condition cannot be treated.  Friends and family members also need to be educated in the use of intra-nasal naloxone for the reversal of opioid overdoses.  

APA has long fostered the development of addiction focused training programs for psychiatrists.  Many psychiatrists have been specifically trained to provide office-based addiction pharmacotherapy and to manage the co-occurring psychiatric disorders that often complicate recovery from substance use disorders.  

More information:

·         Information on addiction
·         Opioid Overdose Prevention Toolkit (SAMHSA)
·         Substance use treatment locator (SAMHSA)
·         Buprenorphine Physician and Treatment locator (SAMHSA)
·         For psychiatrists:  Providers Clinical Support System for Medication Assisted Treatment

Blog contributors:

John Renner, MD

Member, APA Council on Addicition Psychiatry (Past Chair)
Director of Addiction Fellowship Program,
Professor of Psychiatry,  Boston University School of Medicine
Associate Chief of Psychiatry, VA Boston Healthcare System

Frances Levin, MD

Chair, APA Council on Addiction Psychiatry
Kennedy-Leavy Professor of Psychiatry, Columbia University Medical Center
Director, Addiction Psychiatry Fellowship,
New York Presbyterian Hospital
New York State Psychiatric Institute

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What to expect for your first visit with your psychiatrist

By David Goldsmith, M.D., & Arshya Vahabzadeh, M.D. Follow @VahabzadehMD
Resident Psychiatrists, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine

Your Psychiatrist’s Training

A psychiatrist is a physician who is specially trained to diagnose and treat people who are experiencing a wide range of issues, from emotional distress to more severe mental health concerns. People may make their first appointment to visit a psychiatrist when they are having difficulties at work, in relationships, or even as a result of medical conditions. These patients could be experiencing many different symptoms including sadness, lack of energy, anxiety, or mood swings. Other symptoms could include problems with sleep, memory, or appetite. In some circumstances, the symptoms may be much more severe and include hallucinations or suicidal thoughts.

Following medical school, a psychiatrist must undergo at least four years of residency training. He/she will spend that time seeing a wide variety of patients with different psychiatric and medical issues. Some psychiatrists may have additional expertise like treating children or people suffering from drug addiction.

Psychiatrists learn to understand and diagnose complex mental illnesses, including schizophrenia, depression, bipolar disorder, and anxiety. As such, psychiatrists are trained to realize that talking about some issues is quite difficult, so they know how to work with patients who can become very emotional or anxious.

Your First Appointment

The first appointment with a psychiatrist is often an initial evaluation, or intake visit, when the psychiatrist will want to get to know you and what difficulties you are experiencing. These appointments may vary in length but are typically between 40-90 minutes. Your psychiatrist will ask you what kind of issues are concerning you, and how are they affecting your life?

You will be asked about a range of symptoms, and how you have tried to cope with them. Your psychiatrist will want to know about any medical conditions you have now or had in the past. He or she will want to know about past visits with mental health professionals. Many medical and psychiatric conditions may run in families, and usually the psychiatrist will ask you about your family’s health history. They will also ask you about your current medications, both for medical and psychiatric conditions.

Once your psychiatrist has asked you these questions, he or she will make a plan with you and may recommend that you see a particular specialist or have some laboratory tests. Your psychiatrist may suggest a style of talk therapy (psychotherapy) or in some instances, suggest a medication to help with your symptoms.

Your doctor will likely schedule another appointment, so that you can discuss how the treatment plan is going and whether your symptoms have improved. It is very important to ask questions about anything you may not understand, or why you are being prescribed a certain medication or type of therapy. Your psychiatrist will be more than happy to answer your questions and explain things to you in more detail.

Tips for Your First Visit

• Write down a list of symptoms that you have been having if you feel you may forget to mention them.
• Bring along any medical or mental health records that you believe are important.
• It may help to bring a list of your medications.
• You can ask a friend or family member to come to your appointment if you feel that they can provide a unique perspective and make you feel less anxious.
• Always feel free to ask questions about the diagnosis and about any treatments offered.

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Where to go for Mental Health

By Sara Coffey, D.O.



Sara Coffey, D.O.



Trying to find the right doctor for you? With so many specialties and titles it can be confusing to navigate the complex array of mental health professionals. So, where do patients with mental illness start?

Understanding a doctors training and background may be the first place. Patients with mental illness may be seen by their primary care doctors, counselors, psychiatrists, or psychologists. But, what makes these professionals different? All physicians, either M.D.’s or D.O.’s (Osteopathic Doctors), have similar training. Most often, they have completed four years of undergraduate school, with an emphasis on science courses including biology and chemistry. Then they must pass an entrance exam to start a four-year medical school program where they will receive two more years of core science training as well as other courses to help them understand the human body, disease, and prevention. The last two years of medical school focus on clinical rotations through surgery, OB/GYN, psychiatry, internal medicine, family medicine, and include several months of extra training in a specialty area.

Upon completion of medical school, you are officially referred to as “doctor,” but a psychiatrist’s training does not end there. A residency program comes next with hands-on training under the guidance of a more seasoned physician. Take my background for example. As a psychiatry resident, my first year of residency training included two months working on an inpatient pediatric floor, two months on an inpatient general medical hospital floor, and two months on a neurology service. These rotations are important in psychiatry training because psychiatric patients often have other medical issues in addition to mental health problems. A physician should know the difference between anxiety and a heart attack.

It takes eight years or more of school and four to six years additional years of training to become a fully practicing psychiatrist. I’m on that path, and now I will be able to focus on my psychiatry specialty. That will give me the opportunity to learn the science and art of treating patients from experienced psychiatrists. My integrative medical training will also provide a solid foundation to work with a variety of patients and their mental illnesses.