Addiction Medicine

Addiction has existed throughout the ages and throughout the world, but today in the US we consume 80% of the world supply of prescription opioids. I mostly treat people with opioid addiction (heroin, oxycodone, oxycontin, methadone, hydrocodone, hydromorphone, morphine), but many patients have mixed addictions with additional use of benzodiazepines (valium, librium, ativan, clonazepam, xanax etc), alcohol, barbiturates (Phenobarbital), methamphetamines (crystal meth), cocaine, and other substances.

The mainstay of treatment, in my opinion, has always been and will always be, in self-transformative work on the part of the person with addiction. I advise my patients to attend groups (AA/NA based or other types of group treatments), and as part of the program provide individual counseling during each visit to address every aspect of life related to the addiction.

I do prescribe buprenorphine as a crutch, a temporary measure that gives an addict a period of stability (relief of withdrawal and cravings) to start on the road of recovery. This medication can be a blessing and a curse. It serves a useful function for persons who genuinely accept to undergo a profound self-transformative work. And it gives false reassurance to those who hope to get away without such work. To have more information about buprenorphine, read the document that I put together.

Initial consultation for the treatment of addiction is to evaluate the appropriateness of treatment, discuss options and formulate a plan. Generally speaking, patient needs to come in weekly during the first several weeks and occasionally daily for the first several days. Later visits are spaced out, but may need to become more frequent again at the time of taper. I do manage comorbid psychiatric illnesses when necessary, and have helped my patients to stop multi substance abuse and dependence.

Most insurances cover the treatment of drug addiction. For the uninsured, and those who do not wish to involve health insurances, I offer an affordable fee schedule.

In the attached article I share some if my more general views on the practice of "chronic pain management," long term adult ADD treatment, and anxiety treatment with long term benzodiazepine tranquilizers; I called this brief essay Too Much of a Good Thing.