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    Supporting medical students and resident doctors in addictions psychiatry

    Here medical students and resident doctors in addictions psychiatry can find out more about the specialty and explore learning resources we've collated.

    Training in addictions psychiatry

    Through broad consultation among our members, we developed the following brief description of the role of an Addictions Psychiatrist:

    “We are medical doctors who have completed extensive training in psychiatry (including the use of mental health legislation) and addiction. In combining these skills, we have unique expertise in the management of addiction problems in complex cases, particularly co-morbid mental health problems.

    Our extensive knowledge extends to all aspects of addiction, including individual brain mechanisms, behaviour and its overall effect on the family, society and the economy. Combined with excellent communication skills, this enables us to offer a holistic approach that considers how biological, psychological and social factors impact on a person’s life and recovery journey.

    We are the clinical leads for addiction teams and bear the ultimate clinical responsibility for the people we see. Our training has prepared us for formal leadership roles enabling us to take on senior management positions within addiction teams, and to provide consultation on issues of service development, clinical governance, commissioning, public health, interpretation of research findings, training and evidence based practice.”

    See more about what it takes to be an addictions psychiatrist.

    Find out more in our training section, where you'll find information on curricula, exams, CPD and more.

    Addictions psychiatry learning resources

    These learning resources are for medical students as well as resident doctors.

    These resources have been collated to support students and resident doctors, and will be developed over time. If you have any suggestions or would like to contribute to the resources yourself please contact the Addictions Faculty via Stephanie Whitehead at stephanie.whitehead@rcpsych.ac.uk.

    Please note, although we have selected useful resources, where links direct to external websites, the Faculty/RCPsych cannot be responsible for content.

    Web resources

    ATOMIC is a free, evidence-based, mobile-learning application aimed at clinicians and other practitioners who want to improve their knowledge of the acute and chronic clinical harms of non-medical prescription drug use.

    Drug misuse and dependence: UK guidelines on clinical management

    There are a number of clinical guidelines around the management of substance use disorders, which can be found here:

    Further reading

    • The Globalization of Addiction: A Study in Poverty of the Spirit. Bruce K Alexander
    • Rethinking Substance Abuse: What the Science Shows and What we Should do About it. Edited by William Miller & Kathleen Carroll. Guilford Press, 2006
    • Treating Addiction: A Guide for Professionals. William Miller, Alyssa Forcehimes, Allen Zweben. Guilford Press, 2019 (2nd edition)
    • Theory of Addiction. Robert West & Jamie Brown, Wiley Blackwell, 2013

    Government guidance

    Lived experience organisations

    Evidence for recovery support services

    Mutual aid organisations

    Resources for families

    • Adfam are a national UK charity that aim to empower family members and carers, support front-line workers and influence decision makers.
    • Scottish Families Affected by Alcohol or Drugs have a helpline, a guide to local support services and bereavement support services.
    • Al-Anon Family Groups UK provides resources for anyone whose life is or has been affected by someone else’s drinking, as well as resources for members and professionals.

    Resources for students in recovery

    Podcasts

    Key reading

    • Kelly JF & White W (2011) Addiction Recovery Management: Theory, Research & Practice. Humana Press, New York.
    • Best D (2019) Pathways to Recovery and Desistance: The role of social contagion and hope. Policy Press, Bristol
    • White W & Mojer-Torres L (2010) Recovery-Oriented Methadone Maintenance. Monograph series from the Great Lakes Addiction Technology Transfer Center Chicago, IL
    • White, W. (2009). Peer-based Addiction Recovery Support: History, Theory, Practice, and Scientific Evaluation. Chicago, IL: Peer-based Addiction Recovery Support: History, Theory, Practice, and Scientific Evaluation
    • White, W. (2008). Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices. Pittsburgh, PA: Northeast Addiction Technology Transfer Center, Great Lakes Addiction Technology Transfer Center, Philadelphia Department of Behavioral Health & Mental Retardation Services
    • White WL, Kurtz E & Sanders M (2006) Recovery Management. Monograph series from the Great Lakes Addiction Technology Transfer Center Chicago, IL

    Introduction

    Quick references about hallucinogens/psychedelics

    Screening/Assessment

    Diagnosis of hallucinogen use is usually made clinically.

    DSM-5 classification - Hallucinogen related disorders. This comprises of:

    Commonly used research questionnaires that assess the subjective effects of hallucinogens include:

    Management

    Most treatments depend on the individual's clinical presentation. Management of the intoxicated patient is dependent on the specific behavioural manifestation elicited by the drug.

    • UpToDate is an online clinical resource provides detailed information on the clinical features of acute intoxication of hallucinogens and its management
    • NEPTUNE provides guidance on the Clinical Management of Acute and Chronic Harms of Club Drugs and Novel Psychoactive Substances
    • TOXBASE is a well-used resource for acute medicine, the emergency room, and other acute settings for acute management of toxicity

    Introduction

    Quick references about Cannabis

    Epidemiology

    • EMCDDA
    • ONS uses data from the crime survey in England and Wales to provide an overview of the extent and trends of illicit drug use including cannabis use

    Screening and Assessment

    The following are commonly used self-reported screening instruments:

    Cannabis and mental health

    Cannabis can trigger symptoms of psychosis and contribute to the development and maintenance of enduring mental health problems. The following are useful links to overviews of how cannabis is linked to mental health:

    Management

    Further links

    Cannabis and the law

    Introduction

    Epidemiology

    Validated Tools for screening and assessment of alcohol use disorder

    Assessment and management

    Alcohol related brain injury

    Thiamine for the prevention and treatment of people with Wernicke Korsakoff syndrome who abuse alcohol

    Pharmacological Management

    Relapse Prevention

    Psychological Management

    Special Group

    Recovery management

    Introduction

    Epidemiology

    Screening and assessment

    An individual must meet four out of nine of the following criteria in the preceding year to make a diagnosis of gambling disorder:

    • Need to gamble with increasing amounts to achieve the desired excitement.
    • Restless or irritable when trying to cut down or stop gambling.
    • Repeated unsuccessful efforts to control, cut back on or stop gambling.
    • Frequent thoughts about gambling (such as reliving past gambling or planning future gambling).
    • Often gambling when feeling distressed.
    • After losing money gambling, often returning to get even. (This is referred to as "chasing" one's losses.)
    • Lying to hide gambling activity.
    • Risking or losing a close relationship, a job, or a school or job opportunity because of gambling.
    • Relying on others to help with money problems caused by gambling.

    Screening instruments

    National Institute of Health and Care Excellence (NICE) recommend that health professionals ask people about gambling, new draft guidance is out for consultation.

    Management

    Currently, NHS treatment services for gambling disorder cover:

    Pharmacological management