Question: A few of days ago I smoked this joint with a couple of guys I only sort of know in the park and it must have been laced with something because it just ruined me and I can normally really hold my own. I was freaking out and I had to lay down in the park for a couple of hours before I could even walk home. I could barely move and was hallucinating in scary ways. Ever since then I feel really weird, like I am in the world but not quite in the world, like things are fuzzy or warped or something. Like I am in another dimension and I can see and hear everything and even participate but that I am not quite living in the same place as every one else. People talk to me and it sounds weird and it’s almost like I am above it all and watching it happen but that’s not quite right exactly either. It is almost like as acid trip but without the cool hallucinations or good feelings. This is quite unpleasant and I feel like I can’t connect with anyone anymore. I can barely talk to my girlfriend. She knows something is wrong with me but I can’t explain it to her as talking to her normally is quite challenging at the moment. What is going on with me?

Iona Health Says...:

First, let me say that I am very sorry that you are suffering from this recent incident. The problem with buying or smoking marijuana is similar to the same dilemma we face we buy our food. We don’t know what is in our food unless we know the farmer. We don’t know what is in marijuana without knowing the grower and distributor. The first concern that I have is your decision to smoke marijuana with people you did not know or have “trust” with. Secondly, you chose to smoke “something” you thought was marijuana, but was not straight marijuana as you can tell.

Having worked with marijuana users and dealers for years, I can attest that a lot of marijuana is treated or laced. For example, marijuana which has been soaked in formaldehyde and/or PCP, is known for its intense high and rush. More information about this can be found at: http://www.ctclearinghouse.org/topics/customer-files/embalming-fluid-illy-061705.pdf. As you are finding out, the damage from smoking tainted marijuana like this can be enormous.

So you can see that one of the dangers of smoking marijuana is that you can smoke laced marijuana, unknowingly. Marijuana also can be laced with cocaine or crack or codeine. For more information on lacing marijuana with cocaine or crack, please go to this website: http://www.cesar.umd.edu/cesar/drugs/marijuana.asp#laced_mj

I don’t know how long you have been in this altered and uncomfortable state. However, if it continues, I would seek competent medical attention; particularly with a physician who has experience treating substance abuse patients. Most emergency room physicians or doctors who treat addicts are familiar with your type of drug reaction.

I think it was courageous of you to reach out for professional advice. Please know that I wish you every success and a renewed sense of well-being. If I can be of any further assistance, please do not hesitate to contact me.

Warmly,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC

Question: My 17 year old son has Asperger's and he is now using alcohol as a way to cope with his condition in social situations. He says he tried it a few months ago on a band trip out of state and that after a couple of beers he felt so much more relaxed and able to talk to people in a normal social way that it was like the best medicine he has ever had. I have read that other people with Asperger's, adults, will also use alcohol to make it through social occasions more normally. Since he tried alcohol that first time my son started using it to make it through the day at school. Last week he was caught by his gym teacher while sneaking a drink in the changing room. He was suspended and we got the whole story out of him. We were so shocked at first, but now that we have heard his side of the story we can’t be angry and we understand why he would drink as he has been. He has been drinking almost everyday now for months. I can’t believe we never noticed at home. He really needs some emergency help for his drinking, but all the teen alcohol treatment programs we contact seem to be based on a lot of group type therapies, which I don’t think are going to be very effective for my son. Can you tell me what type of alcoholism treatment is going to work best for my son, given his Asperger's?

Iona Health Says...:

As a former director of a teenage substance abuse treatment center, I know the problem well concerning co-occurring teenagers; those with a psychiatric diagnosis(es), such as Asperger's Syndrome, and alcohol abuse. First, I would like to commend you for identifying the problem(s) and actively seek appropriate answers/solutions for your son.

You are correct about your son having potential difficulty in a regular substance abuse group. The programs which I have found to be most effective with co-occurring teenagers are

1. the Seven Challenges Program http://www.sevenchallenges.com/ http://nrepp.samhsa.gov/ViewIntervention.aspx?id=159 and
2. the Matrix Model http://www.matrixinstitute.org/ which offers assessment and free treatment for teens.
   

Both the Seven Challenges Program and the Matrix Model can be offered in individual sessions as was offered in an intensive outpatient program. The ideal therapeutic intervention for co-occurring teens is to form a group of 3-4 teens with similar diagnoses. These groups would not last for a full hour but could be modified to 30 to 45 minutes depending on the clients and the intensity of the group. I would consider a small group as I have described first, and if this is not feasible, I would consider individual and family sessions. Substance abuse treatment programs for teens with Asperger's are rare and difficult to find. However, I would contact the programs listed above and see if they have record of any programs or individual therapists who are trained to administer these programs to teens with Asperger's and an alcohol abuse problem. My last resource would be National Registry of Evidence-based Programs and Practices (NREPP) which is SAMSHA’s National Registry of Evidenced-based Programs and Practices (for Co-Occurring Treatment) http://nrepp.samhsa.gov/SearchResultsNew.aspx?s=b&q=co-occurring treatment

Although alcohol has provided some self-soothing benefit for your son, it brings with it another potential set of problems. After his alcohol abuse has been adequately treated, more appropriate self-soothing behaviors should be identified and pursued. An organization which works with ASD, i.e., Autistic Spectrum Disordered individuals is the Handel Institute. This Institute, through its screeners and practitioners, can assist your son in using non-pharmaceutical interventions for self-soothing exercises.

I hope this information has been useful to you and your family. This problem is not generally addressed and more provision should be made for teens with Asperger's and any kind of substance abuse. Please feel free to contact me again if you ever need anything else.

John W. O’Neal, Ed.S, LPC, NCC