Psychiatrist

Psychiatrist, Dr. Akikur Mohammad, M.D., is an addiction medicine specialist. He is board-certified in addiction medicine by the American Board of Addiction Medicine and in Psychiatry by the American Board of Psychiatry and Neurology. Additionally, Dr. Mohammad is the Founder and CEO of “Inspire Malibu”, a rehabilitation center in Southern California. Dr. Mohammad is currently in the process of writing a new book.

What made you want to become a psychiatrist?

At an early age I became curious about how the brain works, so at medical school it was natural for me to want to pursue neuroscience. The brain is the control tower for the entire body and is, by far, the most complex organ of the human body. Yet, compared to other organs, such as the liver, the kidney and so on, very little is known about its physiology–how it works. It made me curious as a student and has continued to pique my interest throughout my professional career.

Did you always want to work in the field of addiction?

It was during medical school that I was first exposed to the emerging science of addiction medicine. What I found fascinating was how people in general, as well as mental health professionals, were all so disconnected to the development of evidence-based medicine in the treatment of alcohol and drug addiction. The world seemed, for the most part, stuck in the early 20th century when it came to treatment of this chronic disease. Half of those who have a substance addiction also have a dual diagnosis co-morbidity, such as depression. But, too often, treatment is focused exclusively on the cognitive disorder at the exclusion of the physical addiction.

Please discuss your motivation and inspiration for creating Inspire Malibu.

Substance Use Disorder is multifaceted, requiring both pharmaceutical and behavioral treatments. There are some 14,000 so-called rehab clinics in the U.S. -more than the number of Starbucks. Yet, only 10% offer any evidence-based treatment and more often than not, it’s relegated to the initial phase of treatment, detox.

By and large, the treatment of alcohol and drug addiction in the U.S. is grounded in the 12-step philosophy developed in the 1930s by A.A. However, by its own admission, A.A. only has a success rate of 5% of adherents being sober after one year.

It became clear that there was a need for a facility that focused on treatment, first and foremost, based on the recognition of alcohol and drug addiction as a genetically based chronic disease and second, treatment consisting of the latest in evidence-based medication and protocols. There is a room for A.A.-styled, 12-step programs for some patients in an overall treatment program, but it should never be the focus of treatment. To rely exclusively on 12-step therapy for alcohol and drug addiction is not only ineffective but can be dangerous -even life threatening.

Where did you go to school?

I grew up in what is now the nation of Bangladesh. I attended medical school at Friendship University in Moscow in what was then the U.S.S.R. After immigrating to the U.S., my internship and residency program was at the Los Angeles County and University of Southern California Medical Center in the Department of Psychiatry.

What groups/non-profits are you involved with? Which would you recommend for non-MDs in the field of addiction?

American Medical Association, California Medical Association, American Society of Addiction Medicine (ASAM) and California Society of Addiction Medicine (CSAM)
Both ASAM and CSAM have membership programs for non-physician professionals.

What advice would you give someone who wants to follow in your footsteps?

I would point out that addiction medicine is a growing field with a huge demand. One in six Americans has a substance abuse problem. The vast majority of physicians have little to no training in addiction medicine, so there is a great need for trained professionals.

What is special or rewarding about working in the field of addiction medicine?

On a personal level, I experience the satisfaction of knowing that I have helped to save the lives of hundreds of people with the chronic disease of alcohol and drug addiction. It’s extremely gratifying to educate addicts and their families about the fact that addiction isn’t something to be ashamed of any more than having diabetes. Most people simply don’t know what science now says about the disease and how far its treatment has advanced.

What would you change about this specialty to make it better?

The biggest challenge at the moment is dragging the treatment of alcohol and drug addiction from the 1930s into the 21st century.

Please tell me about your background as a young person. Were you influenced by addictive behaviors?

I came from a family of many physicians. No, no one in my family exhibited addictive behaviors.

What one thing do you hope to have accomplished by the end of your career?

By the end of my career, I hope to see science fully incorporated into the treatment of Substance Use Disorder, the licensing of all treatment centers (and rehab clinics) under uniform and strict medical guidelines, and the recognition by the public that 12-step programs should never be a substitute for treatment of addiction by medical professionals.

Science and medicine have advanced to the point where there is really no ethical excuse for denying comprehensive medical, behavioral, and psychological help to those who suffer from the medical illness of addiction. There are proven models of success, and these must be utilized to alleviate this crisis in public health.

Please tell us about the book you are writing.

The book, tentatively entitled The New Science of Overcoming Addiction, is meant for the layman. It’s the first book to be written by a medical professional that explains the current thinking and findings about Substance Use Disorder. It also informs the reader about the latest advances in the evidence-based treatment of the chronic brain disease of addiction, and how and where to get bona-fide treatment.

The book’s premise is that Substance Use Disorder is multifaceted, requiring both pharmaceutical and behavioral treatments. Alcoholism and drug addiction are complex conditions comprised of biological, social, and psychological components.

Instead of arguing over the relative importance of the biological, psychological, and social factors, the book suggests that all of these must be taken into consideration when designing the appropriate treatment for the individual patient. As an addiction medicine physician, I am as interested in how people stop using drugs as why they use them.

How have you changed as a result of the book-writing process?

I have become more dedicated than ever to bringing the treatment of the chronic disease known as alcoholism and drug addiction into the 21st century.

Original Article

Dr. A R Mohammad

By all means, deck your halls with balls of holly… but keep holiday spirits in check when it comes to the punchbowl.

Akikur Mohammad, M.D., a leading addition expert, board-certified psychiatrist, says that while moderate drinking is fine for most of us (note caveat below), it’s never a good idea to gorge on cocktails, beer and wine just because it’s the holidays. Continue reading →

Medical Expert Reveals Fiction Vs. Fact About Heroin, Cocaine, Meth and Marijuana

Heroin addiction is largely confined to minority populations in poor, urban areas, right? Not so fast. While that might have been the profile of a heroin user 20 years ago, today’s addict is white, young and living in the affluent ‘burbs.

So says a comprehensive new study called, appropriately, “The Changing Face of Heroine Use In The United States,” published this week by the journal JAMA Psychiatry.

The study also found that contrary to popular belief, most heroin addicts today did not start on their “silk road” to perdition with another illicit drug, such as marijuana. Instead, most first started getting high with prescription painkillers, likely which they either found at home, from a friend or obtained illegally on the street.

Given that the study destroyed two popular beliefs about addiction, we thought it high time (pardon the pun) to explore whether there might be other myths to be busted. Dr. Akikur Mohammad, M.D., a physician specializing in addiction medicine, and an adjunct professor at University of Southern California Keck School of Medicine, wasted no time in setting the record straight.

Here are five more myths about drug addiction as answered by Dr. Mohammad, who is also the medical director and founder of Inspire Malibu treatment center in Los Angeles.

Fiction #1: The probability of becoming a heroin addict is extremely high, even if you just use it once.

Fact: Most heroin users – like most users of all drugs – never become addicts. Your probability of becoming dependent is estimated to be 32 percent for tobacco, 23 percent for heroin, 17 percent for cocaine, 15 percent for alcohol, 11 percent for stimulants other than cocaine, 9 percent for cannabis, 9 percent for anxiolytic, sedative, and hypnotic drugs, 8 percent for analgesics, 5 percent for psychedelics, and 4 percent for inhalants. Bottom line: Most people simply stop using their drug of choice before it becomes a real problem.

Before and after- the effects of Meth. Pictured here is meth abuser Andrew at age 18 (left) and age 25. Photo courtesy of CBS News.

Fiction #2: No question, meth and crack are the most dangerous of the popular intoxicants today.

Fact: Actually, it’s alcohol. By any measure, alcohol is far more destructive to the user and society as whole than any other drug. From a physiological perspective, alcohol is particularly pernicious because it doesn’t affect just one or two brain receptors but multiple receptors simultaneously. That makes alcohol extremely difficult to counteract with medications to stop the craving that is the hallmark of all substance addiction. As for society, approximately 88,000 deaths occur annually in the U.S. from alcohol – many times more than the deaths caused by all other drugs combined.

Fiction #3: When it’s all said done, the AA and its 12-step philosophy is still the best way for an addict to kick his (or her) habit.

Fact: Addiction is a chronic disease characterized by anatomical and functional changes in the human brain. This is recognized by all the leading medical organizations in the U.S. and worldwide including the American Medical Association, the National Institutes of Health and the World Helath Organization. Indeed, with the advent of new diagnostic technology in the Nineties, such as MRIs and CT scans, the anatomical changes could be clearly seen and studied with brain-imaging technology.

For this reason alone, the AA philosophy does not work. People with the chronic disease of addiction can no more stop their disease by sheer willpower than a diabetic can cure his disease. Indeed, by their own admission, AA only works about 5% of the time.

That’s not to say that for some people, AA can’t be part of an overall addiction treatment program, which also includes pharmaceutical medications and lifestyle modifications. But it flies in the face of 21st century science to think of AA alone as an effective treatment for alcoholism or drug addiction.

Shockingly, even today, an estimated 90% of the approximately 14,000 rehab clinics in the U.S. do not use any evidence-based medicine in their treatment programs and, instead, rely entirely for treatment on the AA philosophy–first developed in the 1930s.

Fiction #4: Addicts are born losers who never amount to anything no matter what you do for them.

Fact: Part of that is correct. Addicts are born with a much higher risk of addiction than the population as a whole – about a 50% genetic factor. As for being losers, studies show that addicts actually have a higher I.Q. than the population at large. In any case, hardly anyone would consider to be “losers” these luminaries who were, or are, addicts: Judy Garland, Robert Downey, Jr., Oprah Winfrey, Bob Dylan, David Bowie, Ray Charles, Keith Urban, Brian Wilson, William F. Buckley, Jr., Elizabeth Taylor, James Baldwin, and yes, Benjamin Franklin.

Courtesy of the NIH – www.drugabuse.gov

Fiction #5: Once an addict relapses, it’s all down hill from there. They really never get better.

Fact: Actually, the relapse rate for addiction is typical of chronic diseases, slightly more than diabetes and less than hypertension and asthma. A relapse is not an occasion to scold, punish or otherwise stigmatize the person. It’s not a moral failure but a symptom. Modern-day diagnostics indicate that most brains eventually return to relatively normal when the drug use stop.

Original Article

Dr. A R Mohammad