Opiate-Induced Hyperalgesia (OIH) Table of Contents The following is a transcription from the above video on Opioid Induced Hyperalgesia. Hi, everybody. Welcome back to the channel. I’m Dr. B, Dr. B addiction recovery. The question I’m going to briefly dissect today is opiate-induced hyperalgesia. I’ve been asked this question many, many times, and for some
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The following is a transcription from the above video on Meth Addiction Signs & Symptoms.
Hi, this is Dr. B. and welcome back to Dr. B. Addiction Recovery. On this channel, we always attempt to take the scientific literature and evidence as applied to substance abuse and related issues. We also take clinical knowledge and experience, and our goal is to distill it down for you. If you are someone that’s struggling with substance abuse or your family and loved one. Now you have formal understanding in an area that is dark and mysterious in what is going on, what to do. And we hope this information helps you move forward in making good, well thought out decisions towards your recovery. Today’s topic, I would like to continue with our methamphetamine series and as it has been presented to me, we can get right to it with how to tell if a loved one is struggling with methamphetamine addiction. This is a great question, but I want to put a little twist on it.
First Question: How to tell if someone is using meth
Number one, as far as the question goes, I’m going to take methamphetamine abuse to be anything but prescription stimulants. And I’m going to kind of knock out, put out of the picture cocaine, GAT, and some of the other products I might take methamphetamine to be anything that is often called meth, methamphetamine, speed, crystal, crank, chalk, tina. What are some of the other names for it? Uppers, ice, go fast, glass. That’s what I’m going to take to be methamphetamines. The other thing, so everything but cocaine and prescribed stimulants. The other thing I want to kind of point out that there are some nuances here, oftentimes it’s new use and oftentimes it’s chronic use, and you may be new to the relationship of this loved one that you have, or it is escalating in terms of signs and symptoms, and you just never knew they were using. Keep those little caveats in mind and I will give some kind of general answers. Number three, it’s a great question, but you can look it up anywhere online. You could just pull up any YouTube show or go online. I recommend SAMSHA, Substance Abuse and Mental Health Administration has great resources, whether you’re a user or a family member. There is facts, there’s epidemiological data. There are statistics and there is education for the user and the loved ones and there is referral sites as well. That’s SAMSHA.
Other than that, I think there was a more interesting question here. Before I get into the more interesting question, I will go over some of the general signs and symptoms. You look for evidence of it. This is a stimulant medication and it’s also a sympathetic stimulant. So these folks are going to start to have increased heart rate, blood pressure. And with that also comes sort of hyperactivity. They don’t sleep. You’re going to see a disruption in sleep pattern. They’re going to start to potentially lose weight, because you’re really breaking things down fast. You might see an elevated mood. You might even see things like psychosis, odd euphoric task focused sort of behavior. But in general, I am going to say that if a person starts behaving out of step with their usual behavior, something is off.
If that out of step behavior is consistent with some of the things that I am describing to you, it’s properly methamphetamines. And if you keep that in mind, it’s a good sign. In general, young adults or any age at all, you don’t just stop sleeping. What I want to do is point something to you. Oftentimes I see loved ones and family sort of give somebody the benefit of the doubt. And we’ve all been in this situation, maybe in our personal lives. And you know, a person goes to sleep every night. Your son goes to sleep every night gets up at 7:00 AM. And you’re starting to see that a couple of nights a week or three nights a week, he’s up all night or he disappears for a few hours and you confront this person about it, your loved one, and they’re like, Oh, I just couldn’t sleep. Oh, I went for a drive. Oh, I can’t sleep again. And what we do is often times we put ourselves in a position where we just accept that and sometimes accepting it one too many times, it really becomes enabling and the progression of the disease gets worse.
So that’s one thing I would like to say. If you see your loved one, suddenly lose 20 pounds in a couple of months, start picking their face, having odd and bizarre behavior, difficulty controlling their mood or aggression, or maybe talking to flying saucers and men from other planets, it is not excusable in the normal, ordinary and usual way. Stop right there and do what needs to be done. And here’s where I think I can give a lot more help in terms of the question, how do I know if a loved one is using methamphetamines?
We just went over the most basic surface structure of that. There is a thousand websites and I recommended SAMSHA to get those answers. My concern and clinical experience is, most of the time, people are in such a state of confusion and darkness about what is really going on and what to do that it falters, inhibits and slows down appropriate treatment and it comes at a great cost to the patient and the family. What do I mean? A mother may call me and I start to see over and over and over again and this is with many folks in many areas. They’re describing to you, well, like I said, he’s going out and howling at the moon every night, he’s lost 25 pounds. He’s picking his face and you tell them, well, this sounds like stimulant abuse and that’s what’s probably going on.
Do you know what they use anything else? And they’re describing to you when they give you sort of the story, they might say something like, he went to a doctor and tried to get some prescription stimulants and that they keep saying, I don’t know what’s going on, doctor. You know, I might go to the psychiatrist to see about depression, or I might go to the psychiatrist to see about schizophrenia. And the answer is right there. We do know that there stimulant abuse. Now they’re not thinking about it in terms and in a way that I am to figure out what’s going on and what needs to be done. The thing in my mind is, how long have they been using, what route of ingestion are they using? How often are they using and is there other substances involved. At that moment? It doesn’t make any difference to me, which substance or how much I need to get that information from the patient when I see them.
And when parents fall into this situation, they often make the wrong decision that is expensive and utilizes a lot of their personal time and resources and energy, and doesn’t get anywhere. And also, it’s wrong. The information is wrong. Just recently had a patient, was a young man. And the kid was at a party and he had drank quite a bit. And he had been also recently doing some cocaine. And that was a new thing for him. Well, as many young folks do, he ended up in the ER and on a ventilator. All mom knows and really understands is hospital, ventilator, drugs, and alcohol. Beyond that, and it’s okay, most folks don’t really have a formal training to understand what that means. And this is where the pitfalls can occur because people will tell him he needs to go into detox and he needs to go into treatment immediately.
And please, it costs this much upfront. Maybe he does, maybe he doesn’t. But I’ll tell you what I’ve seen that scenario many, many, many times as an ER physician at a county facility. It doesn’t mean the person is a drug addict or an alcoholic. This is a young man who might be having all kinds of problems and on this particular evening, for whatever reason, he ingested enough alcohol to put him in the ICU. Methamphetamine use, in general, doesn’t put a new user in the ICU. Yes, you can have this thing called, rhabdomyolyse, which breaks down a lot of proteins and clogs up your kidney. You can have heat stroke, and it can acutely kill you, yes. But in general, it doesn’t put an 18 or 20 year old in the ICU. So the devil is in the details. He drank a little too much alcohol.
He might have had a few hot dogs before he went through the party. He passed out on the wrong side of his body and he ended up getting vomit down his right lung and hence, intubation. So the details matter. So you need to figure out what level of care does a patient need, given their methamphetamine use or abuse. So this is a big picture response here that, first you need to pick out there is methamphetamines involved. After that, what does it mean, what do I do, and for what it means and what I do, you need to go to someone that’s very good at this, or really understands it from a medical clinical perspective and then lays out to you what your options of intensity, of care are. And this should be the way with most substances, but I just see it so often with methamphetamine use.
And I hope this information, again, my goal always here is to give clarity of thought so you can make informed goal-directed decisions that take the route of least resistance in your recovery and in your longterm sobriety. Thank you very much. I hope this video was helpful and gave you some information and tools to proceed ahead. If you would like to know more on this topic and others like it, please click above to my left, to see other related videos. If you enjoy this particular episode, please go ahead and click the subscribe button and the bell button for more information and updates. Thank you very much. Have a great day.
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