When choosing a doctor for a heart problem, most families know to look for a DM Cardiology. Ask those same families what qualification to look for in addiction treatment, and almost nobody knows the answer. It does — and understanding it can change the quality of care your family receives.
The training ladder, explained
Becoming a psychiatrist in India follows a defined ladder. MBBS: five and a half years of medical school. MD Psychiatry (or DNB Psychiatry): three years of postgraduate residency training in mental illness. Most psychiatrists in India practice at this level, and many practice excellently.
Above this sits the super-specialty tier: the DM — Doctorate of Medicine. A DM is a further three years of full-time training, entered through a national-level entrance examination, in one narrow field. DM Cardiology. DM Neurology. And, since relatively recently, DM Addiction Psychiatry.
Why DM Addiction Psychiatry is so rare
DM Addiction Psychiatry is offered at only a small number of institutes in India. The programme at NDDTC (National Drug Dependence Treatment Centre), AIIMS Delhi — the country’s apex centre for drug dependence treatment, where I trained — admits only a handful of candidates. As of 2026, the total number of psychiatrists in India holding this qualification is estimated at fewer than a dozen, serving a country where the national survey on substance use estimated around 16 crore alcohol users, over 3 crore cannabis users and more than 2 crore opioid users.
Source: Magnitude of Substance Use in India, Ambekar et al., NDDTC AIIMS / Ministry of Social Justice and Empowerment, 2019.
What three extra years actually buy
Addiction is not a moral failing and it is not simply “a bad habit” — it is a disorder of the brain’s reward, impulse and control circuitry, frequently entangled with ADHD, depression, anxiety and trauma. The DM years are spent entirely inside that entanglement: managing complicated withdrawal safely; mastering anti-craving pharmacology such as Motivational Interviewing and Relapse Prevention; dual diagnosis — treating addiction and mental illness together; behavioural addictions — gaming, gambling, pornography, internet, and research training, including neuromodulation approaches such as rTMS and Theta Burst Stimulation.
What this means when choosing a doctor
For straightforward conditions, a well-trained MD psychiatrist is entirely appropriate. Consider seeking DM-level addiction expertise when there have been multiple relapses despite treatment; when addiction coexists with another psychiatric condition; when withdrawal has previously been severe or complicated; when behavioural addictions are involved; or when advanced options like neuromodulation are on the
table.
The right question to ask any addiction specialist is simple: “What is your specific training in addiction psychiatry?” A qualified doctor will welcome the question.
