Addiction Psychopharmacology (Medications)
Dr. Siegel specializes in the use of medications to support abstinence and recovery. Through a personalized consultation, he evaluates whether medication-assisted treatment (MAT) could be beneficial. His approach integrates pharmacological support with psychotherapy. Recovery is defined not by abstinence but by a shift from a dysfunctional, substance-driven life to one that is stable and functional. A range of medications is now available to aid in this process.
Benzodiazepine Dependence
Benzodiazepines—such as Xanax, Klonopin, Valium, and Ativan—are commonly prescribed for anxiety. Many individuals who develop dependence start with a legitimate prescription, taking the medication as directed. However, tolerance develops, leading to withdrawal symptoms between doses and the need for increasing amounts to achieve the same effect.
Benzodiazepine withdrawal can be particularly difficult, often causing severe and prolonged anxiety. Dr. Siegel follows the Ashton Method for benzodiazepine tapering, a structured approach designed to minimize withdrawal symptoms. In addition to a gradual taper, he prescribes medications to manage both the underlying anxiety disorder and withdrawal-related symptoms. These may include antidepressants, anticonvulsants, and beta-blockers for specific symptoms such as palpitations.
Suboxone for Opioid and Opiate Dependence
For individuals struggling with opioid (e.g., oxycodone, OxyContin, Percocet) and opiate (e.g., heroin, morphine) addiction, Suboxone (buprenorphine) can be a life-saving treatment. As a partial opioid agonist, Suboxone has a safer profile than full opioids due to its ceiling effect, which limits its effects at higher doses and significantly reduces the risk of overdose. It also binds tightly to opioid receptors, blocking the effects of full opioids and helping to prevent relapse.
A common misconception is that Suboxone simply replaces one drug with another. In reality, it stabilizes brain chemistry, alleviating withdrawal symptoms and cravings while allowing individuals to regain control over their lives. Unlike traditional opioid treatment programs, Suboxone can be prescribed in a doctor's office and filled at a pharmacy, making it an accessible and discreet option. It is also used for outpatient detoxification, allowing for a medically supervised transition off opioids.
Alcohol Dependence
Several medications are available to help individuals reduce or stop drinking. These medications target the neurobiological changes caused by chronic alcohol use and facilitate the brain’s return to a more balanced state.
Some medications reduce dopamine release, making drinking less appealing and easier to quit.
Others help regulate withdrawal-related symptoms such as anxiety, irritability, and agitation, making long-term abstinence more manageable.
For some individuals, a combination of both approaches is most effective.
Dr. Siegel tailors treatment to each patient's specific needs, helping to determine which medication—or combination—will be most beneficial.
Ketamine-Assisted Treatment
Ketamine, an NMDA receptor antagonist, influences the brain’s glutamate system, promoting neuroplasticity and potentially reversing the structural changes caused by substance use. Its rapid-acting antidepressant and anxiolytic effects can relieve the mood disturbances often associated with addiction, such as depression, anxiety, and irritability.
Additionally, ketamine has been shown to reduce drug cravings, lowering the risk of relapse. When used in ketamine-assisted psychotherapy (KAP), it can enhance introspection, facilitate emotional breakthroughs, and support individuals in addressing the deeper psychological factors contributing to their addiction.
Dr. Siegel provides individualized, evidence-based addiction treatment, ensuring that each patient receives the most effective therapeutic approach for their specific needs.