Becker’s Healthcare Podcast

Guest: Dr. Dan Schatz, Medical Director of Addiction Services, NYC Health + Hospitals
Date: August 31, 2025

Episode Overview

In this episode, Mariah Muhammad of Becker’s Healthcare interviews Dr. Dan Schatz, Medical Director of Addiction Services for NYC Health + Hospitals. The discussion delves into the complexities of addiction, how to recognize substance use disorders, accessing care in New York City, barriers to recovery, and the innovative, stigma-reducing strategies being implemented citywide. Dr. Schatz sheds light on trauma-informed and patient-centered approaches, emphasizing compassion, community, and hope.

Key Discussion Points & Insights

1. Dr. Schatz’s Background and Scope of Services

[00:23–01:13]

• Dr. Schatz is a primary care and addiction medicine physician, leading addiction services across the largest public healthcare system in the U.S.
• NYC Health + Hospitals provides about 60% of New York City’s behavioral health services, caring for over 80,000 individuals at 11 acute care facilities.
• Addiction services span outpatient, emergency, inpatient, and community settings.
• Quote:

  "We have to help all services across the health care system." (Dr. Schatz, 00:53)

2. Recognizing Substance Use Disorders: Signs & Next Steps

[01:13–03:27]

• Dr. Schatz references the DSM-5's 11 diagnostic criteria for substance use disorders; meeting two or more indicates a disorder.
• Warning signs include:
  • Biological: Injuries, falling, physical harm.
  • Social: Withdrawing from activities and relationships.
  • Psychological: Cravings, dependence, persistent thoughts about substances.
• Importance of expressing care and concern, regardless of diagnosis.
• Quote:

  "If you see your loved one giving up and retreating from their normal activities, this is where it should raise a flag." (Dr. Schatz, 02:45)

3. Accessing Addiction Care in NYC

[03:27–06:19]

• NYC Health + Hospitals operates 11 acute hospitals, multiple community health centers, and outreach initiatives.
• All staff are trained to recognize, screen for, and refer to addiction services—available at every facility.
• Focus on "low threshold" care, meaning flexible and barrier-free services, e.g. treating multiple substance uses, meeting patients where they are.
• Innovations include community mobile teams and support vans.
• Quote:

  "Our doors are always open, that you're ready, that allows for change to occur in addiction." (Dr. Schatz, 05:11)

4. Challenges in the Recovery Journey

[06:19–10:25]

• Three major needs for patients:
  1. Health and Security: Housing and addressing basic needs.
  2. Connections: Combating loneliness via community and peer support.
     • Growth of the Peer Academy, training individuals with lived experience to help others.
  3. Purpose: Helping patients rediscover meaning in life through work, volunteering, community involvement.
• Addiction is isolating, and love/support from family and friends is integral to recovery.
• Quote:

  "Addiction is a very isolating activity. They're often ostracized or said, just, why can't you just say stop or no? What we need to understand is that they still crave connections to others." (Dr. Schatz, 08:26)

5. NYC Health + Hospitals’ Approach to Overcoming Barriers

[10:41–15:01]

• Stigma around addiction is shifting rapidly, with new cultural and clinical frameworks.
• Addiction is treated as a medical issue, not a moral failing.
• Emphasis on systemwide workforce training to reduce stigma, utilize live actor simulations, and share educational videos.
• Medications for opioid and alcohol use disorders are highly effective, yet relapse is common—approach mirrors chronic disease management.
• Emergency departments use specialized teams (ED Leads, Peers, Social Workers) for immediate engagement and resource linkage.
• Patient dignity, persistent engagement, and trauma-informed care are central.
• Quote:

  "They're not drug seeking. What they're looking for is relief. They're actually in physical and medical withdrawal ... So it shifts from headbutting to, hey, this is a medical issue that we have tools for and that's really important." (Dr. Schatz, 11:17)

6. Training a Trauma-Informed, Patient-Centered Workforce

[15:26–18:52]

• Many patients with severe addiction have childhood trauma; substance use often a coping mechanism.
• Training spans everyone—from front desk staff to physicians—focusing on empathy, dignity, and the patient’s context.
• Systemwide behavioral health training includes videos, live simulations, and collaboratives, reaching 3,000+ staff.
• Stigma is recognized as a life-or-death issue; even minor negative experiences can deter care-seeking.
• Outreach extends into the community so care meets patients wherever they are, including virtually.
• Quote:

  "Stigma is not just some software issue. It's the matter. It's a life or death issue. It means they either seek out care or they don't seek out care..." (Dr. Schatz, 17:47)

Notable Quotes & Memorable Moments

• On recognition and early intervention:

  "The question in itself means that there is a loved one who's concerned about it, which is one of the criteria." (Dr. Schatz, 02:10)

• On low threshold care:

  "If you come into the emergency department, we'll get you care. If you just want to cut down, we'll help you get where you want to go as comfortably and safely as possible." (Dr. Schatz, 05:01)

• On peer support:

  "A lot of our patients actually start in one of our services, realize that they really like helping others ... and after they get their SERPA ... they come back, and now they're part of the team." (Dr. Schatz, 07:41)

• On the importance of persistence and hope:

  "If you're not ready now, we'll get you next time. And we just kind of persistently have hope that the patients will engage at some point and if not, that they know that we're here and we're supportive of them." (Dr. Schatz, 14:11)

• On workforce training and reducing stigma:

  "It's the entire team. And what we need is there's been a history of stigma put upon these patients. So we need a lot of positive experiences to earn their trust." (Dr. Schatz, 17:02)

Timestamps for Important Segments

• [00:23] Dr. Schatz introduces himself and NYC Health + Hospitals’ addiction services
• [01:31] Signs someone is struggling with addiction; DSM-5 criteria explained
• [03:44] How to access addiction services in NYC
• [06:38] Biggest challenges on the path to recovery
• [10:41] NYC Health + Hospitals’ strategies for supporting recovery and reducing stigma
• [15:26] Best approaches to trauma-informed, patient-centered care and workforce training

Closing

Dr. Schatz’s core message is one of hope, community, and systemic change. By weaving medical expertise with compassion, peer support, and accessible care, NYC Health + Hospitals aims to meet the needs of New Yorkers struggling with addiction—wherever they are—while challenging stigma and empowering recovery.