An addiction psychiatrist treats dependence on alcohol, drugs, prescribed medication, and behaviours such as gambling, working from the position that dependence is a medical condition with a physical basis, not a matter of willpower. Long-term heavy use changes the brain's reward and stress systems in measurable ways, and undoing that takes medical treatment alongside psychological work rather than one without the other.
A first assessment looks at what is being used, how much, and what physical effects and withdrawal risks are involved. Stopping some substances suddenly, alcohol and certain sedatives in particular, can be dangerous without medical supervision, so an addiction psychiatrist decides whether detoxification needs to happen in the community with support, or as an inpatient where withdrawal carries higher risk.
Treating what sits underneath
Depression, PTSD and ADHD turn up often alongside addiction, and rarely resolve if the substance use is treated in isolation from them. Part of the specialty's work is untangling which came first and building a treatment plan that addresses both together, since treating one while ignoring the other tends to produce short-lived improvement at best.
Medication also has a role beyond detox: certain drugs can reduce cravings or block the effects of a substance, and an addiction psychiatrist prescribes and monitors these as part of a longer recovery plan built alongside psychological support.