From Understanding to Action: Insights from Catie Hodson on Medicine and Addiction
Spotlight on Catie Hodson
In this episode of Mindset Matters, Mercedes Dodge and Jessica Spissinger welcome Catie Hodson, a PA specializing in outpatient psychiatry, opioid use disorder, and co-occurring conditions such as PTSD, anxiety, and depression.
Catie describes a career guided by going where the need is greatest and creating a seat for herself at the table. Her experience in psychosocial rehabilitation and hospital medicine informs an approach that considers psychiatric symptoms, substance use, physical health, and everyday functioning together.
The following clinical applications build on the episode’s themes and offer practical ways to bring them into patient care.
Navigating Psychiatry and Addiction Medicine: Start with the Timeline
Catie’s work illustrates how closely psychiatric care and addiction treatment intersect. A patient presenting with anxiety, insomnia, or depression may also be experiencing intoxication, withdrawal, trauma-related symptoms, or several overlapping concerns. Understanding the relationship between these experiences helps guide assessment.
How to apply this in practice:
Begin with the patient’s priorities. Ask, “What is causing you the most difficulty right now?” and “What would you like treatment to help you do?”
Build a symptom and substance-use timeline. Explore when psychiatric symptoms began, when substance use started or changed, and how symptoms behave during periods of reduced use or abstinence.
Ask specifically about other substances. Include alcohol, benzodiazepines, stimulants, cannabis, and prescribed medications. This information helps identify additional treatment needs and safety concerns.
Assess immediate safety. Evaluate for overdose, significant intoxication or withdrawal, suicidal thoughts, and other acute psychiatric or medical concerns.
Revisit the assessment over time. Document diagnostic uncertainty and reassess as the clinical picture becomes clearer. Screening, assessment, and ongoing management of both mental health and substance use concerns are central to care for co-occurring disorders.
A useful opening might be: “I’d like to understand how your mood, sleep, and substance use affect each other so we can make a plan that addresses all of them.”
Stigma and Substance Use Disorders: Make the Conversation Safe
Catie highlights the stigma surrounding addiction, including misconceptions about buprenorphine. Clinicians can address this through respectful language, clear explanations, and a willingness to hear patients’ and families’ concerns. Stigmatizing language can interfere with disclosure and engagement in care.
How to apply this in practice:
Use person-first language. Say “a person with opioid use disorder” and “a return to use.” When discussing toxicology results, describe the substance detected rather than using “clean” or “dirty.”
Ask before explaining. “What have you heard about buprenorphine?” can reveal concerns about dependence, treatment duration, or whether medication counts as recovery.
Explain the purpose of treatment plainly. Buprenorphine is a partial opioid agonist that reduces cravings and supports treatment of opioid use disorder. Medications for opioid use disorder are associated with lower overdose risk and overall mortality.
Check understanding. Ask, “How would you explain what this medication is intended to help with?” This gives you an opportunity to clarify misconceptions.
Include supports with permission. Ask whom the patient would like involved and what information they are comfortable sharing.
A possible explanation is: “Buprenorphine is an evidence-based treatment for opioid use disorder. We’ll follow how it affects your cravings, symptoms, safety, and daily functioning.”
Collaborative Care: Turn Referrals into Connections
Catie emphasizes teamwork across psychiatry and addiction medicine. In practice, collaboration requires a clear plan for who will do what, how information will be shared, and how the patient will reach the next step in care.
How to apply this in practice:
Map the care team. Identify the primary care clinician, psychiatric clinician, addiction treatment provider, therapist, case manager, and other supports.
Clarify responsibilities. Establish who manages medications, follows medical concerns, coordinates referrals, and responds to urgent issues.
Use a warm handoff when possible. Introduce the patient to the next team member or help arrange the appointment before the visit ends.
Share a focused clinical summary through appropriate channels. Include current treatment, relevant safety concerns, patient goals, and the specific reason for consultation.
Close the loop. At follow-up, ask whether the connection occurred and what barriers remain.
Offer behavioral and psychosocial supports according to the patient’s needs and preferences. However, declining counseling or being unable to access it should not delay medication treatment for opioid use disorder.
Overdose Prevention: Make Safety Part of Routine Care
A practical extension of the episode’s focus on opioid use disorder is to incorporate overdose prevention into treatment visits. CDC recommends offering naloxone and education about its use to patients with opioid use disorder and their household members or significant others.
How to apply this in practice:
Ask whether the patient has naloxone and whether it is readily accessible.
Review how to recognize a suspected overdose, administer the available naloxone product, and call emergency services.
Use teach-back: “Walk me through what you would do if someone became unresponsive and you suspected an overdose.”
With permission, include someone likely to be present in an emergency.
Revisit access and understanding at subsequent visits.
Present this as routine preparation: “I discuss overdose prevention with patients because having a plan and naloxone available can save a life.”
The Upstream Effects of Public Policy: Make the Plan Feasible
Catie’s discussion of housing, food security, and environmental conditions highlights how circumstances outside the clinic shape care. A treatment plan becomes more useful when clinicians ask how it will fit into the patient’s actual life.
How to apply this in practice:
Ask concrete questions. “Do you have a safe place to stay?” “Can you get to the pharmacy?” “Do you have reliable phone access?”
Explore missed visits without judgment. “What got in the way of coming in?” may reveal transportation problems, work schedules, caregiving demands, or fear of being judged.
Identify one actionable barrier. Choose a problem the patient wants help addressing and connect them with an appropriate team member or resource.
Adapt the plan where possible. Consider appointment timing, medication access, and how the clinic will communicate with the patient.
Follow up on the referral. Ask whether the resource was accessible and useful.
A helpful closing question is: “Which part of this plan feels doable, and which part should we adjust?”
Reaching Out and Building Resilience: Make Boundaries Explicit
Mercedes, Jessica, and Catie discuss the importance of professional boundaries and personal supports. Their conversation offers a practical reminder to establish expectations before work communications begin to consume time intended for rest and relationships.
How to apply this in practice:
Explain how patients should contact the team, expected response times, and the appropriate route for urgent concerns.
Use established coverage arrangements for time away.
Seek consultation when a case feels clinically complex or emotionally difficult.
Protect time for activities that are personally restorative, including exercise, faith, family, or other interests.
Bring recurring workload and coverage problems to the team so they can be addressed together.
A boundary statement might be: “Messages are reviewed during clinic hours. Let’s review whom to contact if you need urgent help outside those hours.”
Teaching Pearls: A Practical Visit Framework
These themes can be translated into a simple sequence for clinical encounters:
Connect: Ask what matters most to the patient.
Assess: Explore psychiatric symptoms, substance use, their timeline, and immediate safety.
Explain: Discuss findings and treatment options using clear, respectful language.
Plan: Agree on achievable next steps and identify barriers.
Coordinate: Clarify team responsibilities and facilitate needed connections.
Confirm: Use teach-back and establish follow-up.
The goal is to leave the encounter with a shared understanding of the concerns, a feasible next step, and a clear path back to care.
Inspiration for Aspiring PAs
Catie’s career offers encouragement for PAs interested in addiction medicine: seek opportunities where your skills are needed, build relationships with experienced colleagues, and establish sustainable work habits early.
For those entering the field, practical starting points include observing experienced clinicians, seeking mentorship, learning local referral pathways, and becoming familiar with evidence-based treatment resources. SAMHSA offers training and technical assistance to support integration of substance use treatment into clinical settings.
Catie’s perspective reminds us that compassionate care takes shape through everyday actions: listening carefully, addressing stigma, coordinating treatment, and helping patients navigate the circumstances that affect their health.
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