An addiction psychiatrist is a doctor who specialises in addiction and in the mental health conditions that can come with it. They look at your physical and mental health before deciding what care you need. Where necessary, they diagnose conditions and prescribe medication.
Not all addiction treatment involves a psychiatrist, and many centres have a part-time psychiatrist on the team, or consult one only when needed.
At Castle Craig, a psychiatrist is a full-time part of the team from the start. They review every patient’s file shortly after admission, including current prescriptions and diagnoses. An on-site psychiatrist helps most when someone has a mental health condition and an addiction together. Each can get in the way of treating the other.
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What is an addiction psychiatrist?
A psychiatrist is a medical doctor who has trained in mental health. An addiction psychiatrist has gone on to train further in addiction psychiatry, a recognised specialism within psychiatry.
That’s a different role from psychologists, counsellors and therapists, who work mainly through talking. Because they aren’t medical doctors, they can’t prescribe medication the way a psychiatrist can.
The Royal College of Psychiatrists is the professional body for psychiatrists in the UK. It describes the work of an addiction psychiatrist as helping people stop or reduce their dependence on a substance or behaviour, and then maintain their healthier lifestyle.
People with addiction can have physical illnesses too, whether or not the addiction caused them. An addictions psychiatrist needs a good knowledge of physical health and of treatments for both the mind and the body. The Royal College adds that the work can affect the lives of carers as well as patients.
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How does addiction psychiatry differ from general psychiatry?
Not every doctor who treats addiction has the same training. In 2014, Public Health England and two medical royal colleges set out three levels of doctor, from generalist to specialist.
At the specialist level are consultant psychiatrists recognised by the General Medical Council, and GPs with extra training. Doctors who train as addiction psychiatrists spend about a year of their higher training in addiction psychiatry.
Generalist doctors can treat addiction, but they need a specialist’s supervision for complex cases. The most severe cases, and leadership roles such as supervising other doctors, are for specialists alone. Addiction psychiatry draws on general psychiatry, psychology and general medicine.
What does an addiction psychiatrist do during treatment?
Whether you need a psychiatrist for drug addiction or alcohol addiction, the work starts with an assessment. An addiction psychiatrist uses it to find out what’s going on, including any mental health conditions that come with the addiction, and gives a diagnosis where one applies.
If you need medication, the psychiatrist prescribes it and keeps managing it as treatment goes on. Guidance on the role of addiction specialist doctors adds that their work includes assessing the risk of suicide and harm to others, and prescribing safely when someone’s needs are complicated.
In the NHS, a key part of the job is giving clinical advice and guidance to the other professionals and services involved in addiction treatment. In a treatment centre, the psychiatrist gives the same advice to the rest of the team.
That guidance also says specialist doctors can oversee the therapy and support around treatment. Some psychiatrists have trained in psychotherapy too, and run therapy sessions themselves.
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What is dual diagnosis, and why does it change the treatment approach?
Dual diagnosis means having a mental health condition and an addiction at the same time. Commonly, this can include ADHD and PTSD.
According to the Department of Health and Social Care and NHS England, drug, alcohol, and mental health challenges often happen together and ought not be treated separately. People with both can find that services often fail to meet their needs and struggle to make use of the support available.
Treatment has to look at both from the start. For alcohol, guidance from the National Institute for Health and Care Excellence (NICE) says to assess mental health conditions as part of any full assessment, and use the results in the care plan. This is since many of these conditions, though not all, improve with treatment for the substance dependecny.
Without an addiction psychiatrist, a mental health condition can go unnoticed or get treated apart from the addiction. At Castle Craig, the psychiatrist treats the two together as part of our evidence based addiction treatment.
I came to Castle Craig not really knowing if anything could change for me, and I’m leaving with a sense of hope I hadn’t felt in a long time. I’ll always be grateful to the staff and the place itself for giving me the chance to find my way back to myself and build a better me.
When should someone see an addiction psychiatrist?
You might want to see an addiction psychiatrist if:
- Your addiction is long-term or complicated.
- You have a history of mental health conditions.
- Treatment in the past wasn’t enough.
- You suspect there’s a mental health condition that nobody has diagnosed.
When it comes to alcohol use disorder specifically, NICE notes that people with a significant mental health condition and/or those assessed to be at high risk of suicide should be referred to a psychiatrist.
If you’re having thoughts of suicide, you can call Samaritans free on 116 123 at any time, or 999 in an emergency.
If you see a psychiatrist for addiction, you’ll start with an addiction psychiatry assessment. For drugs, the UK guidelines state this assessment should include identifying the degree of challenge, use or dependence, and physical or mental health challenges.
How Castle Craig’s psychiatrist-led model works in practice
UK guidelines don’t require a psychiatrist in every care plan, so how involved one is varies from place to place. If you’re comparing rehabs, ask whether the psychiatrist specialises in addiction, and whether they look at your file early in your stay.
Castle Craig’s Medical Director, Dr Peter McCann, is a psychiatrist with a specialist qualification in addiction. In drug rehab, as elsewhere at Castle Craig, a psychiatrist reviews every patient’s file shortly after admission, looking at current prescriptions and diagnoses, and may meet with you.
Addiction treatment comes from a multidisciplinary team that Dr McCann leads, overseeing the care of every patient. If you have complex needs, such as a mental health condition alongside the addiction, the psychiatrist helps plan your ongoing care. If you stay beyond six weeks, you join our Advanced Programme. This extra time can help if you have underlying mental health problems or a history of trauma.
Find out more about our treatment approach
If someone you know is entering treatment
When your family member or friend arrives at Castle Craig, our nurses and resident doctor assess them first. They stay in our admissions unit while that assessment happens.
Once the team judges them safe, they move to the Castle or the Recovery Gardens for the rest of their treatment. If the assessment finds a mental health condition alongside the addiction, the psychiatrist helps plan that part of their care too.
You can be involved as well. Our family programme is part of residential treatment, and later in their stay, their main therapist will talk with them about how and when to involve family members in some sessions.
If you don’t take part in family therapy, you can join an online workshop, included in the cost of treatment.
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74%
Data from the Office for Health Improvement and Disparities shows that 74% of adults starting drug and alcohol treatment in England said they had a mental health treatment need.
Frequently asked questions about addiction psychiatrists
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Can an addiction psychiatrist prescribe medication for withdrawal symptoms?
Yes, a psychiatrist for alcohol addiction and drug addiction can prescribe medicine to help you through withdrawal. Stopping alcohol or some drugs suddenly can be dangerous, so get medical advice before you stop. At Castle Craig, medical staff manage detox, and the wider team helps make prescribing decisions.
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How much does an addiction psychiatrist cost?
A private psychiatrist in the UK usually charges between £350 and £800 for a first assessment. The price depends on the psychiatrist’s seniority and where they practise. Those figures cover private psychiatry in general. At Castle Craig, a psychiatrist’s review is part of treatment and included in the cost. Our admissions team can explain what treatment costs.
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Is there a difference between a psychiatrist and a psychologist in addiction treatment?
Yes, a psychiatrist is a doctor, so they can prescribe medication and look at your physical health as well as your mental health. A psychologist is trained in how people think and behave, and usually works through therapy.
