The one-year clinical fellowship features a six-month training in the Addiction Medicine Services at the UPMC Western Psychiatric Hospital and a six-month training at the Veteran’s Administration Pittsburgh Health System (VAPHS). Fellows are members of fully-integrated teams at both the UPMC Western Psychiatric Hospital and the VAPHS.
Rotations through UPMC Western Psychiatric Hospital:
The 26-bed dual diagnosis unit at the UPMC Western Psychiatric Hospital provides the full range of assessment and treatment of patients with substance use and co-occurring disorders. It provides individual, group, and family therapies in addition to pharmacotherapy. Motivational Interviewing and integrating pharmacological approaches with psychosocial treatments are the focus of the rotation. The fellows are an integral part of the treatment team and provide supervision to psychiatry residents, medical students, and clinical psychology interns.
Fellows learn how to utilize the various withdrawal management protocols and the overall management of patients in the 18-bed acute medically-managed inpatient withdrawal management unit at UPMC Mercy. This unit serves patients with substance use disorders at risk for complicated withdrawal from opioids, alcohol, and sedative hypnotics.
The ambulatory withdrawal management program is offered at the Center for Psychiatric and Chemical Dependency Services in collaboration with the UPMC Western Psychiatric Hospital Psychiatric Emergency Services (PES). Patients who do not meet the criteria for inpatient withdrawal management are treated for withdrawal from opioids, alcohol and sedative hypnotics and linked to outpatient care.
The services provided at CPCDS include outpatient withdrawal management for alcohol, sedative hypnotics and opioids (described above), individual outpatient addiction treatment for all substance use disorders, and intensive outpatient program services for adults, young adults, and adolescents. Addictions commonly treated at CPCDS include alcohol, cocaine and amphetamines, benzodiazepines, opioid, marijuana, tobacco, and behavioral addictions. CPCDS staff and psychiatrists are well-experenced in providing integrated treatment for patients with co-occurring disorders. Treatment with medications for opioid use disorder (MOUD; buprenorphine and extended-release naltrexone), alcohol use disorder (MAUD), and tobacco use disorder are well-integrated into patient care at CPCDS. An integral part of the fellowship training is learning to prescribe, manage, and monitor treatments with these medications. Fellows maintain a caseload of adults, young adults, and adolescent patients and follow them longitudinally at CPCDS.
The Narcotic Addiction Treatment Program is a comprehensive outpatient treatment program that provides integrated care and MOUD treatment (i.e. methadone and buprenorphine) for patients with opioid use disorders and co-occurring psychiatric disorders. Fellows are assigned a caseload of patients to treat and coordinate care closely with the treatment team.
Rotations through VAPHS:
The Center for Treatment of Addictive Disorders Outpatient Rehabilitation and Education (CORE) Program is a 20 patient capacity 14- to 21-day intensive intervention that is held in both residential and non-residential settings. The majority of the patients involved in the program have substance use and co-occurring psychiatric disorders. Fellows are assigned a caseload of patients to treat and coordinate care with their treatment team.
This is a clinic that treats patients with opioid use disorders integrating MOUD (methadone and buprenorphine) and psychosocial treatments and has the capacity to serve up to 120 patients. A significant proportion of patients participating in this program have co-occurring disorders (mostly mood disorders, anxiety disorders, and trauma-related disorders). Fellows are assigned a caseload of patients to treat and coordinate care with their treatment team.
The program utilizes buprenorphine for the treatment of opioid use disorder in various clinical locations including the Center for the Treatment of Addictive Disorders, Rapid Access Clinics, and the Substance Abuse Day Program. Fellows are assigned a caseload of patients to treat and coordinate care with their treatment team.
This service provides psychiatric consultation services at the VA for patients with substance use and co-occurring psychiatric disorders and medical comorbidities. Fellows provide psychiatric consultations as needed.