Addiction treatment that addresses what drives the use — not just the use itself.
Substance use disorders rarely exist in isolation. At Wave Psychiatric Group, our board-certified psychiatrists treat addiction in the context of the full psychiatric picture — addressing the depression, anxiety, trauma, and other conditions that so frequently underlie or co-occur with problematic substance use, within a practice that takes both dimensions of the presentation seriously.
Understanding substance use disorders
Substance use disorders exist on a spectrum of severity — from hazardous use patterns that carry meaningful health and functional risks, to moderate disorders characterized by loss of control and significant life consequences, to severe addiction involving profound physiological dependence, compulsive use despite serious harm, and the full neurobiological reorganization of reward and motivation circuits around the substance.
What defines a substance use disorder is not just the amount consumed or the frequency of use, but the relationship between the person and the substance — the degree to which use has become compulsive, the extent to which control has been lost, and the consequences that have accumulated despite continued use. Shame, secrecy, and the persistent belief that the problem is a matter of willpower rather than a medical condition delay treatment for many people and cause enormous unnecessary suffering in the interim.
Substance use disorders are medical conditions with identifiable neurobiological underpinnings. They are also conditions with deep psychological and social dimensions — shaped by trauma, attachment, meaning, identity, and the circumstances of a person's life in ways that purely biological models do not fully capture. Effective treatment takes all of these dimensions seriously.
The relationship between substance use and psychiatric illness
The co-occurrence of substance use disorders and psychiatric illness is the rule rather than the exception. The majority of people with a substance use disorder have at least one co-occurring psychiatric condition — most commonly depression, anxiety disorders, PTSD, ADHD, or bipolar disorder — and the relationship between the two is bidirectional and complex.
Substances are frequently used in the service of psychiatric symptoms — alcohol to quiet anxiety, cannabis to manage depression or insomnia, benzodiazepines to manage panic. This self-medication dynamic is clinically important not because it excuses or justifies problematic use, but because understanding what the substance is doing for the person is essential to developing a treatment plan that addresses the underlying need — and because treating the substance use without addressing the psychiatric condition it was serving is one of the most common reasons addiction treatment fails.
The reverse is equally important. Substance use significantly worsens the course of virtually every psychiatric condition — disrupting sleep, destabilizing mood, impairing the efficacy of psychiatric medications, and interfering with the psychotherapeutic work that psychiatric recovery requires. Treating depression or anxiety in the context of ongoing heavy alcohol use, for example, produces systematically worse outcomes than addressing both simultaneously.
Our psychiatrists approach substance use and psychiatric illness as two dimensions of a single clinical picture that require integrated attention — not sequential treatment in which one problem must be resolved before the other can be addressed.
Substance use presentations we treat
Alcohol use disorder
Alcohol use disorder is one of the most prevalent and most undertreated medical conditions in the United States. It spans a wide spectrum of severity — from problematic drinking that is causing health and relational consequences, to severe dependence with physiological withdrawal risk. Our psychiatrists assess alcohol use thoroughly in every initial evaluation and treat alcohol use disorder as a primary clinical focus when it is present, including medication management and close coordination with psychotherapy and support resources.
Medically supervised alcohol withdrawal is a clinical priority for patients with severe dependence — alcohol withdrawal carries risks including seizure and delirium tremens that require medical management. Our psychiatrists assess withdrawal risk carefully and coordinate medical supervision when indicated, including referral to appropriate medical or inpatient settings when outpatient management is not safe.
Cannabis use disorder
Cannabis use disorder is increasingly prevalent as legal access has expanded and as the potency of available cannabis products has increased substantially. Many patients do not recognize their cannabis use as problematic because of its legal status and its cultural normalization — but cannabis use disorder produces real functional impairment, real withdrawal symptoms including anxiety, irritability, and sleep disruption, and real interference with psychiatric treatment. Our psychiatrists address cannabis use directly and without judgment as a clinical issue that warrants honest attention.
Benzodiazepine dependence
Benzodiazepine dependence is one of the most common iatrogenic substance use problems in psychiatric practice — frequently arising not from recreational use but from long-term therapeutic prescribing that has produced physiological dependence. Patients who have been on benzodiazepines for months or years — often prescribed by primary care physicians or previous psychiatrists for anxiety or insomnia — frequently present to Wave dependent on these medications without a clear plan for how to address that dependence.
Benzodiazepine discontinuation requires a carefully managed, gradual taper — abrupt withdrawal from high-dose benzodiazepines carries serious risks including seizure. Our psychiatrists manage benzodiazepine tapers in a structured, supportive way, typically in combination with treatment of the underlying anxiety or insomnia that the benzodiazepine was prescribed to address. This is one of the scenarios in which integrated psychiatric care — addressing the medication dependence and the underlying condition simultaneously — is particularly valuable.
Co-occurring psychiatric illness and substance use
For patients whose primary presentation involves a psychiatric condition alongside substance use — depression and alcohol use, PTSD and cannabis use, anxiety and benzodiazepine dependence — our psychiatrists provide integrated treatment that addresses both dimensions within a single clinical relationship. We do not require sobriety as a precondition for psychiatric treatment. We work with patients where they are, with the goal of reducing substance use and improving psychiatric outcomes simultaneously and collaboratively.
What Wave does not treat — and where we refer
We are committed to being direct about the scope of our practice so that patients can make informed decisions about where to seek care.
Wave is an outpatient psychiatric practice. We treat substance use disorders in the context of co-occurring psychiatric illness and provide medication management for alcohol and opioid use disorders within an outpatient setting. We do not provide the intensive structure of residential treatment, partial hospitalization programs, or intensive outpatient addiction programs — and for patients whose severity of addiction requires that level of care, referral to an appropriate program is the right clinical decision and one we make without hesitation.
We maintain referral relationships with trusted addiction medicine specialists, residential treatment programs, and intensive outpatient programs in the Los Angeles area, and we coordinate actively with those settings for patients who need a higher level of care.
Opioid use disorder Wave offers buprenorphine — including Suboxone — for the treatment of opioid use disorder for appropriate patients. Buprenorphine is a highly effective, evidence-based medication-assisted treatment for opioid use disorder that significantly reduces cravings, prevents withdrawal, and dramatically lowers the risk of overdose and death. Our psychiatrists prescribe it within the context of a comprehensive psychiatric evaluation and ongoing treatment relationship. Patients requiring methadone maintenance are referred to licensed opioid treatment programs.
Medication-assisted treatment
Several medications have strong evidence bases for the treatment of substance use disorders and are prescribed at Wave when clinically indicated.
For alcohol use disorder, naltrexone — an opioid receptor antagonist that reduces the rewarding effects of alcohol and craving — has the strongest evidence base of any medication for alcohol use disorder and is significantly underutilized relative to its clinical value. Acamprosate, which reduces the distress of protracted alcohol withdrawal and supports abstinence, is an evidence-based alternative for patients who cannot tolerate naltrexone. Disulfiram — which produces aversive reactions to alcohol consumption — is a third option used in selected patients with strong motivation and appropriate support. Our psychiatrists discuss the evidence base, mechanism, and practical considerations of each option with patients and prescribe based on individual clinical circumstances.
For opioid use disorder, buprenorphine / naloxone is the primary medication-assisted treatment offered at Wave. It is prescribed within the context of a comprehensive psychiatric evaluation, ongoing monitoring, and a treatment relationship that addresses both the opioid use disorder and any co-occurring psychiatric conditions.
Insurance and fees
Wave Psychiatric Group accepts Aetna, Optum / UnitedHealthcare Behavioral Health, Meritain Health, Oxford Health Plans, ComPsych, UC SHIP, and others for diagnostic assessment appointments. Self-pay rates are also available.
Call us at 323-688-6380 or complete our intake form and our team will verify your benefits before your first appointment.
Frequently Asked Questions
Do I need to be sober before I can see a psychiatrist at Wave?
No. We do not require sobriety as a precondition for psychiatric treatment. We work with patients where they are, with the goal of improving both psychiatric symptoms and substance use outcomes simultaneously. For patients in active addiction, waiting for sobriety before addressing psychiatric illness is often not clinically realistic — and the psychiatric illness is frequently what is driving the substance use.
Is addiction a choice or a disease?
This is a question that carries enormous moral and clinical weight, and it deserves a direct answer. Addiction involves a complex interaction of biological vulnerability, psychological factors, and social circumstances that produces genuine changes in brain function — in reward processing, impulse control, stress response, and decision-making — that are measurable and that go well beyond a simple choice. At the same time, people with addiction make choices, and treatment involves supporting the development of agency and self-determination alongside addressing the neurobiological dimensions of the condition. Framing addiction as purely a moral failure is both scientifically inaccurate and clinically unhelpful. Framing it as purely a brain disease without psychological and social dimensions is equally incomplete. We approach it as what it is — a complex condition requiring a comprehensive, non-judgmental clinical response.
Can psychiatric medication help with addiction?
Yes, in several important ways. Medications for alcohol use disorder — naltrexone, acamprosate, disulfiram — have meaningful evidence bases and are significantly underused. Buprenorphine is a highly effective and potentially life-saving treatment for opioid use disorder. Treating co-occurring psychiatric conditions — depression, anxiety, PTSD, ADHD — with appropriate medication frequently reduces substance use by addressing what was driving it. Our psychiatrists discuss medication options honestly and prescribe them when the evidence and the clinical picture support doing so.
What is benzodiazepine dependence and how is it treated? Benzodiazepine dependence refers to the physiological adaptation that occurs with regular benzodiazepine use — in which the brain adjusts to the presence of the medication and produces withdrawal symptoms when it is reduced or stopped. It can develop with therapeutic doses taken as prescribed and does not require recreational use or misuse. Treatment involves a gradual, medically supervised taper — typically over weeks to months depending on the dose, duration of use, and the specific benzodiazepine — alongside treatment of the underlying condition for which the benzodiazepine was originally prescribed. Our psychiatrists manage benzodiazepine tapers in a structured, supportive way and do not rush the process.