Can addiction be treated with a psychedelic drug such as psilocybin? How about the dissociative anesthetic, ketamine? Are methadone, buprenorphine (Suboxone), and naltrexone (vivitrol) good for treating opioid addiction? What kinds of psychotherapy are best and what parts of the brain do they target? Why is naloxone the most important drug of all when it comes to treating opioid addiction?
This diagram of the brain shows regions of the central nervous system affected by addiction and targeted by specific addiction treatments.
Lloyd Sederer, M.D., is currently an adjunct professor at the Columbia University School of Public Health, teaching residents in the Columbia Psychiatry programs, drawing on his decades of experience as a public health doctor. He is a recipient of the Irma Bland Award and the Exemplary Psychiatrist Award from the National Alliance on Mental Illness.
He has won many top awards in the fields of psychiatry and mental health, and he has served as a leader in the field of public health as a chief medical officer and mental health commissioner in New York City and New York State over the past two decades, only recently retiring from his New York State office.
In the 90s, Dr. Sederer was the psychiatric administrator, chief psychiatrist and medical director at McLean hospital, a Harvard teaching hospital. He has published thirteen books, and he has published hundreds of articles in top medical journals and newspapers. He is also published in the Huffington Post as a medical journalist and medical editor.
What is the future of the treatment of addiction and related mental illness? According to Dr. Lloyd Sederer, the path to saving more lives from going forward will involve providing better access to the tools that we already have. We already have harm reduction strategies, including the opioid overdose rescue drug, naloxone. And, we have effective medication-assisted treatments for treating dependence on alcohol and opioids.
Our understanding of the functioning of the brain is more advanced than ever before in history. A wide variety of therapies can be applied to target various regions of the brain that are affected by substance misuse. In addition to existing medications and therapies, there are also new medical treatments on the horizon, including psilocybin, which has already been proven effective in treating some mental disorders.
With psilocybin, an existing, ancient form of medical therapy is being brought up to date with current medical science. Safe, synthetic forms of the substance have been studied in major research centers with promising results.
Just as important as mental health care therapies such as cognitive behavioral therapy, motivational interviewing, and contingency management, and medications, such as methadone, buprenorphine, and naltrexone, are the forming of relationships to promote abstinence and recovery.
Dr. Sederer believes that, to be successful in helping people to recover, their treating clinician must meet them where they are and understand why they are using drugs or alcohol. Drugs serve a purpose for people who use them and it is important to start from there and work towards helping them find healthy replacements for drugs when they are ready.
In our talk, Dr. Sederer and I discuss two of his recent books. We talk about “Ink-Stained for Life” and “The Addiction Solution.” Both books are fascinating and I highly recommend them to my audience. Dr. Sederer is a compelling author in both his non medical publications and in his medical writing aimed at professional audiences.
“Ink-Stained for Life” is a collection of fourteen stories and essays relating Dr. Sederer’s early life as a child in The Bronx to his adult life as a doctor, and the present, in 2020. The book demonstrates the improbable nature of the path from living as a child, on the streets of New York City, to being a leader in public health in the State of New York.
The book shares Dr. Sederer’s philosophies on life and his passionate optimism with discussions about topics such as intelligence and genius, wealth and struggling in the middle class, Judaism and being Jewish without living as an observant Jew, living in New York City, being the leader of a world-class psychiatric hospital, working in the world of public health in New York City and New York State, addiction treatment and much more.
With Dr. Sederer’s decades of experience in solving the issues of addiction treatment and behavioral healthcare in New York, we can learn a great deal about what must be done in many of our communities across the country to improve addiction treatment and end the addiction epidemic.
Addressing substance problems is especially important now, during the COVID 19 pandemic. Addiction rates and overdoses have been increasing, so now, more than ever, it is important to make changes to public policy.
If you are struggling with a substance use disorder or if you have loved ones who are addicted, or if you are currently a patient receiving mental health services for substance or alcohol dependence, you may find this interview to be interesting and possibly helpful in giving you some direction in getting help in finding appropriate clinical services.
Please visit Dr. Sederer here: https://www.askdrlloyd.com/