About the Practice
My name is Dr. David Siegel. I've been practicing addiction medicine in New York City for over twenty years.
My practice is small and completely private — just you and me. No programs, no group sessions, no one-size-fits-all approaches. There are no crowded waiting rooms, no office staff, no intrusion from third parties. Sessions are conducted in person at my office on the Upper West Side of Manhattan or by video. I answer my own phone and if I'm tied up at the moment, I return voicemails as soon as I'm free. I'm also available for emergencies by phone around the clock.
Everyone who comes to me has their own story, their own reasons for where they are, and their own path forward. My first work is to understand that — as fully as I can.
How I Think About Addiction
Addiction rarely has a single cause. Biology, life history, psychological experience, and the pharmacology of substances all interact. When someone becomes dependent on a substance or behavior, those forces become intertwined.
Effective treatment needs to address all of them. The medical dimension — stabilization, medications as appropriate, careful tapering — creates the neurological conditions for recovery. The psychological dimension — understanding what the substance or behavior has been managing — allows deeper change to occur.
My work combines both. The medical treatment and the conversation are not separate processes. They are parts of the same clinical approach.
Understanding What's Happened
When someone becomes dependent on a substance, their brain and body have done something biologically logical — they've reorganized themselves around that substance to maintain function. This is not weakness. This is not failure. It is the mind and body doing what they are designed to do.
Taking that substance away suddenly doesn't fix this — it can collapse the system entirely. Withdrawal is real, it can be serious, and returning to one's own equilibrium takes longer than most people expect. This is why treatment begins with stabilization: replacing what someone has become dependent on with something safer, more manageable, something we can work with carefully over time. That creates the conditions — biological and psychological — that make everything else possible.
The Work
Addiction is often a way of managing something real — pain, anxiety, experiences that were never fully understood or worked through. Addressing the surface of the problem without understanding what's underneath it rarely leads anywhere lasting.
What I try to provide is a genuine therapeutic relationship — an ongoing conversation, built around you as an individual, in which it becomes possible to look at things that have never felt safe to look at before. Not by following a program or a protocol, but carefully, at whatever pace makes sense. By helping me understand them, most people find they begin to explain themselves to themselves. That process, done honestly and without hurry, is where real change happens.
Most people who come to me have tried something else first — a detox, a program, a therapist who didn't understand the addiction piece, or a doctor who wouldn't engage with anything beyond the medication. They arrive having found those experiences incomplete. What they tend to find here is different.