Hallucinogen persisting perception disorder, or HPPD, is a disorder characterized by the continual presence of sensory disturbances, usually visual, that are reminiscent of those generated by the ingestion of hallucinogens such as LSD. HPPD is different from “acid flashbacks” in that they are relatively permanent from day to day, while flashbacks are transient. The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) lists the following criteria for the diagnosis of
Self-Injurious Behavior
Is There a Connection Between Self-Harm and Addiction? Self Injurious Behavior (SIJ) is defined as the intentional, direct injuring of body tissue, most often done without suicidal intentions. Cutting is a common form of SIJ. SIJ is common in patients with borderline personality disorder (which I will discuss in another post). Borderline personality disorder has a high incidence of concurrent substance abuse. The following video provides an excellent description and
Medications for Alcohol Addiction
This is Dr. Stuart Kloda. I am an addiction medicine physician in New York City, and I have a solo private office located at Columbus Circle. Today, I am going to be talking about medications that are used in the treatment of alcohol dependence. One of the receptors that alcohol stimulate is the mu opioid receptor. This is the receptor that narcotic pain medications such as Percocet and Oxycontin also
Topamax for Alcohol Dependence
There are a lot of medications that are used in addiction and psychiatric treatment that are used as “off-label”. Drug companies test new medications for safety and FDA approval. The medications are tested for specific illnesses in order to demonstrate safety and efficacy. It would be impossible to test new medications for all illnesses. That is why, when a medication is used for an illness not tested by the drug
Naltrexone for Alcohol Dependence
Alcohol exerts its pleasurable effects by stimulating a few different receptors in the brain. One receptor that alcohol stimulates is the mu-opioid receptor. This is the same receptor that pain medications such as Percocet stimulate. Stimulation of the mu-opioid receptor causes the release of dopamine in the brain. Dopamine promotes feelings of reward, pleasure, and euphoria. Naltrexone is a mu-opioid receptor antagonist. This means that it blocks the effects of
Baclofen for Alcohol Dependence
One of the receptors that alcohol stimulates is the GABA-A receptor. GABA-A receptor stimulation results in relaxation and relief of anxiety. Some people drink, in part, to calm symptoms of anxiety. In this type of patient, when the alcohol is taken away, the original anxiety becomes symptomatic, along with new alcohol withdrawal anxiety. So now the patient has to deal with two types of anxiety, and frequently with a dysphoric
The Definition of Recovery
Some people in the addiction community do not consider a person with opiate or opioid addiction to be in recovery if he or she is on methadone or Suboxone. It is unfortunate that this dogmatic and dated line of thinking is still employed by some who provide addiction treatment. When a patient starts taking methadone or Suboxone, he or she goes from the destructive use of an opioid to a
Treatment of Cocaine and Methamphetamine Addictions
Cocaine and methamphetamine addictions can be extremely difficult to overcome. With these two drugs, there are no highly effective medications to use as a part of medication assisted recovery. The use of these two drugs causes a surge of dopamine in the brain. Dopamine is thought of as being the “reward” and “pleasure” neurotransmitter. The brain’s natural production of dopamine becomes depleted with continued use. The depression and fatigue that
Stuart Kloda, MD – Xanax Detox – NYC
This is Dr. Stuart Kloda. I’m an addiction medicine physician in New York City. I have a solo private office located at Columbus Circle. Today I’m going to be talking about the outpatient detoxification, or medically supervised withdrawal, from the class of medications known as the benzodiazepines. These are drugs such as Xanax, Klonopin, Valium, and Ativan. They are frequently prescribed for anxiety and for patients with anxiety disorders. Xanax
Outpatient Medical Detox Part III: Xanax – Klonopin – Valium – Ativan
Some patients will develop somatic symptoms during their medical detox. These are symptoms such as palpitations, chest tightness, and feeling “that I want to crawl out of my skin”. These symptoms can be treated with a class of medications called beta blockers. Beta blockers are a class of heart medications that slow the heart rate down. They calm the nervous system down as well. I use Betaxolol. It is a