Substance-Related and Addictive Disorders

Alcohol Addiction

If drinking has started to take more from your life than it gives, it may be a sign of alcohol dependence, but it’s important to remember, recovery is possible. While occasional drinking may feel harmless, for some individuals, it can gradually turn into dependency. If alcohol has begun to interfere with your life, relationships, or well-being, know that you are not alone.

Understanding Alcoholism 

Alcoholism, also called Alcohol Use Disorder (AUD), is a chronic medical condition that can affect anyone, regardless of age, background, or lifestyle. It is marked by a loss of control over drinking, leading to serious consequences for both physical and mental health, as well as personal and professional life. Often, alcohol is used as a way to cope with stress, emotional pain, or underlying mental health concerns. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), millions of adults struggle with AUD every year.

Left untreated, alcoholism tends to worsen over time, but recovery is possible with the proper care. At the Brain and Mind Healing Center, Dr. Kotbi, Former Chief of the Addiction and Rehabilitation Program at Weill Cornell Medicine/NYP Westchester site, Former Training Director of the Addiction Psychiatry Fellowship at Weill Cornell/NYP Westchester site, and a board-certified Addiction Medicine specialist in treating complex substance use disorders and co-occurring conditions, offers a personalized and compassionate approach. As a distinguished educator and clinician, Dr. Kotbi provides a comprehensive care approach, combining expert diagnostic skills with personalized treatment planning for patients with complex co-morbidities. His expertise spans psychiatric, neurological, medical, and addiction disorders, allowing for compassionate and holistic care. This approach includes personalized evaluations, ongoing medication management, and second-opinion consultations, with collaborative behavioral support from licensed therapists when necessary.

Signs to Watch For

● Memory gaps or blackouts
● Sudden mood swings or irritability
● Making excuses for drinking (to relax, manage stress, or “feel normal”)
● Hangover symptoms even when not drinking
● Neglecting responsibilities at work, school, or home in favor of alcohol
● Risky behaviors, such as drinking and driving
● Denial of the problem despite clear warning signs
● Anxiety or distress when alcohol isn’t available

Drug Addiction

 If drug use has shifted from an occasional choice to something you feel you can’t do without, it may be a sign of addiction. Drug dependency develops when recreational or experimental use turns into a habit, and before long, both the body and mind can become reliant on the substance. Whether the drugs are legally prescribed or obtained illegally, addiction can progress quickly and bring significant harm to health, relationships, and overall quality of life.

Understanding Drug Addiction 

Drug addiction is a chronic and progressive condition that can affect anyone, regardless of background. It often begins subtly but can rapidly take control, creating both physical dependence and psychological cravings. Common substances linked to addiction include opioids (such as heroin or morphine), prescription medications, benzodiazepines, stimulants like methamphetamines, and synthetic or designer drugs.

The effects can be devastating—ranging from heart and lung disease to strokes, brain damage, and even death. According to the United Nations, more than 29 million people worldwide live with drug use disorders. Yet recovery is possible. With the right support and treatment, many people have been able to break free from dependency, rebuild their health, and reclaim their lives. At the Brain and Mind Healing Center, Dr. Kotbi, Former Chief of the Addiction and Rehabilitation Program at Weill Cornell Medicine/NYP Westchester site, Former Training Director of the Addiction Psychiatry Fellowship at Weill Cornell/NYP Westchester site, and a board-certified Addiction Medicine specialist in treating complex substance use disorders and co-occurring conditions, provides expert, evidence-based care tailored to each individual. As a distinguished educator and clinician, Dr. Kotbi provides a comprehensive care approach, combining expert diagnostic skills with personalized treatment planning for patients with complex co-morbidities. His expertise spans psychiatric, neurological, medical, and addiction disorders, allowing for compassionate and holistic care. This approach includes personalized evaluations, ongoing medication management, and second-opinion consultations, with collaborative behavioral support from licensed therapists when necessary.

Signs to Watch For
● Intense mood swings or irritability
● Changes in friends, hobbies, or daily routines
● Risky behaviors such as driving under the influence of drugs
● Memory problems and cognitive decline
● Loss of motivation or changes in personality
● Inability to stop using despite negative consequences
● Denial of the severity of drug use
● Anxiety or distress when drugs are unavailable
● Physical signs of withdrawal, such as bloodshot eyes or nosebleeds

 Gambling Addiction

When gambling shifts from an occasional pastime to a compulsive behavior that controls your thoughts, emotions, and finances, it may be a sign of gambling addiction. What begins as entertainment can quickly spiral into repeated risk-taking, mounting losses, and devastating consequences for both the individual and their loved ones.

Understanding Pathological Gambling 

Pathological gambling, also known as gambling disorder, is a progressive behavioral addiction that mirrors many of the same patterns seen in alcohol and drug dependency. Individuals often lose control, experience powerful urges to keep betting, and struggle with denial about the severity of their problem. Many people with gambling addiction also turn to alcohol or drugs as a way to cope with the anxiety, guilt, or depression that gambling creates, leading to overlapping struggles.

The good news is that effective, evidence-based treatments are available. At the Brain and Mind Healing Center, Dr. Kotbi, Former Chief of the Addiction and Rehabilitation Program at Weill Cornell Medicine/NYP Westchester site, Former Training Director of the Addiction Psychiatry Fellowship at Weill Cornell/NYP Westchester site, and a board-certified Addiction Medicine specialist in treating complex substance use disorders and co-occurring conditions—provides discreet, individualized care designed to help patients regain control, restore stability, and rebuild healthier lives. As a distinguished educator and clinician, Dr. Kotbi provides a comprehensive care approach, combining expert diagnostic skills with personalized treatment planning for patients with complex co-morbidities. His expertise spans psychiatric, neurological, medical, and addiction disorders, allowing for compassionate and holistic care. This approach includes personalized evaluations, ongoing medication management, and second-opinion consultations, with collaborative behavioral support from licensed therapists when necessary.

Signs to Watch For
● Repeated unsuccessful attempts to cut back or stop gambling
● Lying to family or friends to hide the extent of gambling behavior
● Needing to gamble with larger amounts of money to feel the same thrill
● Gambling as a way to escape stress, guilt, or depression
● Damaging or losing important relationships, career opportunities, or finances due to gambling
● Thoughts of self-harm or suicide related to gambling losses or shame