Addiction Medicine program launched

SYRACUSE, N.Y.— Upstate Medical University is using the neuroscience-based psychodynamics of addiction as a blueprint for a program to help patients break their cycle of alcohol or drug abuse.

Upstate's Addiction Medicine program, offered by Upstate's Department of Psychiatry and Behavioral Sciences, uses a culturally competent and individualized system of care to help a patient better understand the addiction and manage its effects.

"The care we offer is delivered by physicians and other medical providers who understand how drugs change the brain and what to do about it," said Brian Johnson, M.D., director of the addiction program and associate professor of psychiatry and behavioral sciences, and anesthesia at Upstate. The program enhances consciousness of addiction and addresses how denial works in each patient added Johnson.

"Prescription addiction is a significant and growing problem," he said. "Our program has a holistic multidisciplinary pain service staffed by pain fellows and psychiatry residents. Patients take over the leadership of their own recovery, aided by a combination of medications such as anti-inflammatory drugs and procedures such as blocks of nerves that give dysfunctional pain signals," he said.

A Sober Support Person (SSP) who is either a family member of a friend must accompany participants who are using drugs and alcohol.

"A fundamental nature of addiction is the inability to tolerate relationships and the feelings that arise within relationships," Johnson said. "The SSP model helps the participant to learn to depend on people rather than drugs to address these issues. This model also provides the SSP with skills to effectively help the addicted participant."

A unique aspect of the program is the ability to treat the classic dual diagnosis patient who does not fit comfortably in either psychiatric or addiction programs. "We use safe outpatient detoxification with the SSP given some responsibility for monitoring withdrawal symptoms and helping with medications," Johnson said. "Alcohol and urine drug screens are not done as the treatment is based on the withdrawal symptoms observed and not on the history or urine results."

During detoxification, the patient, SSP and psychiatrist make a plan together, with parameters for calling the psychiatrist, who is available 24 hours a day/seven days a week. The patient continues in treatment daily until both the withdrawal syndrome has ended, and the patient is judged stable enough to tolerate a lower intensity of care.

Participants must arrive in withdrawal from alcohol, opioids or benzodiazepines and must be sober. Patients with acute medical conditions are referred to Upstate University Hospital's Emergency Department.

Outpatient extended evaluation and referral services are also provided through the program. "We are a neuropsychoanalytic psychiatric service, so we are organized to understand both the brain changes that have been created by addictive drugs or alcohol, and the underlying issues that contribute to addictive illness," Johnson said. "Every patient is screened for depression and has a cognitive examination because drugs and alcohol cause such frightening changes in one's ability to think."

For more information, call 315-464-3130.