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Alcohol and drug abuse are leading contributors to hospitalization
and prolonged length of stay. Subspecialty substance abuse care can
help:
- detect a suspected abuse problem
- assist family members
- confirm a diagnosis
- behaviorally manage a difficult case
- identify a dual psychiatric diagnosis
- make treatment recommendations
- conduct an intervention
- join or take over a patients care
- plan a detox regimen
- manage concurrent pain or pregnancy
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The Addiction Psychiatry Service was developed to meet clinical, education
and research objectives with respect to substance abuse within a central
coordinated program. The Addiction Psychiatry Service assists clinicians
in improving identification, behavioral management and referral of
substance abusing patients through readily available consultation,
active liaison to high incidence areas and facilitation of post-discharge
follow-up care.
The Addiction Psychiatry Service coordinates and promotes a variety
of hospital-wide educational programs and training opportunities.
The Service assists all inpatient units, clinical services and departments
in meeting the core training and educational needs necessary to manage
substance abuse effectively within the hospital. Educational content
is developed in accordance with the specific educational needs of
individual units and disciplines.
Specifically, the Addiction Psychiatry Service is responsible for
assisting hospital clinicians to improve:
1. identification of substance abusing patients by:
- encouragement of more adequate history taking, using brief assessment
tools
- increased case-finding resulting from active liaison to high incidence
units such as Burn-Trauma, OB, ED, General Medicine and Orthopedics
2. compliance with accepted standards of clinical care for inpatient
substance abuse management (of withdrawal, intoxication, in-hospital
drug use, etc.)
3. utilization of specialized medical and psychiatric expertise for
cases of substance abuse complicated by concurrent conditions such
as pain, pregnancy and/or mental illness
4. referral to self-help groups in the Longwood Medical area for patients
while in-hospital
5. access to substance abuse treatment services following discharge,
through liaison and referral relationships with community agencies.
Outpatients are also evaluated by the Addiction Psychiatry clinicians.
Though we do not offer ongoing treatment for patients with substance
abuse issues, we can assess them, refer them for treatment elsewhere
and help outpatient staff in monitoring and managing their patients.
MGH ADDICTION SERVICES
Clinical Director: Patrick L. Lillard, M.D.
(plillard@partners.org)
Director: David R. Gastfriend, M.D. (dgastfriend@partners.org)
The MGH Addiction Services program offers general hospital consultation,
outpatient care, ambulatory detoxification and ongoing clinical research.
Any House Officer may a request a consultation for any patient among
the medical and surgical beds, the inpatient psychiatry unit or the
Emergency Department.
Consults are provided in a team model, consisting of staff and fellow
addiction psychiatrists as well as addictions specialists, who are
masters-degreed addiction counselors with a dedicated intake and referral
role, and who also offer consultation, placement, connection to self-help
groups, case management and longitudinal patient tracking.
The outpatient program. the West End Clinic. provides over 6,000 visits
annually. Outpatient treatment services include individual, couple,
family and group treatment. Modalities include psycho-education, individual
and group therapy, short- and long-term addictions counseling, ambulatory
detoxification and pharmacotherapies for addictions and for concurrent
psychiatric disorders. Any department or unit may call to request
help with substance abuse academic conferences, in-service or case
conferences.
Patients may also be referred for NIH-funded clinical studies of pharmacotherapies,
behavioral therapies, treatment and placement matching, treatment
motivation assessment and neuro-imaging/neuro-endocrine phenomena.
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