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How to Become a Medical Addiction Specialist


Overview

It is estimated that over 20 million Americans need drug or alcohol treatment at few are able to receive services from certified clinicians with specific training in addiction. The treatment of those who fall victim to addiction of medication and alcohol falls on the shoulders of Addiction Specialists – hard working and caring individuals that infuse the fields of public health, psychology, social work, mental health counseling, internal medicine and other to help people on the path to recovery. And for those looking for factual information on learning how to become an addiction specialist, you've come to the right place.

There are two types of addiction specialists – the medical doctor and the psychiatrist. This career track is dedicated to those interested in knowing more about addiction medicine including job responsibilities and prospects, education and American Board of Addiction Medicine (ABAM) certification.

What is an Addiction Specialist?

According to the American Society of Addiction Medicine, “The addiction medicine physician provides medical care with the bio-psycho-social framework for persons with addition, for the individual with substance-related health conditions, for persons who manifest unhealthy substance use, and for family members whose health and functioning are affected by another’s substance use or addiction.”That is a long way of saying that a medical addiction specialist is a doctor who has been specially trained and certified to help within the complex case of someone who is addicted to any substance.

Because of the complex nature of addiction and the various medical and psychological issues that could present alongside of addiction, addiction medicine physicians are able to offer nuanced treatment of patients. These treatment plans are likely to cover a broad range of patient care and can include attention to the physical body, the mind for psychiatric care and the beliefs of the patient. Some of the work that the physician may be involved with includes:

  • Detoxification procedures to help patients eliminate the substance from their bodies and begin treatment
  • Rehabilitation including physical and mental therapies designed to improve lifestyle choices and deal with causes of addition
  • Harm reduction for the patient including elimination of substance and risk factors and abstinence training
  • Treatment both physically and mentally with an effort to prevent relapse
  • Individual and Group Therapy sessions that can focus on understanding the effect substance abuse has on the body as well as processing the causes of addiction and abuse in a group setting
  • Oversight of Halfway Houses to ensure residents maintain their sobriety plans and medical services are offered when needed for residents
  • Treatment of Withdrawal Symptoms which can include cardiac or respiratory arrest, seizures and other physical reactions to the removal of the substance
  • Acute Intervention including in the cases of overdose, cardiac arrest, seizure and self harm
  • Long term treatment and therapy to reduce the chance of relapse and increase the length of time patients are sober by offering support and accountability during transition and after
  • Treatment of infectious disease associated with addiction like HIV, and hepatitis which can be acquired during addiction

Doctors who are trained in addiction care are able to provide information for the prevention, evaluation and treatment of addiction in various care settings. See below for more information on the types of work environments that one can choose as an addiction medicine specialist.

Educational Track

Step by Step Education Path to Becoming an Addiction Specialist

 The minimum requirement for becoming an addiction medicine specialist is a doctorate degree. Additional fellowship time and a certification exam are recommended for board certification.

Bachelor’s Degree

The start of the path to becoming an addiction medicine physician is the same as other medical specialties. All doctors must complete at least three years of an undergraduate degree with special attention to completing the science related courses and lab work that are required for entrance into medical school and successful testing on the MCAT.

The MCAT is usually taken in the undergraduate student’s junior year and the test will determine if the student has the necessary scientific and critical thinking foundation of knowledge for medical school.

Undergraduate studies have a substantial influence on medical school entry. A student’s GPA, overall and in science related courses, will be one of the first indicators of their ability to complete the demanding course work of medical school. An application to medical school will also include MCAT scores, letters of reference, extracurricular information and any leadership roles or positions held that show a dedication to the medical field. These roles can be anything from CNA licensure and work which shows patient care, volunteer hours at a local hospital, or other medical training like EMT.

Medical School

Next, the student will apply to and then complete medical school. Medical school consists of four years of study split into two parts. The first part is two years of classroom time where students learn the biology, chemistry, physiology, anatomy and other foundations of medical work. During this time students will be introduced to basic patient care practices under strict supervision of teachers and mentors.

The second two years of medical school consist of patient care and rotations that are designed to give students a broad overview of the medical field. During this time students will be introduced and gain experience in various specialties. Their skills and knowledge will be both tested and improved and they will likely find the types of settings and work that best suits their interests.

Residency

After medical school, aspiring physicians must complete a three-year residency. The focus of this residency is based on the specialty chosen and the requirements of any fellowships that occur after residency.

Residency is said to be one of the most challenging times during a doctor’s training. In three years, residents will experience a variety of medical situations, demanding shifts and schedules, and will work with new teams of people with new expectations. It is important that during residency, the resident is able to stay focused, learn as much as possible, ask questions and begin fine-tuning their skills as a physician. Teaching hospitals often have specific requirements in place for residents which will include a number of work hours, in-service training, teaching conferences and meetings, and opportunities to take leadership roles and more.

Students who wish to become addiction specialists can choose to work in a detox unit or rehab clinic during residency. Contacting their school’s psychiatry department may provide resources on these availabilities. It is also recommended that students attend the ASAM annual Medical-Scientific Conference and seek a mentor that can guide them into the work they are most interested in.

Fellowship

During fellowship a doctor has the opportunity to learn the specialized skills necessary for his or her choice of medical specialty. The time and education completed before fellowship provides the necessary core of information for specializing in a particular field.

Fellowships generally last between one and three years, dependent upon the specialty chosen, the physician, the program and other factors. Fellowships can include patient care, research and lab work, and other training opportunities provided by doctors in the field of choice who may take on a mentorship role for doctors in training.

A list of accredited addiction medicine fellowships and their descriptions can be found through the American Board of Addiction Medicine website. All medical specialties are eligible to apply for an addiction medicine fellowship.

Addiction Medicine Certification

Doctors who are seeking certification as an addiction specialist can obtain the necessary training and credentialing through the American Society of Addiction Medicine- (ASAM). ASAM offers live conferences, study materials and courses for those that want to explore what their role as a medical provider is in the lives of patients with addictions and test for certification by taking the certification exam.

These courses cover substance abuse detection, prevention, and treatment by highlighting topics such as neurobiology, identification and screening, treatment referral, medication and more. By the end of training and testing physicians will have a deeper understanding of the way the brain is affected by substances, be able to screen and identify patients, provide brief counseling and evaluate the patient’s readiness to change, know how to motivate behavioral changes, conduct assessments and recommend levels of care and be familiar with the recovery groups and practices that may be available to patients.

In addition to the certification exam, physicians are required to complete a minimum number of hours focused on the “Teaching, research, administration and clinical care of the prevention of as well as the treatment of individuals who are at risk for or have a substance abuse disorder.” These hours must include direct clinical patient care.

Additional Credentials

While it is not necessary for an addiction specialist to obtain additional licenses or certifications, it is recommended that they have a Drug Enforcement Administration (DEA) number and a Buprenorphine waiver in addition to their board certification as many states or facilities may require them.

Career Path

Understanding the Career Path 

Work Environments

Addiction specialists can work in settings that include: ambulatory care, acute care, long-term care facilities, psychiatric settings, and residential facilities. Each of these environments will provide a different patient care experience and salary range for the physician.

According to the American Society of Addiction Medicine, “Some addiction medicine physicians limit their practice to patients with addiction or other patterns of unhealthy substance use. Others focus their practice on patients within their initial medical specialty who have substance-related health conditions.” This choice is up to the physician and how he or she desires to practice medicine – either with a focus on addiction or with a focus on medicine that has a deeper understanding of the issues associated with addictions.

Overall, it is reported that addiction medicine specialists have high job satisfaction and a lot of control over their schedule though it is expected that some environment will be more demanding than others.

Salary

There are currently 3,000 physicians who are board certified in addiction medicine. With current estimates indicating that over 20 million people need treatment for addiction and addiction related medical illnesses, the job prospects for those certified in addiction medicine are good. As demand is increasing, it is projected that salary will increase as well.

For salary information pertaining to doctors that wish to compliment their current practice with addiction identification, prevention and treatment services please refer the primary specialty of the physician.

For those looking to primarily be an addiction specialist estimated salary for the average residential care physician is around $50,000. This is substantially lower than many medical specialties as the position is still “young” and gaining recognition. Salaries can very dependent on the company one works for, the location of the facility, the specific industry and setting, experience and benefits. For example, an addiction care physician that oversees a private treatment facility would get paid more than one who is working for a state health department.

Taking on the career path of learning how to become an addiction specialist involves compassion, strong intestinal fortitude and a willingness to help others overcome serious hurdles on their path to recovery. This is a profession that is rewarding in many ways beyond financially – but is best suited to people who have a strong desire to help others overcome issues.

Additional Resources

  • American Board of Addiction Medicine
  • American Osteopathic Academy of Addiction Medicine
  • The Association for Addiction Professionals
  • National Association of Addiction Treatment Providers
  • The State Association of Addiction Services

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