• Dr. Barry Stimmel is Ombudsperson and Dean Emeritus for Medical Education at Mount Sinai School of Medicine. He also serves as Katherine and Clifford Goldsmith Professor of Medicine (Cardiology) and Professor of Medical Education. A practicing internist and cardiologist, he established the Narcotics Rehabilitation Center (NRC) at The Mount Sinai Medical Center in 1970. The NRC was the first program in New York City to use methadone solely in an ambulatory care setting. Treating over 10,000 heroin users, the NRC served as a model multidisciplinary treatment program for the State of New York. Nationally and internationally known for his treatment and study of heroin dependency, he has served on the White House Office of National Drug Control Policy Committee of Physicians for National Drug Control Strategy. He edits the Journal of Addictive Diseases and has written over 140 articles and 8 books dealing with drug abuse, the effects of mood-altering drugs on the heart, and pain control. In addition, he lectures extensively on issues in medical education, pain management, and substance abuse.


While advances in neuroscience have clearly delineated the areas of the brain that are affected by mood-altering drugs, the success rate of treatment for people dependent upon or addicted to these drugs remains essentially unchanged over the last several decades. This is due in large part to paying inadequate attention to the craving that occurs after discontinuing a mood-altering drug that produces physical dependency. This article will review the changes that occur when one becomes physically dependent on a mood-altering drug and the process to follow in order to maximize the chances of success in maintaining abstinence when drug use has been discontinued.