Dual Diagnosis
Another group of patients I focus on in my practice are those individuals of any age who have combined substance use and psychiatric challenges. I have been interested in the way substances of abuse effect the brain since medical school when I wrote my thesis on the brain reward system. Compulsive patterns of drug and alcohol use as well as other compulsive behaviors are uniquely challenging to live with and to treat. I am a strong believer in twelve step programs and encourage patients to participate and work with a sponsor. This provides an aspect of treatment that simply cannot be offered in a doctor’s office: fellowship, mutual support from peers and honest confrontations. Quitting drugs and alcohol is surprisingly easy but staying stopped is extremely difficult. Group programs help with this problem better, in my experience, than any other type of treatment. Families generally must be involved for these treatments to be successful. When indicated I also offer pharmacologic remedies for drug cravings such as naltrexone or acamprosate. I do not offer buprenorphine treatments in my practice.