Addiction & Substance Use

We avoid a basic aspect of human existence-namely, we are all a little lost and not knowing, and we had better accept this. In reminding our patients that the worst fate in life is not to suffer-but to suffer alone-we also remind ourselves.

Half of all mental health disorders occur by age 14. Early interventions may mitigate progression to more serious and persistent mental health concerns.

Here, a psychiatrist certified by the American Board of Addiction Medicine discusses new treatment criteria for addiction.

Both the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry have identified substance abuse as a top risk factor for suicide in youths.

For patients with hepatic disease, benzodiazepines that are conjugated and renally cleared (eg, lorazepam) should be used instead of those metabolized by the liver. Take the quiz and learn more.

In a new study, "as needed" use of an opioid antagonist for heightened alcohol craving appeared to reduce the number of heavy drinking days and total amount of alcohol consumed.

Calling all psychiatrists: we conducted a survey of your opinions about prescribing medical cannabis and invite you to view the results.

Impulse control disorders are common psychiatric conditions in which affected individuals typically report significant impairment in social and occupational functioning, and may incur legal and financial difficulties as well.

Are there differences in the neuroimaging of persons who just gamble and those who pathologically gamble?

A panel of experts at the APA Annual Meeting discussed how changes in DSM-5 may affect clinical practice. Highlights here.

A clinician’s notes and clinical records should document and defend treatment decisions, and are the best defense in court. Here: 3 key things every patient record should include.

Thinking about suicidal behavior as a diagnosable problem will help bridge the gap in how psychiatrists think about suicidality and how it is perceived by patients and their families.

Certain aspects of depression result from maladaptive stress-induced changes in reward circuits of the brain.

Which of the following complementary and alternative medicine (CAM) therapies may have beneficial effects on symptoms of mild cognitive impairment (MCI) and Alzheimer disease (AD)?

The Department of Psychiatry at the Mount Sinai School of Medicine and the James J. Peters Veterans Affairs Medical Center is seeking a faculty member in its Substance Abuse Services at the rank of Assistant Professor or Associate Professor to conduct clinical care and teaching in the field of addiction medicine. The position will be based at the James J. Peters Veterans Affairs Medical Center, a major affiliate hospital which serves as a training site for medical students, residents and an ACGME credited fellowship in addiction psychiatry. There are opportunities to join ongoing funded programs or to develop new research or academic initiatives.

Being a Therapist features intimate portraits of psychotherapists in their own work spaces. An excerpt of his interview with Otto Kernberg, MD, follows.

The poorly conceived DSM-5 Somatic Symptom Disorder substitutes a false psychiatric certainty that misleadingly covers medical uncertainty about the appropriate diagnosis. It is better to admit what we don't know than cover it with meaningless labels.

Has the Mental Health Parity and Addiction Equity had any real impact on your ability to provide care to patients, or are you experiencing the shells and mortars of paperwork and denials? And will the average patient ever really benefit from the laws, or were they just passed to make the country feel better about the state of psychiatric care in the US?

Psychiatrists need to understand how living in violent families and neighborhoods increases the likelihood of trauma and the psychiatric sequelae associated with it as well as how to respond in the aftermath.

The ethical aim of psychiatry is the relief of suffering and incapacity.

Psychiatrists vary in their eagerness to share therapeutic decisions with patients: some believe that adherence is paramount and paternalism is often necessary to prevent loss of insight with consequent impaired judgment and functional decline. These authors argue in favor of a radically more collaborative style.

Plaintiffs in this lawsuit claim that CPT coding policy has resulted in decreased reimbursement for psychiatrists, who will now receive 20% less for evaluation and management services than what Anthem pays other physicians.

While the diagnostic categories of DSM-III and DSM-IV (and soon DSM-5) have provided the basis for much useful research, little has been written about how much of DSM-and how much “evidence-based medicine”-is built on a foundation of fantasy.

Changes will mean patients will only be covered for psychiatrists’ services that include medical evaluation and management; CPT coding will not allow for coverage of psychotherapy as a separate and equal category for payment.

Frame analysis can not only help us to discern the roots of such standoffs but also to conceptualize specific ways of addressing the conflicts in therapeutic language with the patient, with the goal of forging an integrated approach to treatment.