Lesley Omary, M.D. joined the faculty of Vanderbilt University Medical Center in 2013. She is currently Associate Professor of Clinical Psychiatry and Behavioral Sciences, and has a secondary appointment in the Department of Surgery. She directs the Transplant Psychiatry Service, where her clinical work focuses on psychiatric assessment and treatment for patients who need or have had a solid organ transplant, including liver, lung, heart, and kidney. She also performs psychiatric evaluations for potential living kidney donors and patients needing a larynx transplant.

Prior to joining the Vanderbilt faculty, Dr. Omary worked in the community mental health setting in Chicago. She primarily saw refugees and immigrants with Post Traumatic Stress Disorder from civilian trauma experienced during wartime, and patients with chronic mental illnesses who were experiencing homelessness. She completed her psychiatry residency at the University of Wisconsin-Madison, where she was Chief Resident, and her internship at Northwestern University. She graduated from the University of Virginia School of Medicine.

Dr. Kast is serving as VUMC's interim Division Director for Addiction Psychiatry for AY2024-25. He has served as Program Director for the Addiction Psychiatry Fellowship since 2021, revising the curriculum, expanding program size, and securing grant funding for a research-focused fellowship position. He lectures on substance-related and addictive disorders across undergraduate, graduate, medical school, resident, fellow, and continuing medical education contexts at Vanderbilt. He also teaches and supervises psychodynamic psychotherapy and provides longitudinal supervision and mentorship to general psychiatry residents. In addition to this work, Dr. Kast maintains a practice focused on psychoanalysis and psychodynamic psychotherapy in the community.

From 2020-24, Dr. Kast led the Tennessee State Opioid Response ECHO Tele-Education Hub at Vanderbilt, providing a CME platform for community clinicians caring for individuals with substance use disorders. This work expanded to include an annual regional conference, the Mid-South Addiction Conference, in partnership with the Tennessee Society for Addiction Medicine in 2022.

Dr. Kast joined the Vanderbilt faculty in 2020 after fellowship training in addiction psychiatry at Harvard Medical School and Mass General Brigham's hospitals. He trained in general psychiatry at Weill Cornell and New York-Presbyterian Hospital, where he served as chief resident. He is a candidate in psychoanalysis at the Psychoanalytic Institute of Northern California (PINC), and he previously completed the first year of analytic training at Columbia while in New York. Before this postgraduate work, he completed undergraduate and medical studies at Notre Dame and the Johns Hopkins University School of Medicine, respectively. Dr. Kast is originally from the Ohio River valley of rural southern Indiana and northern Kentucky. 
 

Clinical Description

Dr. Kast serves as an attending addiction psychiatrist on the Addiction Consult Service at VUAH, where he has been Clinical Director since 2020. He also cares for outpatients with SUD and co-occurring disorders in the Vanderbilt Recovery Clinic. He has previously attended on the inpatient Co-occurring Disorders Unit at VPH and in the Vanderbilt Bridge Clinic for low-barrier, high-acuity outpatient stabilization. Dr. Kast supervises clinical fellows, residents, and medical students across these levels of care.

Research Description

Dr. Kast's scholarly interests include substance-related and addictive disorders, medical education, and psychoanalytic/psychodynamic psychotherapy.

Representative Publications

Kast KA, Le TDV, Stewart LS, Wiese AD, Reddy IA, Smith J, Marcovitz DE, Reese TJ. Impact of inpatient addiction psychiatry consultation on opioid use disorder outcomes. Am J Addict. 2024 Mar 28. doi: 10.1111/ajad.13540. Epub ahead of print. PMID: 38546154.

Marcovitz D, Dear ML, Donald R, Edwards DA, Kast KA, Le TDV, Shah MV, Ferrell J, Gatto C, Hennessy C, Buie R, Rice TW, Sullivan W, White KD, Van Winkle G, Wolf R, Lindsell CJ; Vanderbilt Learning Healthcare System Platform Investigators. Effect of a Co-Located Bridging Recovery Initiative on Hospital Length of Stay Among Patients With Opioid Use Disorder: The BRIDGE Randomized Clinical Trial. JAMA Netw Open. 2024 Feb 5;7(2):e2356430.

Fleenor ML, Beavers JR, Tidwell WP, Atchison L, Woo E, Medvecz AJ, Beyene RT, Kast KA, Marcovitz D, Dennis B, Guillamondegui OD, Smith MC. Comparison of phenobarbital monotherapy to a benzodiazepine-based regimen for management of alcohol withdrawal syndrome in trauma patients. J Trauma Acute Care Surg. 2024 Mar 1;96(3):493-498. doi: 10.1097/TA.0000000000004116. Epub 2023 Aug 21. PMID: 37599414.

Marcovitz D, Kast KA. More effective communication during inpatient addiction treatment. Substance Abuse. 2023 Jan-Apr;44(1):12-16. doi: 10.1177/08897077231165064. Epub 2023 May 3. PMID: 37226907.

Audet CM, Pettapiece-Phillips M, Kast KA, White KD, Perkins JM, Marcovitz D. Implementation of a hospital-based intervention for MOUD initiation and referral to a Bridge Clinic for opioid use disorder. Journal of Substance Use and Addiction Treatment. 2023 Mar;146:208961. doi: 10.1016/j.josat.2023.208961. Epub 2023 Jan 24. PMID: 36880904; PMCID: PMC10018480.

Hwang B, Unruh BT, Kast KA. Applying good psychiatric management for borderline personality disorder in hospitalized patients with co-occurring substance use disorders. J Acad Consult Liaison Psychiatry. 2023 Jan-Feb;64(1):83-91. doi: 10.1016/j.jaclp.2022.08.003. Epub 2022 Aug 19. PMID: 35995146.

Kast KA, Avery J. Substance intoxication and withdrawal. Book chapter in The Psychiatric Consult: navigating challenging treatment plans. Eds. Alyson Gorun, Anna Kim, Christian Umfrid, Janna Gordon-Elliott. Springer Publishing. 2022.

Kast KA, Rao V, Wilens T. Pharmacotherapy for attention-deficit/hyperactivity disorder and retention in outpatient substance use disorder treatment: a retrospective cohort study. J Clin Psychiatry. 2021; 82(2).

Gopaldas M, Kast KA. Neurobiology of substance use disorders. Book chapter in Addiction Medicine: a case and evidence-based guide. Eds. Jonathan D. Avery, David Hankins. Springer Publishing. 2021.

Marcovitz D, Pettapiece-Phillips MJ, Kast KA, White KD, Himelhoch H, Audet CM. Implementation of a hub-and-spoke network for opioid use disorder in middle Tennessee. Psychiatric Services. 2021; Dec 8.

Marcovitz D, White KD, Sullivan W, Limper HM, Dear ML, Buie R, Edwards D, Chastain C, Kast KA, Lindsell CJ. Bridging Recovery Initiative Despite Gaps in Entry (BRIDGE): study protocol for randomized controlled trial of a bridge clinic compared with usual care for patients with opioid use disorder. Trials. 2021; Oct 30;22(1):757.

Marcovitz D, Maruti S, Kast KA, Suzuki J. The use of therapeutic metaphor on an addiction consult service. Psychosomatics. 2020; 62(1):102-108.

Kast KA, Avery J. Epidemiology, genetics, and neurobiology of substance use and disorders. Book chapter in Absolute Addiction Psychiatry Review: an essential board exam study guide. Ed. Carla Marienfeld. Springer Publishing. 2020.

The Opioid Epidemic and the Therapeutic Community Model: an essential guide. Eds. Jonathan D. Avery, Kristopher A. Kast. Springer Publishing. 2019.

Kast KA, Avery J. The case of Dr. Sigi Halsted: overdose in the O.R., or substance use disorders in early career physicians. Book chapter in Early Career Physician Mental Health and Wellness: a clinical casebook. Eds. Anna H. Rosen, Janna S. Gordon-Elliott. Springer Publishing. 2019.

Kast KA, Avery J. Medical students and substance use disorders. Book chapter in Medical Student Well-Being: an essential guide. Eds. Dana Zappetti, Jonathan Avery. Springer Publishing. 2019.

Avery J, Taylor KE, Kast KA, Kattan J, Gordon-Elliott J, Mauer E, Avery J, Penzner JB. Attitudes toward individuals with mental illness and substance use disorders among resident physicians. Prim Care Companion CNS Disord. 2019 Jan 3;21(1).

Avery J, Knoepflmacher D, Mauer E, Kast KA, Greiner M, Penzner J. Improvement in residents' attitudes toward individuals with substance use disorders following an online training module on stigma. HSS Journal. 2018 Nov 1.

Kast KA, Gershengoren L. Cannabinoid hyperemesis syndrome and the consulting psychiatrist: a case study of diagnosis and treatment for an emerging disorder in psychiatric practice. J Psychiatr Pract. 2018 Jan; 24(1): 51-55.

Kathy Gracey received her MEd in Counseling Psychology from the University of Mississippi. She has been a member of the Department of Psychiatry and Behavioral Sciences since 1992. She serves as the administrator, responsible for oversight and implementation, of multiple programs serving at-risk children, youth and families.

Ms. Gracey has been the key person with the Vanderbilt Center of Excellence to assist the Department of Children's Services (DCS) with the implementation of a statewide assessment intervention for all children/families in DCS custody along with the implementation of a statewide assessment for non-custody families. She has assisted with the roll-out of the Juvenile Justice Assessment  that has been implemented in approximately 58 juvenile justice courts, training over 300 court staff in Tennessee. This entailed significant collaboration within the Tennessee state system (i.e., Department of Children's Services, Department of Mental Health and Substance Abuse Services along with the Administrative Office of the Courts, which included multi-regional training, networking, and on-going technical assistance. Additional Statewide system improvement initiatives  in collaboration with the TN Department of Mental Health and Substance Abuse Services are projects that support evidence-based practices for our TN System of Care and TN First Episode Psychosis initiative.

Ms. Gracey's research interests include trauma, system improvement, child welfare and juvenile justice.

In 1986, Ms. Gracey moved to Nashville to become Director of a not-for-profit organization that served youth that had experienced sexual trauma. She has been implementing programs at Vanderbilt for at-risk youth and families an youth who have experienced complex trauma for the last 29 years.

Dr. Azzazy is an Assistant Clinical Professor of Psychiatry in the Department of Psychiatry and Behavioral Sciences at Vanderbilt University Medical Center and a Staff Psychiatrist at the Tennessee Valley VA Healthcare System. She received her degree from Lincoln Memorial University DeBusk College of Osteopathic Medicine, completed psychiatry residency at East Tennessee State University, and completed a geriatric psychiatry fellowship at Vanderbilt University Medical Center. Dr. Azzazy teaches psychiatry residents, as well as geriatric psychiatry fellows and geriatric medicine fellows. Her areas of interest include Alzheimer’s Disease, Lewy Body Dementia, Frontotemporal Dementia, Parkinson’s Dementia and Psychosis, and caregiver support.

Suzanne has served the school-based program since 2008 both as a clinician and team leader. She has completed training in RECAP, TF-CBT and the ARC framework. Suzanne helps coordinate student interns in the school-based program. Her prior experience includes teaching parenting classes and providing in-home services to at-risk youth.    

Clinical Description

Suzanne's focus is on providing clinical therapy interventions to elementary school-aged children from underserved, at-risk populations.