Addiction medicine

Addiction medicine is a medical specialty that deals with the treatment of addiction. The specialty often crosses over into other areas, since various aspects of addiction fall within the fields of public health, psychiatry, and internal medicine, among others. Incorporated within the specialty are the processes of detoxification, rehabilitation, harm reduction, abstinence-based treatment, individual and group therapies, oversight of halfway houses, treatment of withdrawal-related symptoms, acute intervention, and long term therapies designed to reduce likelihood of relapse. Some specialists, primarily those who also have expertise in family medicine or internal medicine, also provide treatment for disease states commonly associated with substance use, such as hepatitis and HIV infection.

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Physicians specializing in the field are in general agreement concerning applicability of treatment to those with addiction to drugs, such as alcohol and heroin, and to gambling, which has similar characteristics and has been well described in the scientific literature. There is less agreement concerning definition or treatment of other so-called addictive behavior such as sexual addiction and internet addiction, such behaviors not being marked generally by physiologic tolerance or withdrawal.

Doctors focusing on addiction medicine are medical specialists who focus on addictive disease and have had special study and training focusing on the prevention and treatment of such diseases. There are two routes to specialization in the addiction field: one via a psychiatric pathway and one outside of psychiatry. The American Society of Addiction Medicine notes that approximately 40% of its members are psychiatrists while the remainder have received medical training in other fields.^[1]

Within the United States, there are two accepted specialty examinations.^[2] One is a Certificate in Added Qualifications in Addiction Psychiatry from the American Board of Psychiatry and Neurology.^[3] The other is a certificate from the American Society of Addiction Medicine following a peer-reviewed Board-type examination.^[4] The latter approach is available to all physicians, while the former is available only to board-certified psychiatrists.

References

In Vol. 2 of Psychedelic Medicine: New Evidence for Hallucinogens as Treatments Michael J. Winkelman and Thomas B. Roberts (editors) (2007). Westport, CT: Praeger/Greenwood. Chapter 1, Halpern, John H. "Hallucinogens in the Treatment of Alcoholism and Other Addictions," Chapter 2, Yensen, Richard, and Dryer, Donna, "Addiction, Despair, and the Soul: Successful Psychedelic Psychotherapy: A Case Study," Chapter 3. Calabrese, Joseph D. "The Therapeutic Use of Peyote in the Native American Church," Chapter 4. Alper, R. Kenneth, and Lotsof, Howard S. "The Use of Ibogaine in the Treatment of Addictions," Chapter 5. Krupitsky, Evgeny, and Kolp, Eli. "Ketamine Psychedelic Psychotherapy." Chapter 6. Mabit, Jacques. "Ayahuasca in the Treatment of Addictions".

1. ^ http://www.asam.org
2. ^ Schnoll et al: "Physician certification in addiction medicine 1986-1990: a four-year experience". J Addict Dis. 1993;12(1):123-33
3. ^ http://www.abpn.com/cert_subspecialties.htm
4. ^ http://www.asam.org/cert/cert_gf2.htm