Education landing image

Addictions Fellowship

We are offering to qualified candidates this ACGME accredited fellowship in Addictions Psychiatry at  Western Psychiatric Institute and Clinic and the VA Pittsburgh Healthcare System, (VAPHS). This one year residency position (PGY5) is a clinical fellowship in an environment that is rich in clinical, research and teaching opportunities. With a broad base and multiple levels of care this program offers a comprehensive educational experience.

Candidates must have completed or be about to complete an ACGME approved residency in psychiatry and have passed USMLE STEP 3.

Overview

Objectives

Clinical Activities

Didactic Activities

Research Activities

Dissemination to Clients and Families

The Training Environment

Mission and Vision

Pittsburgh

For further information or to apply please contact

Antoine Douaihy, M.D.
Director
Associate Professor of Psychiatry
 
University of Pittsburgh
Western Psychiatric Institute and Clinic
Medical Director
Addiction Medicine Services
3811 O’Hara St.
Pittsburgh, Pennsylvania, 15213
 
412-586-9537
 
douaihya@upmc.edu
 
Application Form

Overview

Multiple barriers exist preventing addiction treatment – among them lack of sufficient numbers of psychiatrists with specialty training in addictions.  This program is designed to provide training of much needed future leaders of the multidisciplinary teams effective in addictions treatment.

To provide the broad-based experiences fellows will function as fully-integrated team members at both the Western Psychiatric Institute and Clinic (WPIC) of the University of Pittsburgh and the VAPHS.

Both sites offer unique training opportunities.  WPIC Addictions Medicine Services, (AMS) offers clinics specialized in perinatal and adolescent addiction, couples and family therapy, dedicated inpatient dual diagnosis and detoxification units, and a general psychiatric ER-based intake service. In addition to residential partial programs and ambulatory detoxification programs, VAPHS offers a dedicated Psychiatric Addiction/Liaison Service, an office-based buprenorphine opioid substitution service, group motivational interviewing and the opportunity to see a large number of patients with addictive disorders complicated by combat-related PTSD.

By combining the expertise available at VAPHS and WPIC, we have created a well rounded training program. This will address the training needs of the fellows and prepare them to manage any of the diverse presentations of patients suffering from substance use disorders in the population at large.

Objectives

By the end of the program, fellows will have acquired the knowledge, skills, clinical judgment, and attitudes essential to the practice of addiction psychiatry at the consultant level. They will be competent in the evaluation and follow-up a variety of patients of both sexes, including adolescents, adults, and geriatric age groups spanning a broad range of diagnoses.

The fellows will be able to provide both primary and consultative care in both inpatient (including intensive care) and outpatient settings for patients with a wide variety of types of substance-related disorders. They will be expected to supervise and teach junior residents and medical students. They will have had the opportunity to attend clinical, basic science, and research conferences as well as seminars and critical literature review activities pertaining to substance related disorders.

They will have a comprehensive understanding of the pharmacology of all commonly used substances, as well as the actions of pharmacological agents used to treat these conditions.

The training offered will focus on the biopsychosocial and functional concepts of diagnosis and treatment as applied to inpatient, outpatient, and other treatment settings. Iatrogenic aspects of illness, as well as cultural, ethnic, racial, socioeconomic, ethical, and legal considerations that may affect or interact with the psychiatric care of these patients.

Clinical Activities

Each fellow will rotate for a total of 6 months at VAPHS and for 6 months at WPIC.  Didactic activities will run in parallel over the 12 months.

WPIC Rotations

  1. Inpatient Psychiatric Dual Diagnosis Services - A 27-bed acute psychiatric inpatient unit is provided at WPIC where patients receive comprehensive psychiatric evaluation and management services for co-morbid psychiatric and substance use disorders.
  2. Inpatient Detoxification Services - A 15-bed acute medically-managed inpatient detoxification unit at UPMC Mercy which serves patients with primary substance dependence disorders at risk for withdrawal complications.
  3. Ambulatory detoxification - offered at our Oakland-based treatment program through the Emergency Intake clinic to patients who do not require inpatient care, but need medical management and psychosocial support during the withdrawal process.  
  4. Living Sober Short-term Residential Treatment Program - This is an 18-bed, short-term (2-4 week) rehabilitation program housed in Homestead that serves patients with addiction, including those with co-morbid psychiatric illness.  
  5. CPCDS – An Adult and Adolescent Service offering individual, group and family therapy, and medication management to patients with substance use and dual disorders at several locations and at different levels of care, including detoxification, partial services, and intensive outpatient.
  6. Perinatal Addiction Center (PAC) - This specialized woman’s program offers coordinated medical, obstetrical, pediatric and psychosocial care and individualized outpatient treatment for pregnant women and mothers with substance use disorders.
  7. Alcohol Highway Safety Program - This community prevention program offers a driving-under-the-influence program for adults arrested and mandated to attend DUI classes and an underage drinking program for youths arrested for underage drinking. 

VAPHS Rotations

  1. CORE Program - 20 patient capacity residential/partial program. Most patients stay in the domiciliary overnight. 50% – 70% have comorbid and substance use disorder. Patients in this program may under go alcohol and opioid detoxification through this program.
  2. OSTC - This is an opioid maintenance clinic utilizing methadone and buprenorphine with the capacity to serve up to 120 patients. A significant proportion of patients participating in this program are dually diagnosed.
  3. Office-based opioid substitution - We utilize buprenorphine for treatment of opioid dependence in the Center for the Treatment of Addictive Disorders, (CTAD),  RAC clinic and University Drive SADP clinic utilizing buprenorphine.
  4. Psychiatric/Addiction Consult Service (University Drive) - This service offers consultation in a general hospital setting for patients with comorbid addiction issues. Consultations are peformed by psychiatry and the SADP team.
  5. Dual Diagnosis Clinic – This ambulatory program involves the assessment and management of patients with substance use disorders and includes a large population of patients with trauma related co-morbidities.
  6. Motivational Interviewing - This CTAD program offers motivational groups run by 2 psychologists highly trained in the techniques of motivational interviewing.
  7. Time-Limited Case Management - This program of coordinated case management for veterans with comorbid psychiatric disorders (schizophrenia and bipolar disorder) and substance use disorders provides continuity of care from inpatient through outpatient phases of treatment. This interdisciplinary program of care management includes psychiatrists, psychologists, social workers and provides psychopharmacology case management and inpatient and outpatient group intervention with a clinician-supervised Vet-to-Vet component.

Didactic Activities

The 12-month didactic program consists of a series of didactic and seminar courses conducted during 4-hour blocks on Friday afternoons.  The curriculum for the weekly didactics will include: Diagnosis and Assessment, Epidemiology and Genetics of Substance Use Disorders, (SUD), Neurobiology of Addiction, Developmental Factors in Risk for SUD, Impact of SUD on the Developing Brain, Brain Imaging and Addiction, Dual Diagnosis Treatment Approaches, Pharmacotherapy of Addictive Disorders, Motivational Interviewing and other Cognitive and Behavioral Interventions; Chronic Pain and Addiction; Family Factors in Addiction—Assessment and Treatment; Religion, Spirituality and Addiction; and Medicolegal and Ethical Issues in Addiction. 

A series of weekly one-hour seminars includes a focus on critical analysis of research papers and the writing and publication of manuscripts, critical review of newly published research findings on addiction, discussion of clinical trials methodologies for the treatment of complex comorbid disorders, and career challenges in addiction psychiatry.  The fellows  may also attend WPIC Grand Rounds, VA MIRECC Brown Bag Seminars and WPIC Journal Clubs.

Research Activities

WPIC and the VAPHS have a significant portfolio of research studies funded by the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), private foundations and pharmaceutical companies.  Fellows will be encouraged to participate in these programs.

Dissemination to Clients and Families

AMS and VAPHS faculty and staff have published many papers, books and treatment manuals for professionals on the treatment of addiction, HIV, and co-occurring psychiatric disorders. Faculty and staff have also published numerous recovery materials for patients and families. These recovery workbooks and journals are used in many treatment programs in the U.S. and other countries, and some have been translated to foreign languages.

The Training Environment

The University of Pittsburgh, Department of Psychiatry and VAPHS offer an extremely rich clinical, research and teaching environment to promote Addiction Medicine. For more than 40 years, the Department of Psychiatry has been a national leader in the diagnosis, management, and treatment of mental health and addictive disorders.
Over the past 20 years, the Department of Psychiatry and VAPHS have contributed to the growth of Addiction Medicine. Together we offer over 25 clinical and prevention programs in over 11 locations throughout the area. AMS at WPIC has grown considerably during this time and has integrated treatment and prevention programs in multiple medical, psychiatric and community settings.

AMS works closely with other UPMC hospitals and community agencies to provide consultation and training on issues related to substance use disorders and co-occurring medical and psychiatric disorders. Each year, faculty and staff of AMS provide a large array of clinical training workshops to the medical center and community. Dr. Douaihy, medical director of Addiction Medicine Services, AMS and VAPHS colleagues have established assessment and treatment protocols to facilitate detoxification and stabilization of addicted patients seen in a variety of medical or psychiatric settings.

Mission and Vision

Our Programs are committed to providing comprehensive addiction and dual diagnosis assessment, treatment, prevention, education and research programs that are patient-oriented, evidence-based and recovery focused. The dedicated staff and faculty seek to engage individuals and families through motivational, culturally competent, goal-focused treatment, in compassionate, caring environments at accessible community locations. Recovery is fostered and promoted through the establishment of a healing partnership that addresses the biopsychosocial and spiritual aspects of addiction.

Pittsburgh

Pittsburgh was recently voted “America’s most livable city” by "Places Rated Almanac" and is a city of great vitality and variety.

The renaissance in recent times has made it safe, clean and fun. With a wealth of affordable housing options it is one of the nation's most diverse architectural communities.

The city is the site of many major corporate headquarters, yet retains its small-town friendliness.

Nestled in the Allegheny Mountains at the confluence of three major rivers, the "City of Bridges" abounds in natural beauty, with many parks and recreational sites.

Pittsburgh is a city where all young professionals can find a lifestyle that best fits their needs. Within walking or short driving distances, there are many parks, hiking trails, water sports, microbreweries, restaurants, clubs and quaint stores

As a center for culture and the arts, Pittsburgh is second-to-none for a city its size. For sports fans, the city offers the major league thrills of Steelers football, Penguins hockey, and Pirates baseball.

An ethnically rich city, Pittsburgh has retained its neighborhoods and small communities with surprises everywhere.