Our trainees are exposed to a broad variety of patients with problems associated with addiction including inpatients, outpatients, adolescents, patients with medical illnesses, and patients with co-occurring psychiatric disorders. The patient population is representative of the diverse socioeconomic groups of the Bronx.
In each clinical site, we will endeavor to triage to our trainees as many different types of patients with addictive disorders and from a multitude of backgrounds.
The AECOM Division of Substance Abuse (DoSA) has been in operation since 1968, when it began as a small inpatient service located at the Bronx Psychiatric Center. Since inception, the programís primary focus has been the treatment of opioid dependence through the methadone maintenance modality and Medically Supervised Drug Free Treatment. Currently, the AECOM Division of Substance Abuse is the second largest public treatment program in New York State, serving over 3500 Bronx residents in 3 neighborhood clinical facilities. Innovative services have been developed with special focus on the children and families of patients, on persons with cocaine addiction, and on patients at high risk for HIV and HCV-related illnesses. The Division is funded through the New York State Office of Alcoholism and Substance Abuse Services ("OASAS") NYS AIDS Institute, is licensed and approved by OASAS, the New York State Department of Health, the U.S. Drug Enforcement Administration, and the U.S. Food and Drug Administration and is accredited by CARF.
The clinic population is approximately 60% males and 40% females: 40% white, 40% hispanic, and 20% black. The ages range from 19 to 70. The diagnoses, other than the predominant opioid dependencies, include the gamut of chemical dependencies, including a substantial minority using cocaine and alcohol; and a substantial number of the patients carry non-substance-related psychiatric diagnoses - including: major depressive disorder, bipolar disorder, schizophrenia, schizoaffective disorder, panic disorder, post-traumatic stress disorder, sleep disorders, sexual disorders, and personality disorders. The types of treatment provided include methadone maintenance, buprenorphine treatment, methadone-to-abstinence detoxification, psychotropic medications (antidepressants, mood stabilizers, non-habit-forming sedatives), individual/group/family counseling, 12-step groups, primary care medicine treatments, HCV treatment.
Melrose-on-Track (MOT) Evaluation and Methadone Treatment Program is located in an economically disadvantaged section of the Bronx, on the lower level of a 10+ story office building. Melrose-on-Track carries 475 recently enrolled methadone-maintained patients and evaluates 65 new patients per month - serving as an entry and central evaluation unit for the Division of Substance Abuse - from which patients are relocated to one of DoSAís nine other neighborhood programs after approximately a 6 month intensive induction. Melrose-on-Track also provides primary care medical services in support of our chemical-dependency-related services. The clinic population is approximately 55% males and 45% females: 20% white, 55% Hispanic, and 25% black. The ages range from 19 to 55. The diagnoses of the patients is comparable to those described in the above description of the DoSA/MMTP program, as are the treatments offered. In addition, acupuncture is available to patients at Melrose-on-Track.
The NextSteps is a non-methadone outpatient clinic operated under the auspices of the Division of Substance Abuse of the Albert Einstein College of Medicine. It operates in the same physical space as the Melrose-on-Track program. The clinic population is approximately 45% males and 55% females: 35% white, 35% hispanic, and 30% black. The ages range from 20 to 50. The diagnoses include the full range of chemical dependencies. The predominant treatment modality is group, with individual counselors assigned as well.
Montefiore Medical Center (MMC) serves as a Consultation/Liaison training site in the Addiction Psychiatry program. MMC is a 1,000+ bed facility, one of the nationís largest centers of Residency and Fellowship training in all medical disciplines. All medical specialties are practiced in this University Hospital for the Albert Einstein College of Medicine. MMC, proper, is located five miles from the Albert Einstein College of Medicine, however, the Weiler Division is a short walk from AECOM. Medical students rotate through all of the major Montefiore departments and affiliates. The neighborhood around the hospital is diverse, both economically and culturally, representing patients of all ages and from all parts of the world. Educational activities undertaken by the medical center and its affiliates span the full arena of biomedical training, including physicians, post-graduate medical education (residents and fellows), nursing, occupational therapy, psychology, and social work. Montefiore Hospital, with its many satellite outpatient clinics, serves as a hub of health care provision for well over 1 million residents of the Bronx borough of New York City.
The Montefiore North Hospital, located in North Central Bronx NYC, is a 369-bed hospital affiliated with Albert Einstein College of Medicine and Montefiore and was previously called Our Lady of Mercy hospital. It is now part of Montefiore Hospital, which hires about 2,600 physicians and has approximately 1,500 patient beds and includes over 80 accredited fellowship/residency programs.
Demographics of the patient population
The Detoxification Unit admits approximately 1,600 patients annually. The patient population is diverse (approximately 50% African-American/Afro-Carribean, 30% Hispanic, and 20% White). The detox unit treats Alcohol and Opiate dependent patients, amongst others (cocaine, benzo, cannabis etc). Such diverse patient population provides residents the opportunity to treat a wide range of substance abuse problems. The service utilizes medical detoxification, individual and group counseling, health education, 12-step meetings, and motivational interviewing technique, and cognitive-behavioral therapy.
The staff consists of one full-time attending psychiatrist, four part-time physician assistants, 3 social workers, 3 counselors and a full-time component of nursing staff.
This service consists of two (2) components:
The Sound View Throgs Neck Community Mental Health Center (SVTN CMHC) is a not-for-profit organization, owned and operated by the Albert Einstein College of Medicine. Currently, the Center provides services for approximately 3,300 patients and greater than 100,000 patient visits per annum, to patients living in the northeastern section of the Bronx. It services an economically and racially diverse population. Faculty and staff hold appointments at the Albert Einstein College of Medicine. SVTN CMHC also supports training in nursing, social work and psychology. The Center currently has three contracts with the City of New York to provide mental health services and is licensed through the State of New York Office of Mental Health.
The Sound View Throgs Neck Community Mental Health Center - Adult Outpatient MICA Treatment Program is located in a Northeastern Bronx Residential Neighborhood at 2527 Glebe Avenue. The Center has a census of approximately 249 MICA patients. Each patient is evaluated, and an individual treatment plan is formulated with the patient. Daily group activities are an integral part of the treatment plan. There are approximately 55% male and 45% female patients currently enrolled in our program. There are 35% Hispanic and 65% non-Hispanic patients. Roughly forty percent of individuals with substance use disorders have significant co-occurring psychiatric disorders. The addiction psychiatrist should be the one best trained and prepared to diagnose, treat and educate other providers about the integrated treatment of these co-occurring disorders.
Sound View Throgs Neck Community Mental Health Center (Turnbull Site) - Adolescent Outpatient Program (0.1 fte.)
The Outpatient Children and Adolescent Program at the Sound View Throgs Neck CMHC provide psychiatric evaluation and treatment for children and adolescents with developmental and emotional problems. The goal of the Program is to provide diagnostic evaluation and individual, group and family therapy, as well as medication intervention on either a long-term or short-term basis.
Total Census: 749
Census with age break-down:
Ages 5-8: 95 (12.68%)
Ages 9-11: 201 (26.84%)
Ages 12-14: 207 (27.64%)
Ages 15-17: 185 (24.70%)
Ages 18+: 61 (8.14%)
Census with gender break-down:
Males: 445 (59.41%)
Females: 304 (40.59%)
Census with ethnicity break-down:
Caucasian: 7 (0.93%)
African American: 242 (32.31%)
Hispanic: 430 (57.41%)
Asian: 1 (0.13%)
Native American: 1 (0.13%)
Unknown: 61 (8.14%)
Other:: 7 (0.93%)
Diagnoses include but are not limited to: