Substance Use Evaluation and Medication Management in Maryland
Who This Service Is For
This service may be appropriate for adults who:
Are concerned about how much or how frequently they use alcohol or another substance
Have tried to reduce or stop but found it difficult
Experience cravings or repeated return to use
Continue using despite problems at home, work, school, or in relationships
Use substances to manage anxiety, depression, trauma symptoms, stress, or sleep
Are in recovery and need continued psychiatric medication management
Have both substance use and another mental health concern
Want a confidential evaluation before deciding what to do next
You do not need to arrive with a specific diagnosis or treatment plan. The first step is an honest conversation about what has been happening and what you would like to change.
Comprehensive Substance Use Evaluation
The evaluation may include discussion of:
The substances being used
Frequency, amount, patterns, and duration of use
Cravings, tolerance, or withdrawal symptoms
Prior attempts to reduce or stop
Previous treatment or recovery experience
Overdose, medical, or safety history
Current medications
Anxiety, depression, trauma, ADHD, sleep, or mood symptoms
Family, work, relationship, and legal consequences
Your goals, readiness, concerns, and available support
Substance use and psychiatric symptoms can affect one another. A careful assessment helps determine whether symptoms are substance-related, part of another psychiatric condition, or a combination of both.
Medication Management
When clinically appropriate, medication may be considered as part of treatment for certain substance use disorders, cravings, withdrawal prevention, relapse prevention, or co-occurring psychiatric symptoms.
Medication decisions depend on the substance involved, current use, medical history, withdrawal risk, other medications, laboratory or monitoring needs, previous treatment, and the appropriate level of care.
Medication is not automatically prescribed during an initial consultation, and some patients may need additional records, medical testing, in-person assessment, or coordination with another treatment program.
Our Treatment Approach
Care is collaborative, practical, and respectful. We may use motivational interviewing, supportive therapy, psychoeducation, relapse-prevention strategies, harm-reduction principles, and structured goal setting during medication-management visits.
Treatment goals may include abstinence, reduced use, improved safety, relapse prevention, better psychiatric stability, or connection to a more intensive treatment program.
When appropriate, we may recommend individual therapy, group treatment, peer recovery support, intensive outpatient care, detoxification, residential treatment, or coordination with your primary-care or specialty providers.
Outpatient Care and Safety
R&K Wellness Group is an outpatient psychiatric practice. We do not provide medical detoxification, emergency treatment, inpatient care, or around-the-clock monitoring.
Patients experiencing severe withdrawal, overdose, confusion, seizures, hallucinations, medical instability, immediate danger, or another emergency should call 911 or go to the nearest emergency department.
For suicidal crisis or emotional distress, call or text 988.
Appointment Availability
Appointments are available with Oswaldo X. Romero, DNP, PMHNP-BC:
In person in Rockville, Maryland
By secure telehealth when clinically appropriate for patients located in Maryland
In English or Spanish
The first appointment is a consultation to determine whether outpatient treatment at R&K Wellness Group is clinically appropriate.
