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What is Substance Use Disorder (SUD)?

According to the CDC, "substance use disorder (SUD) is a chronic disease that involves a pattern of substance use that negatively impacts a person's health, social function, and ability to control substances." SUDs are characterized by cognitive, behavioral, and physiological symptoms that indicate an individual continues to use a substance despite harmful consequences. SUDs can range in severity from mild to severe and can affect people of any race, gender, income level, or social class.

To help diagnose SUD, the American Psychiatric Association, offers a set of criteria that includes:

1. Impaired control over substance use.

2. Social impairment following substance use.

3. Risky use of substances.

4. Pharmacological indicators such as tolerance and withdrawal.

The FDA has approved several medications specifically designed for the management of Alcohol Use Disorders (AUD) and Opioid Use Disorders (OUD). These medications are intended to alleviate withdrawal symptoms and reduce the psychological cravings that contribute to chemical imbalances in the body. They are used within the framework of evidence-supported treatment practices and focus on directly treating the disorder.

For Alcohol Use Disorder Treatments (AUD), the commonly prescribed medications include:

1. Acamprosate: Helps reduce the desire to drink alcohol by restoring the natural balance of neurotransmitters in the brain.

2. Disulfiram: Acts as a deterrent by causing unpleasant reactions, such as flushing, nausea, and palpitations, when alcohol is consumed.

3. Naltrexone: Reduces both the euphoria associated with drinking and the craving for alcohol.

These medications do not cure AUD but are most effective when used as part of a comprehensive treatment program that includes psychological counseling and support. The goal is to support recovery and enable individuals to manage their drinking behaviors more effectively.

To treat opioid use disorder, three primary medications are commonly prescribed: methadone, buprenorphine, and naltrexone. These medications work by reducing opioid cravings and blocking the euphoric effects of opioids, which aids in preventing relapse. Methadone and buprenorphine are opioid agonists that help alleviate withdrawal symptoms and decrease cravings, while naltrexone is an antagonist that blocks opioid receptors and prevents opioid effects. Despite their effectiveness, these medications are underutilized in many treatment programs.

Frequently Asked Questions


What types of services do you provide?

We provide two main services: psychopharmacology evaluations and medication management. First, you’ll meet with a provider for an evaluation to determine your treatment plan, which may include medication, therapy, lifestyle changes, or other recommendations. Second, if medication is appropriate, our providers will help you manage and adjust your medication to make sure it works effectively.

What is the difference between therapy and medication management?

Therapy, sometimes called “talk therapy,” involves talking with a mental health professional to address mental health issues through dialogue and behavioral strategies. Medication management, on the other hand, is a medical approach where a mental health professional prescribes, monitors, and adjusts psychiatric medication to treat mental health conditions to address your physiological symptoms. Often, a combination of talk therapy and medication management is beneficial.

Does this replace my need for a therapist?

Our providers are here to address your concerns and offer support, but it’s important to note that they are not meant to replace a licensed therapist. Evidence suggests that for many mental health conditions, a combination of medication and psychotherapy is the most effective approach.

How does online psychiatry work?

Virtual psychiatry works just like in-person psychiatry, except instead of sitting in a doctor’s office, you’ll talk to your provider during live video appointments.

What should I expect during a mental health assessment or evaluation?

You’ll connect 1:1 with your new provider to discuss your needs. If appropriate, they’ll prescribe medication and send it to your pharmacy of choice. Regular check-ins will help you track how you’re feeling and any side effects, and your provider will make any needed adjustments.

How do I prepare for my first appointment? How long are typical appointments?

Before your scheduled appointment, you’ll receive new patient forms, which you’ll need to complete in advance. We will also ask for your insurance information, a valid form of identification, a list of any of your current medications, and any relevant medical records or previous psychiatric evaluations.

Typical appointment times vary depending on the nature of your visit and your treatment plan. Initial consultations usually last around 60 minutes, during which you'll have an in-depth discussion with your provider. Follow-up appointments are typically shorter, ranging from 15 to 30 minutes, but this may be adjusted based on your specific needs and progress.

What should I do in case of an emergency or crisis?

If you’re having a medical or mental health emergency, call 911.

Call or text 833-773-2445 for 24/7 Crisis and Mental Health Support from the Massachusetts Behavioral Health Help Line.

How do I schedule an appointment?

To schedule an appointment, please fill out our Appointment Request Form. Someone from the Monomoy Health team will contact you for more information and to help schedule your first appointment. We look forward to working with you!

Do you offer virtual/online appointments?

Yes, we offer virtual appointments. That means you can meet with your provider from the comfort of your home. We recommend choosing a well-lit and quiet space for your meeting.

Are my appointments and information confidential?

Yes. We adhere to the highest standards of privacy and confidentiality to ensure that your personal and medical information is safe, and privacy is a top priority in our practice. For more information, please download our HIPAA policy.