Addiction physician

Addiction medicine is a cross-disciplinary medical field that studies and treats the full range of dependency behaviours. It encompasses addictions involving psychoactive substances, including alcohol, tobacco, cannabis, cocaine, opioids and misused medication, as well as behavioural addictions without substances, such as gambling, screen and video-game addiction, internet addiction and compulsive shopping. Addiction is now scientifically recognised as a chronic disorder of the brain’s reward system, characterised by a persistent loss of control despite awareness of the adverse consequences for health, finances and emotional life.

The approach taken by an addiction specialist is fundamentally different from punishment or blame. The practitioner uses motivational interviewing to assess where the person stands in their desire for change, following Prochaska’s model. They quantify dependence using validated clinical tools and assess its effects on the body, including the liver, nervous system and cardiovascular system. Care may aim either at immediate, complete cessation or at a controlled, gradual reduction in use as part of harm reduction. Where physical dependence is severe, the doctor prescribes treatments to support withdrawal, such as nicotine replacements, opioid substitution treatments or anti-anxiety medication to prevent delirium tremens, safeguarding the body during the transition.

Attempting to stop an addictive substance alone carries a risk of potentially dangerous withdrawal syndromes and a high relapse rate due to craving: an overwhelming urge to use, triggered by stress or an environmental cue. The addiction specialist helps the patient understand their emotional triggers, reorganise their lifestyle and find healthy new sources of satisfaction. They often coordinate follow-up with psychologists, mutual support groups and social workers to consolidate reintegration across all areas of life.

The addiction specialist regards relapse as a common stage in learning to stop, rather than a moral failure. They teach the patient to recognise early warning signs and draw on contingency coping strategies. They work with patient associations, treatment centres and supported accommodation services to ensure stable reintegration.