Addictions Q&A
22 experts · 182 questions answered
Latest Q&As
Panic attack after starting Effexor
Although drugs such as Effexor are prescribed for anxiety, it is not uncommon for the serotonin based antidepressants to precipitate serious panic attacks when they are first started. The marijuana probably also played a role in this panic attack, as both the marijuana and the Effexor affect the aut
Answered by Dr. Stuart Shipko
Adolescents and marijuana
A worried parent describes their nearly-18-year-old son smoking weed and feeling blamed and helpless, unsure what to do to avoid losing him.
Answered by Jim LaPierre
Adolescence and marijuana
Hi there and thank you for writing to me! I would encourage you to talk openly and honestly with your son about marijuana. For many adolecents, marijuana use can be a sign that something is amiss - but perhaps not in the way you might think. Many folks use marijuana to medicate anxiety, Attention De
Answered by Jim LaPierre
Tinnitus after stopping marijuana
This is a pretty uncommon symptom, and I don't think that the phenomenon has ever been studied. It is so uncommon that I went online to see if anyone was posting their experiences on marijuana withdrawal tinnitus. People have reported withdrawal related tinnitus. From what I could learn from the pos
Answered by Dr. Stuart Shipko
Tapering
Hi there and thanks for reaching out. I applaud your efforts at tapering and your goal of being free of the substance. To be perfectly candid with you, going down 1mg every seven to ten days is totally manageable. Adding loperimide seems unnecessary to me. I get your thinking here and I agree that k
Answered by Jim LaPierre
Addcited without the High
Hi there and thanks for your question. Unfortunately, yes - we can say that people become addicted to steroids because they continue to use despite negative consequences. The high of steroids is not the euphoria that it is with other drugs - it is more about achieving the desired outcome. I encourag
Answered by Jim LaPierre
Cocaine addiction
With cocaine, becoming psychologically addicted is more the issue than physical addiction. Cocaine's effect is very seductive because the high produces strong elation and illusions of power. Because the high is so short lived, the user tends to need to use often in order to sustain those feelings. A
Answered by Zelik Mintz
Breaking Out or Breaking Down?
Hey there, thanks for your question. I'm intrigued by your use of the word, "dosing." I have no interest in judging you. I point to this word because it feels like a gross rationalization. You're self medicating? I get that. Heroin for you is medicine - cheap opiates take the edge off anxiety and pa
Answered by Jim LaPierre
Differences Between Drugs & Addictions
Hi there and thanks for your question. Yes, as they say, "addiction is addiction, is addiction" and yet there are differences and some of them need to be acknowledged and addressed. In my experience 95% of what we have to deal with is ourselves and in order to do that we have to be clean and sober.
Answered by Jim LaPierre
When You Can't Stop Self Medicating
Hi there - thanks for your question. Everything you're saying suggests to me that you've been using marijuana to self medicate anxiety. My guess is that you struggled with feelings of nervousness or worry before you started smoking and now those same feelings are returning but with greater intensity
Answered by Jim LaPierre
Tripping and Slipping
Hi there and thanks for your question. It's great that your brother is off coke but I think you have every reason to be concerned. Having run into some pretty significant and objective problems, he stops using one drug, does another, and is coping poorly. Treatment on an outpatient basis would be th
Answered by Jim LaPierre
Question on how to wean off of Ativan (a benzodiazepine). addendum
I think that it is a good idea to wait until you are completely weaned off of the Metoprolol and stabilized on thyroid replacement before bothering to taper off of the Ativan (lorazepam). Typically Hashimoto's thyroiditis results in low thyroid. Often people associate high thyroid with anxiety, but
Answered by Dr. Stuart Shipko
Question on how to wean off of Ativan (a benzodiazepine).
These are questions that come up frequently. I address these questions in my eBook, Xanax Withdrawal. http://xanaxwithdrawalbook.com/ Although written primarily based on my experience with Xanax, the principles apply to lorazepam mg for mg. I have gotten better results from a direct taper rather tha
Answered by Dr. Stuart Shipko
Suboxone Patients Need Treatment
Thank you for your question. Suboxone is not meant to be a treatment for addiction on its own. It is meant to be used as one part of a treatment program.The other parts are Narcotics Anonymous or a similar support group and counseling. It sounds like you are trying hard to stay clean. But it seems l
Answered by Anna Deeds
Really?
Hi there. Thank you for your question - especially as it addresses a misconception: It's actually very simple:One does damage and every one that follows does as well. The popularity of the drug ebbs and flows and frankly it's hard fr me t imagine anyone finding it all that entertaining in the first
Answered by Jim LaPierre
Getting out of Your Head & Listening to Your Gut
Hey - thanks for your truly excellent question. I'm gonna take some of your words and elaborate on them: "...a part of me knows this is fucked up." Yup - that's your gut feeling. You're smart and therefore all the more able to rationalize and justify. There is part of you that knows that if you were
Answered by Jim LaPierre
Snorting prescribed medicine
Your Dad is using a "route of administration" that is not prescribed by his doctor. No doctor prescribes medication to be snorted to my knowledge. That means it is at least an "abuse" of his prescribed medication. I recommend you tell your Dad what you saw, unless he has ever been abusive to you. If
Answered by Jennifer Hamilton
How long is inpatient treatment for a painkiller addiction?
Inpatient care for opiate dependency is variable, depending on drug, dosage, duration of use, route of administration and a number of other factors. I have had patients with the same issue you bring up: the employer finding out, and I have seen some patients sneak in a detox while telling the employ
Answered by Dr. Stuart Shipko
Addiction is a Selfish Disease
Dear Mother, You've crossed over to the addicted person you said you'd never become. This is all too common and furthermore, a tragedy. If you love your kids you would seek help immediately and find a safe place for your children to stay. You have lost complete control and this is child abuse and ch
Answered by Jeannie Cameron, LMHC
Cleaning Up
Hi there and thanks for your question. The time it takes to heal depends upon the severity of the injection sites Larger track mark take longer to go away. Genetics play a role as well - if you generally heal quickly then they'll go faster. In most cases, a few months and they'll heal to the point o
Answered by Jim LaPierre
Counseling for Resistance
Thank you for your question. Counseling addicts at a methadone clinic can be a challenge for even the most experienced counselor. Some of them don't want help, some of them aren't sure if they want help, some of them do want help but want to tell you what kind of help they need and a few do want you
Answered by Anna Deeds
My new therapist lowered my Xanax by half and its not working
What you describe is all too common. In the process of marketing the SSRIs, such as Paxil and Prozac, the drug companies did their best to vilify the competition - Xanax.- to try to take a bite out of the Xanax market. The dangers of the drug have been exaggerated. Many clinicians have a knee jerk t
Answered by Dr. Stuart Shipko
Overdose
Someone who snorts heroin asks whether an overdose could happen too fast to call an ambulance, or if it would always be slow enough to get help in time.
Answered by Anna Deeds
HIV transmission sharing a smoke
A reader shared a pipe with a stranger whose lips were bleeding from dryness and cracking, and now worries about HIV transmission, asking whether they should get tested or if their fear is unfounded.
Answered by Zelik Mintz
Did cocain almost give me a heart attack?
Cocaine increases the heart rate, and at the same time causes some degree of constriction of the blood vessels that feed the heart. These are effects that occur each time it is used. Cocaine can also cause arrhythmia at times, but this doesn't occur each time it is used. Cocaine has the potential to
Answered by Dr. Stuart Shipko
Is it possible to get addicted to Ativan after only using it 2 to 3 weeks?
In a word, yes. You are not addicted in the classical sense, but have developed a dependency. The rate at which this can occur is highly variable. In your case dependency is more likely because you took a relatively high dosage. Fifty 1 mg tablets over 20 days comes out to more than 2 mg a day. I im
Answered by Dr. Stuart Shipko
Suboxone Taper
Thank you for your question. The best way is to taper slowly to minimize withdrawal. Because every person's body is different, it is hard to say what is slow enough for you. The best advice I can give is to pay attention to your body and your emotions. You might want to keep a journal to track how w
Answered by Anna Deeds
Exasperated Mother
Dear mom, my heart goes out to you as this is a too familiar scenario across our country. The fact that your son is "holding" drugs for a friend and so familiar with the "street names" tells me he has access to a broad range of drugs. When teenagers use drugs and/or alcohol, it is better to overreac
Answered by Jeannie Cameron, LMHC
Setting Boundaries with Old Drug Friends
Hi! Thanks for your question. I favor simple and direct - "I need for you to know that I'm not using anymore." Seems sufficient to me. Setting boundaries is a little more tricky - "I can't be around you when you're high." or "I can't be around drugs." What a lot of us find, sadly is that what we tho
Answered by Jim LaPierre
Can long term tramadol permanently deplete my serotonin?
Most people are surprised to learn that depression is not caused by a 'chemical imbalance' related to serotonin or any other neurotransmitter. Actually, the chemical imbalance concept was originally a marketing strategy. Chemical imbalances aside, depression that people experience when stopping opia
Answered by Dr. Stuart Shipko