Category Archives: Addiction

‘Smiles’ linked to teen deaths

Latest designer drug called ‘Smiles’ linked to teen deaths

By Stephanie Pappas

Published September 24, 2012 in Fox


Law enforcement officials and parents are concerned about the next in a long line of illegal synthetic drugs: 2C-I, also known as “Smiles.”

The drug, a hallucinogen, has been linked to two deaths in East Grand Forks, North Dakota, though little is known about this drug’s dangers. Other synthetic drugs, including K2 or “fake weed,” have caused problems by proliferating before being made illegal.

“There is hardly any research at all in the scientific literature on these things, even in animals, much less any sort of formal safety evaluation in humans,” said Matthew Johnson, a professor of behavioral pharmacology at Johns Hopkins University.

A new high

2C-I is part of the 2C family of drugs, a group of closely related molecules that have psychedelic effects. Along with the other 2Cs, 2C-I was discovered by chemist and synthetic-drug guru Alexander Shulgin, who published the formulas of psychoactive drugs in his book “PiHKAL: A Chemical Love Story.” As of July 2012, the Drug Enforcement Administration classifies 2C-I as a Schedule I controlled substance, making it illegal to manufacture, buy, sell or possess the drug. [Trippy Tales: The History of 8 Hallucinogens]

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Recognizing and Treating PTSD

Common Reactions After Trauma

“After going through a trauma, survivors often say that their first feeling is relief to be alive. This may be followed by stress, fear, and anger. Trauma survivors may also find they are unable to stop thinking about what happened. Many survivors will show a high level of arousal, which causes them to react strongly to sounds and sights around them.

Most people have some kind of stress reaction after a trauma. Having such a reaction has nothing to do with personal weakness. Stress reactions may last for several days or even a few weeks. For most people, if symptoms occur, they will slowly decrease over time.

What are common reactions to trauma?
All kinds of trauma survivors commonly experience stress reactions. This is true for veterans, children, and disaster rescue or relief workers. If you understand what is happening when you or someone you know reacts to a traumatic event, you may be less fearful and better able to handle things.

Reactions to a trauma may include:

Feeling hopeless about the future
Feeling detached or unconcerned about others
Having trouble concentrating or making decisions
Feeling jumpy and getting startled easily at sudden noises
Feeling on guard and constantly alert
Having disturbing dreams and memories or flashbacks
Having work or school problems
You may also experience more physical reactions such as:

Stomach upset and trouble eating
Trouble sleeping and feeling very tired
Pounding heart, rapid breathing, feeling edgy
Severe headache if thinking of the event
Failure to engage in exercise, diet, safe sex, regular health care
Excess smoking, alcohol, drugs, food
Having your ongoing medical problems get worse
You may have more emotional troubles such as:

Feeling nervous, helpless, fearful, sad
Feeling shocked, numb, and not able to feel love or joy
Avoiding people, places, and things related to the event
Being irritable or having outbursts of anger
Becoming easily upset or agitated
Blaming yourself or having negative views of oneself or the world
Distrust of others, getting into conflicts, being over controlling
Being withdrawn, feeling rejected or abandoned
Loss of intimacy or feeling detached
Recovery from stress reactions
Turn to your family and friends when you are ready to talk. They are your personal support system. Recovery is an ongoing gradual process. It doesn’t happen through suddenly being “cured” and it doesn’t mean that you will forget what happened. Most people will recover from trauma naturally. If your stress reactions are getting in the way of your relationships, work, or other important activities, you may want to talk to a counselor or your doctor. Good treatments are available.

Common problems that can occur after a trauma
Posttraumatic Stress Disorder (PTSD). PTSD is a condition that can develop after you have gone through a life-threatening event. If you have PTSD, you may have trouble keeping yourself from thinking over and over about what happened to you. You may try to avoid people and places that remind you of the trauma. You may feel numb. Lastly, if you have PTSD, you might find that you have trouble relaxing. You may startle easily and you may feel on guard most of the time.

Depression. Depression involves feeling down or sad more days than not. If you are depressed, you may lose interest in activities that used to be enjoyable or fun. You may feel low in energy and be overly tired. You may feel hopeless or in despair, and you may think that things will never get better. Depression is more likely when you have had losses such as the death of close friends. If you are depressed, at times you might think about hurting or killing yourself. For this reason, getting help for depression is very important.

Self-blame, guilt and shame. Sometimes in trying to make sense of a traumatic event, you may blame yourself in some way. You may think you are responsible for bad things that happened, or for surviving when others didn’t. You may feel guilty for what you did or did not do. Remember, we all tend to be our own worst critics. Most of the time, that guilt, shame or self-blame is not justified.

Suicidal thoughts. Trauma and personal loss can lead a depressed person to think about hurting or killing themselves. If you think someone you know may be feeling suicidal, you should directly ask them. You will NOT put the idea in their head. If someone is thinking about killing themselves, call the Suicide Prevention Lifeline 1-800-273-TALK (8255)*. You can also call a counselor, doctor, or 911.

Anger or aggressive behavior. Trauma can be connected with anger in many ways. After a trauma, you might think that what happened to you was unfair or unjust. You might not understand why the event happened and why it happened to you. These thoughts can result in intense anger. Although anger is a natural and healthy emotion, intense feelings of anger and aggressive behavior can cause problems with family, friends, or co-workers. If you become violent when angry, you just make the situation worse. Violence can lead to people being injured, and there may be legal consequences.

Alcohol/Drug abuse. Drinking or “self-medicating” with drugs is a common, and unhealthy, way of coping with upsetting events. You may drink too much or use drugs to numb yourself and to try to deal with difficult thoughts, feelings, and memories related to the trauma. While using alcohol or drugs may offer a quick solution, it can actually lead to more problems. If someone close begins to lose control of drinking or drug use, you should try to get them to see a health care provider about managing their drinking or drug use.

Summing it all up
Right after a trauma, almost every survivor will find him or herself unable to stop thinking about what happened. Stress reactions such as increased fear, nervousness, jumpiness, upsetting memories, and efforts to avoid reminders, will gradually decrease over time for most people.

Use your personal support systems, family and friends, when you are ready to talk. Recovery is an ongoing gradual process. It doesn’t happen through suddenly being “cured” and it doesn’t mean that you will forget what happened. Most people will recover from trauma naturally over time. If your emotional reactions are getting in the way of your relationships, work, or other important activities, you may want to talk to a counselor or your doctor. Good treatments are available.”

When a loved one has an addiction

“If someone you love has a problem with addiction, your top priority is to take care of yourself before you can take care of anybody else. Think about the instructions you get on an airplane: “If the cabin pressure drops, secure your own oxygen mask first, then help others with theirs.” That philosophy applies here, too.

You can turn to support groups like Al-Anon (an AA spin-off for the family and friends of alcoholics) or Alateen (an offshoot of Al-Anon geared toward teenagers and preteens who are affected by the drinking of a parent or other close relative) for help. These groups are free and open to the public, and they have frequent meetings in most towns.

These fellowship groups can help you better understand your loved one’s problem with addiction. In particular, you can learn you aren’t responsible for it and that you can’t force him or her to stop. These groups also can teach you effective ways to cope as your friend or family member faces the consequences of addiction and, if all goes well, finds his or her way to recovery.

Some groups advocate “tough love” — confronting people with addiction and trying to force them to seek help while others recommend the exact opposite approach. For example, the CRAFT (Community Reinforcement Approach and Family Training) intervention encourages family members to avoid confrontation and instead use encouragement and other positive motivational strategies when trying to convince a loved one to seek help for addiction.

You also may want to seek advice and support from a therapist, clergy member, doctor, or social worker who is knowledgeable about addiction.

Interventions: How do you help a loved one who refuses help?

In an intervention, family and close friends gather with the person with addiction to discuss the issue. Historically, clinicians advocated a rather draconian approach to interventions, instructing those holding the intervention to begin by asking the identified patient to be quiet and simply listen. In this approach, the affected person had no say in the discussion, and was often given an ultimatum.

Many clinicians now favor a more interactive approach to interventions, where the person with addiction can voice concerns without fear of reproach. Contemporary intervention approaches use various devices to gain the interest of the person with addiction so that the family doesn’t have to cut ties or support.

Interventions, whether traditional or contemporary, share some common elements. At the outset, the affected person’s family and loved ones recount how the problem with addiction has affected each of them. By confronting the loved one with the consequences of the addiction, both objective and subjective, an intervention might penetrate the person’s denial and help him or her decide to seek treatment.

Don’t do this on your own

Because an intervention is a complicated and delicate process, friends and family members should not try it on their own. Seek the help of a professional — such as a doctor, therapist, or member of the clergy — who has experience with the process.

Timing is crucial. It’s best to set up an intervention shortly after an addiction-related problem has occurred and to investigate treatment options in advance.

Bear in mind that interventions can be painful and do not always work. In fact, interventions can backfire, because they can make people with addiction feel alienated from his or her support system. This can further distance them from the help they need. For these reasons, interventions should be considered only as a last resort in response to a desperate situation.”

This article is reprinted in its entirety from the July 10, 2012 Health Beat, a publication of the Harvard University Medical School

Internet Addiction

Dr. Hokemeyer discusses the concept of an addictive personality in relation to internet addiction

A real high for some high-tech users [Reading Eagle, Pa.]

By Dan Kelly, Reading Eagle, Pa. McClatchy-Tribune Information Services

July 12–If you drink alcohol or take drugs, it stands to reason that they will have an impact on the balance of chemicals in your brain.

But can spending too much time on Facebook, Twitter and other social media cause a surge of compounds that act like drugs or alcohol and keep you coming back?

Experts say yes — emphatically.

“It’s funny you should mention that,” said George M. Vogel, executive director of the Berks County Council on Chemical Abuse. “The working title of our annual meeting in November is ‘Cybertechnology: Are we too connected?’ ”

Vogel said social media — like alcohol and chemicals — can become addictive because in the process of surfing the Web, our brains generate endorphins that produce a sense of pleasure. Like other highs, we crave that first Internet high and keep going back trying to duplicate that original experience. The result is that a person who once surfed the Web for a half-hour is spending 40 to 80 hours a week logged on.

In January 2011, a group of researchers at the University of Bergen in Norway developed a test they called the Bergen Facebook Addiction Scale.

The test confirmed that people were responding to Facebook in the same way drug addicts and alcoholics responded to their substance of choice.

Addictive personality traits

Another danger is that someone who has an addictive personality can become addicted to the Internet after kicking a drug or alcohol addiction.

Examples commonly used by researchers include a man who kicks an alcohol addiction, then becomes addicted to searching for sex partners on the Internet, or a woman who beats an addiction to painkillers, then develops an addiction to Internet shopping.

“When it comes to addiction I look for two things: tolerance and withdrawal,” said Dr. Paul Hokemeyer, an addiction specialist with Caron Treatment Centers, the addiction treatment facility near Wernersville.

When it comes to the Internet, the symptoms are the same as with drugs and alcohol.

“Tolerance is when a person needs more and more time,” Hokemeyer said. “They go from 15 minutes to five to eight hours a day.

“With withdrawal, all they feel is fear, dread and anxiety over not being connected.”

A person kicking one addiction doesn’t mean the loss of his or her addictive personality traits.

“Addiction is a lifelong process,” Hokemeyer said.

Hokemeyer said counselors are starting to see more and better studies and data linking the Internet and addiction.

“We’re beginning to see some trends,” he said.

Scientist now believe that, with the Internet, people are developing what is called a process addiction, rather than a substance addiction.

“They get addicted not to sex but the process of finding sex on the Internet, or the process of shopping,” Hokemeyer said.

Counselors are finding more cases involving patients who are becoming addicted to behaviors and not just substances, said Tom Adil, director of adolescent services at Reading Hospital.

Whether addicted to a substance or a process, the result is seldom good.

“It is like an adolescent cutting themselves,” Adil said.

In that process, the cutting produces pain. The pain causes the brain to release adrenaline, like the natural fight-or-flight response in humans. The adrenaline causes the body to produce endorphins that create a pleasurable sensation.

When someone can’t cope with a problem, a substance or a process becomes a method of taking the pain away.

“Like any addiction, negative types of coping run aground (because) of negative consequences,” Adil said.

Contact Dan Kelly: 610-371-5040 or


(c)2012 the Reading Eagle (Reading, Pa.)

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Internet Addiction: Know the Signs

Internet Addiction: When Cyberspace Disconnects Us

Over the last several months I’ve become aware that the practice of psychotherapy has expanded beyond the confines of the treatment room and into the ethers of cyberspace. No longer does my relationship with my patients consist of just the patient and me. We now are joined electronically with a host of others who are not physically present with us. Here are two examples from my clinical practice to illustrate this point.
Mark is a 42 year-old banker who came into session distraught over being “de-friended” by a woman with whom he terminated a short, but intense relationship. Several weeks earlier we had processed his emotions around the breakup and, in my opinion, had for the most part resolved his conflicts. Somehow this act of kicking him out of her social network cut him more deeply then the actual break-up itself and he found himself in a downward spiral.
Eliza is a 38 year-old stylist who has a rather tortured relationship with her mother. Hardly a session goes by where she doesn’t bring her mother into the session through the text messages she keeps on her phone. “You’re not going to believe what she said to me this week,” the patient huffs before pulling out her phone and delving deep into her resentments.
To be quite honest, I’m not sure what to make of these cyber situations. One the one hand, they are incredibly valuable. They enable the patient to reconnect with their emotions and represent the reality of the world in which they live. On the other hand, they hold the potential to distract the patient from their own personal experience and may indicate the presence of what researchers have labeled an Internet addiction.
Yes, that’s right. To the long list of things to which we can find ourselves addicted, we can now add an addiction to the Internet. For many of you, this comes as no surprise. As a result of our constant “connectivity”, we live in a world where people are not fully present in it. Rather than being where they are, many of us are obsessed with where we are being texted and emailed.
So what constitutes an Internet addiction? The researchers who have looked at this phenomenon base their definitions on other addictions that do not involve taking a substance like alcohol or drugs. These “non-ingestion” addictions include addictions to activities like shopping, gambling, video games and sex. In determining whether a person is addicted to the Internet, researchers look for the following six criteria:


  1. Significance: The Internet has become the central feature in a person’s life and dominates it.
  2. Mood Regulation: The Internet is used to change a person’s mood. When people are anxious or sad, they go to their electronic device to change how they feel.
  3. Tolerance: The Internet takes up more and more of a person’s time.
  4. Withdraw: When the person is not connected to the Internet they begin to feel anxious and uncomfortable.
  5. Isolation: The person’s use of the Internet begins to isolate them from other human beings.
  6. Reversion: After attempting to stop, the person reverts back to the same level of use or increases their level of use.

It’s unfortunate that a tool that can add such value to our lives holds the potential to detract from it. The Internet and the extraordinary content contained therein enhance our lives in so many ways. From the ability to learn about a wide variety of topics (via the Oz Blog) to the opportunity to connect with long lost family and friends, the Internet can help us heal and grow.
At the same time the Internet holds the power to limit our human experience and growth. By taking us out of our relationships with other human beings, the Internet can become yet another destructive addiction. Human beings are meant to live in relationship to other human beings, not electronic devices. We must mindfully use the Internet in ways that enhance our human relationships- not substitute for them.

Addicted to Prostitution

Dr. Paul Hokemeyer, a sober doctor who has appeared repeatedly on Good Morning America and specializes in sex addiction among other topics, says that sex industry work can be classified as a “process” addiction. “You can get addicted to the affirmation of being valued by someone for your body, although it’s a very linear form of validating yourself that’s unhealthy and destructive,” he says.”

To read  McCarton Ackerman’s insightful article for  in it’s entirety click here


Cutting, also know as “self injurious” behavior in clinical and academic settings, is a phenomenon that most people can’t understand. It’s a behavior whereby a person deliberately cuts or harms themselves to manage their emotional pain. McCarton Ackerman is a talented and incredibly insightful writer who captured the nuances of this difficult topic in his most recent article for In it he writes,

When 21-year-old Alexa, a student from Los Angeles, speaks about her battle with cutting, she uses the dark language of progressive drug addiction. “I started when I was 19,” she says. “At first, it was very shallow cuts along one specific area of my wrist—just slightly more than a scrape. But as I continued, it progressed. They began going up and down my arms. Within a few months, I had to start going to the hospital and getting stitches for it. After a year, I basically ran out of room on that part of my body.” 

Click here to read the article in its entirety.

Domestic Violence: Tyson at Stony Brook University

That domestic violence and substance abuse disorders go hand and hand is no secret to those of us who work in the field. It’s also no secret that the faces, neighborhoods, professions, religions and even genders of both abusers and survivors is as diverse as the human race. What connects these people is the underlying fear and rage, the need to control others and the lack of control over oneself that the abusers share.

All of this was discussed at the screening of the film Tyson and the panel discussion with the students that took place afterwards. As one of the panel members, I was impressed by the level of insight the students had around this issue and with the robust participation of male students in the audience. Domestic violence is unacceptable. We must work together as a team of human beings, un divided by race, gender, education or socio-ecomonic status to eradicate it from our world.

Bath Salts: Should a Parent be Concerned?

If you hear your kids talking about bath salts you should definitely be concerned. Chances are they’re not talking about sweet smelling crystals they use to relax in the tub. They’re talking about a new “designer drug” that is widely available over the internet and in the corner market. Because these bath salts circumvent existing drug control laws, they are accessible to anyone of any age who has the ability to pay for them.

In contrast to traditional bath salts that are used by people to relax, these new bath salts act as hallucinogenic amphetamines when ingested. Because they are “uncontrolled” they represent great challenges to parents, school boards, law enforcement officials, physicians and hospitals.  They are dangerous to our kids and parents need to make sure they are discussing these dangers with them. For more information on bath salts, check out this fantastic article by Matt McMillen on WebMD

Domestic Violence and Substance Abuse

This evening I’m on a panel of experts who are discussing the film Tyson at Stony Brook University. Tyson, is a film about legendary boxer Mike Tyson and his struggles in life. The film graphically explores Mr. Tyson’s addictions and the role domestic violence played in his relationships with women.

As an addictions and relationship therapist, I’m grateful for Mr. Tyson’s and Sony Pictures’ willingness to discuss a sensitive topic. Too many women and families live in the fear, isolation and destruction left in domestic violence’s wake. If we are to end this abuse, we must be willing to discuss it openly and provide families with a way out of the emotional and physical prisons that domestic violence and substance abuse disorders create.

Domestic violence and substance abuse disorders share a number of characteristics. These include loss of control, continuation of behavior in spite of negative consequences, obsessive thoughts, increased tolerance of the abuse, and impact on the entire family (Irons & Schneider, 1997). In addition, we think domestic violence and substance abuse doesn’t occur in nice families or neighborhoods like ours. In fact, both addictions and domestic violence are blind to economics, religion, race or social class. They occur everywhere with all too much frequency.

I look forward to my opportunity to discuss this film tonight with my colleagues. I see it as another step in eradicating the silence and secrecy surrounding these destructive disorders.