Understanding Addiction: A Complex Condition

Substance use disorders (addiction) are complex conditions involving compulsive drug or alcohol use despite harmful consequences. Research indicates that addiction involves changes in the brain's reward system (dopamine pathways), motivation circuits (nucleus accumbens, prefrontal cortex), learning and memory systems (hippocampus), and stress response systems (HPA axis). It's not simply a matter of willpower—it's a neurobiological condition that requires comprehensive treatment addressing biological, psychological, and social factors.

When I evaluate patients with substance use disorders, I'm assessing multiple systems: patterns of use, withdrawal symptoms, tolerance, impact on functioning, co-occurring mental health conditions, underlying trauma or stress, and factors that may contribute to substance use. Addiction often co-occurs with other mental health conditions, a situation known as dual diagnosis or co-occurring disorders.

Common co-occurring conditions include depression, anxiety, PTSD, bipolar disorder, and ADHD. When mental health conditions and substance use disorders occur together, they often interact, making each condition more challenging to treat. According to the National Institute of Mental Health, approximately half of people with a substance use disorder also have a co-occurring mental health condition. Integrated treatment addressing both conditions simultaneously is essential for recovery. If you're experiencing co-occurring conditions, see our pages on depression treatment, anxiety treatment, PTSD treatment, or bipolar disorder treatment.

An Integrative Approach to Addiction Treatment

Effective addiction treatment requires a comprehensive approach addressing the biological, psychological, and social aspects of addiction. Research indicates that addiction involves changes in multiple brain systems: reward pathways (dopamine), stress response systems (cortisol, HPA axis), executive function (prefrontal cortex), and memory systems (conditioned responses). Medication-assisted treatment (MAT) can be helpful for certain substance use disorders, but it's most effective when combined with psychotherapy, lifestyle changes, and support systems. Learn more about how psychiatrists safely combine psychotherapy and medication.

When I work with patients with substance use disorders, I'm addressing these systems comprehensively. My approach includes:

Comprehensive Evaluation: Thorough assessment of substance use patterns, mental health symptoms, medical history, and psychosocial factors contributing to addiction
Dual Diagnosis Treatment: Integrated treatment addressing both substance use disorders and co-occurring mental health conditions simultaneously
Medication-Assisted Treatment (MAT): When appropriate, medications such as naltrexone, acamprosate, or buprenorphine may support recovery from alcohol or opioid use disorders
Psychotherapy: Evidence-based psychotherapeutic approaches including motivational interviewing, cognitive-behavioral therapy, and relapse prevention strategies
Addressing Underlying Factors: Treatment of co-occurring mental health conditions, trauma, stress, and other factors that may contribute to substance use
Lifestyle Support: Attention to sleep, nutrition, stress management, and building a life that supports recovery
Recovery Planning: Development of strategies to prevent relapse, build support systems, and maintain long-term recovery

Recovery from addiction is possible, but it's often a process involving setbacks and learning. Treatment provides support, tools, and strategies to navigate this process and build a life that supports sobriety.

Dual Diagnosis: Addressing Co-Occurring Conditions

When substance use disorders co-occur with mental health conditions, integrated treatment is essential. Treating one condition while ignoring the other often leads to poor outcomes. Common scenarios include:

Using substances to self-medicate symptoms of depression, anxiety, or trauma
Substance use triggering or worsening mental health symptoms
Shared underlying factors (genetics, trauma, stress) contributing to both conditions
Substance use and mental health conditions interacting in complex ways

Integrated treatment addresses both conditions simultaneously, recognizing how they interact and developing strategies to manage both effectively. This may involve medication for mental health conditions, medication-assisted treatment for substance use, psychotherapy addressing both, and lifestyle changes supporting overall recovery.

What to Expect in Treatment

Your initial evaluation is comprehensive—typically 90 minutes—allowing time to understand your substance use patterns, mental health symptoms, and treatment goals. We develop a collaborative treatment plan addressing both substance use and any co-occurring mental health conditions.

Treatment typically involves a combination of medication management (for mental health conditions and, when appropriate, medication-assisted treatment for substance use), psychotherapy, and lifestyle support. Recovery is a process, and treatment provides ongoing support as you navigate this process.

The goal is not just abstinence—it's building a life that supports recovery, addressing underlying factors contributing to substance use, and developing strategies to maintain long-term sobriety and mental health. Recovery is possible, and many people achieve significant improvement with appropriate, integrated treatment.

Serving Los Angeles Area

I provide adult addiction treatment to patients throughout Los Angeles County, including Hollywood, Beverly Hills, Santa Monica, West Hollywood, Burbank, Glendale, Pasadena, and surrounding areas. The practice is located in Hollywood and offers both in-person and telepsychiatry visits for adults throughout California.

If you're struggling with substance use or have a co-occurring mental health condition, know that effective, integrated treatment is available. Recovery is possible with appropriate care.

References & Resources

For additional information about addiction and dual diagnosis, I recommend these authoritative sources:

Contact us to schedule a consultation or learn more about our approach to addiction treatment.