OxyContin is classified as a Schedule II drug as it has a high potential for abuse that can lead to severe psychological and physical dependence.

According to several studies, hazardous abuse of opiates is increasing in general, but abuse of OxyContin is mentioned most frequently in the studies.  Several factors have contributed to rising hazardous use and diversion of OxyContin in the U.S.  First, the large amount of OxyContin available  compared with other types of oxycodone pills makes them more likely to be stolen or diverted.  Second, the rising trend of crushing OxyContin pills to rapidly release oxycodone despite warning, and then injecting or snorting the drug.  Last but not least, the ability to purchase OxyContin legitimately by prescription for a few dollars and then easily sell it illegally for as much as $20 per pill.

People who abuse OxyContin are at higher risk of severe withdrawal symptoms as they tend to use more than the standard prescribed doses.

The most common effects of OxyContin include euphoria, constipation, fatigue, dizziness, nausea, lightheadedness, headache, dry mouth, anxiety, itchy skin, and profuse sweating.  High doses can cause shallow breathing, bradycardia, apnea, hypotension, pupil constriction, and in some cases circulatory collapse, respiratory arrest, and death.

Severe withdrawal symptoms are likely if OxyContin use is discontinued abruptly.  Symptoms of OxyContin withdrawal, similar to other opioids, are anxiety, nausea, insomnia, muscle pain, muscle weakness, and fever.  Psychological dependence will continue after the physical withdrawal, and psychosocial treatment is recommended.

Medically supervised OxyContin detoxification (detox) is recommended for cases of OxyContin abuse and OxyContin dependence.

Dual diagnosis and co-occurring disorders are psychiatric disorders that are occurring along with substance abuse or substance dependence disorders.

More than half of people experiencing alcohol and drug abuse or dependence disorders are also suffering from a co-occurring mental disorder.

Diagnosing a dual diagnosis/co-occurring disorder condition in substance abusers can be difficult, as drug abuse itself often induces psychiatric symptoms.  In determining the correct dual diagnosis/co-occurring disorder diagnosis it is necessary to differentiate between substance induced and pre-existing mental illness.

Self Medication and Drug or Alcohol Abuse and Dependence

Often people suffering from mental disorders attempt to deal with the problem themselves by "self medicating."  It is common for people experiencing mental disorders to feel relief when drinking alcohol or taking drugs, so it is natural that they should start using these substances to alleviate or control their symptoms.

The problem with self medicating a mental disorder is that prolonged use of alcohol and recreational drugs will likely create a condition of pathological dependence.  In addition, use of certain substances may actually increase the symptoms or create new symptoms.

Treatment for Dual Diagnosis/Co-Occurring Disorders

Summit Malibu's world-class therapists have decades of experience treating the many dual diagnosis/co-occurring disorders that often accompany substance dependence.

Click on the links below to learns more about treatment of dual diagnosis/co-occurring disorders, such as:

• Anxiety Disorder
• Attention Deficit Hyperactivity Disorder (ADHD)
• Bi-Polar Disorder
• Borderline Personality Disorder (BPD)
• Depression
• Obsessive Compulsive Disorder (OCD)
• Panic Disorder
• Post Traumatic Stress Disorder (PTSD)
• Social Anxiety Disorder

Dexedrine (dexetroamphetamine) is a psychostimulant drug that produces increased wakefulness and focus in association with decreased fatigue and decreased appetite.

Physical effects of dextroamphetamine can include hyperactivity, restlessness, dilated pupils, blood shot eyes, dry mouth, headache, tachycardia, hypertension, fever, diarrhea, constipation, blurred vision, aphasia, dizziness, twitching, insomnia, numbness, palpitations, arrhythmias, tremors, and convulsions.

In cases of high doses or long term abuse and dependence, physical effects may include coma, stroke, heart attack, and sudden death.

Psychological effects can include euphoria, anxiety, increased libido, alertness, concentration, energy, self-esteem, self-confidence, sociability, irritability, aggression, psychosomatic disorders, psychomotor agitation, hubris, excessive feelings of power and invincibility, repetitive and obsessive behaviors, and paranoia.

In cases of high doses or long term abuse and dependence, psychological effects can include a condition known as "amphetamine psychosis."

Withdrawal symptoms from dextroamphetamine primarily consist of mental fatigue, mental depression, and an increased appetite.  Symptoms may last for days with occasional use, but may last for weeks or months with chronic use.  The severity of symptoms is dependent on the length of time and the amount of dextroamphetamine taken.

Withdrawal symptoms may also include anxiety, agitation, excessive sleep, vivid or lucid dreams, suicidal thoughts, and psychosis.

Dextroamphetamine (along with amphetamine and methylphenidate) has become a popular recreational stimulant drug because of its euphoric effects and its common use as a so-called "study drug."  It is one of the most widely used and one of the most addictive recreational drugs available.

Treatment for Dexedrine abuse and dependence often requires medically supervised detoxification followed by concentrated psychosocial treatment.

Even short term Dexedrine abuse lasting only a few weeks or months may require medical and psychosocial treatment.  Severity of withdrawal symptoms are dependent on length and frequency of use, with the most severe cases requiring months of treatment.  Continued social support is usually recommended as psychological dependence lasts well after physical dependence has been successfully treated.

Post traumatic stress disorder (PTSD) is a severe anxiety disorder that may develop after an event that results in psychological trauma, such as a threat of death, a threat to physical, sexual, or psychological integrity, a near-death experience, etc.

The trauma preceding PTSD overwhelms the person's ability to cope in a normal manner.

Diagnostic symptoms include re-experiencing the original trauma through flashbacks or nightmares; avoidance of stimuli associated with the trauma; difficulty falling or staying asleep; anger; and hypervigilance.  symptoms would last more than one month and would cause significant impairment in social, occupational, or other important areas of functioning.

PTSD is believed to be caused by either physical trauma or psychological trauma, and frequently a combination of both.  Possible sources of trauma include experiencing or witnessing childhood or adult physical, emotional or sexual abuse.

In addition, experiencing or witnessing an event perceived as life-threatening such as physical assault, adult experiences of sexual assault, accidents, drug addiction, illnesses, medical complications, or employment in occupations exposed to war (such as soldiers) or disaster (such as emergency service workers).

Treatment for PTSD

Treatment for PTSD usually involves psychotherapy, especially Cognitive Behavioral Therapy and Dialectical Behavioral Therapy.  Relaxation therapy is also helpful to reduce and cope with residual anxiety.

A variety of medications have been applied to the disorder, including mood stabilizers, anti-depressants, and anti-psychotics.

Many PTSD medications list possible dependence (addiction) as one of the side effects.

Many of the medications prescribed for PTSD have the potential for creating a secondary condition of substance abuse or substance dependence.  Some long-term users of PTSD medications report that they felt compelled to take other prescription drugs and even illegal drugs to enhance the waning effects of their medication over time.  Other users reported a transition to illegal drugs with similar effects when the PTSD was withdrawn.

Dual Diagnosis/Co-Occurring Disorder

PTSD often occurs together with substance abuse and substance dependence disorders.  Often the substance use is the result of an attempt to "self-medicate" but just as often substance dependence is the primary disorder with PTSD being secondary.  In either case, both disorders must be treated simultaneously to achieve an effective outcome.

The SADQ is sometimes used to to predict the levels of medication needed during alcohol detoxification.

The test is divided into 5 sections:

1. Physical withdrawal symptoms
2. Affective withdrawal symptoms
3. Craving and relief drinking
4. Typical daily consumption
5. Reinstatement of dependence after a period of abstinence.

Each item is scored on a 4-point scale, giving a possible range of 0 to 60.  A score of over 30 indicates severe alcohol dependence.

The SADQ Test

1. The day after drinking alcohol, do you wake up feeling sweaty?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
2. The day after drinking alcohol, do your hands shake first thing in the morning?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
3. The day after drinking alcohol, does your body shake violently first thing in the morning if you don't have a drink?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
4. The day after drinking alcohol, do you wake up drenched in sweat?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
5. The day after drinking alcohol, do you dread waking up?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
6. The day after drinking alcohol, are you frightened of meeting people first thing in the morning?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
7. The day after drinking alcohol, do you feel at the edge of despair when you wake up?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
8. The day after drinking alcohol, do you feel frightened when you wake up?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
9. The day after drinking alcohol, do you like a drink in the morning?
   (1) Almost never
   (2) Sometimes
   (3) Often
   (4) Nearly always
10. The day after drinking alcohol, do you gulp your first few drinks down as fast as possible?
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
11. The day after drinking alcohol, do you drink to get rid of the shakes?
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
12. The day after drinking alcohol, do you have a strong craving for drink when you wake up?
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
13. During a heavy drinking period, do you drink more than 1/4 bottle of spirits (or 1 bottle of wine, or 4 pints of beer) each day.
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
14. During a heavy drinking period, do you drink more than half a bottle of spirits per day (8 pints of beer, 2 bottles of wine).
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
15. During a heavy drinking period, do you drink more than a bottle of spirits per day (3 bottles of wine, 5 litres of cider or 10 pints of lager)
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly always
16. During a heavy drinking period, do you drink more than 2 bottles of spirits per day (7 bottles of wine, 9 litres of cider, 20 pints of beer).
    (1) Almost never
    (2) Sometimes
    (3) Often
    (4) Nearly alwaysFOR THE NEXT 4 QUESTIONS:
    Imagine you have been abstinent for a few weeks, then drink heavily for a couple of days.
17. The morning after would you start to sweat?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say
18. ...would your hands shake?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say
19. ...would your body shake?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say
20. ...would you be craving for a drink?
    (0) Not at all
    (1) Slightly
    (2) Moderately
    (3) Nearly always
    (4) I haven't been abstinent for that long, so it's hard to say

Scoring the Test

The test is scored by totaling the numbers in the parenthesis next to the answers given by the participant.

• A score of less than 3 indicates no alcohol dependence.
• A score between 4 and 20 indicates mild dependence.
• A score between 20 and 30 indicates moderate dependence.
• A score of over 30 indicates severe dependence.

Social anxiety disorder is a potentially disabling disorder, but can be controlled and successfully treated.

Physical symptoms often accompanying social anxiety disorder include excessive blushing, sweating (hyperhidrosis), trembling, palpitations, nausea, and stammering.  Panic attacks may also occur under intense fear and discomfort.

An early diagnosis may help minimize the symptoms and the development of additional problems such as depression.

Social anxiety disorder often occurs alongside low self-esteem and clinical depression, due to lack of personal relationships and long periods of isolation from avoiding social situations.  An early diagnosis may help minimize the symptoms and the development of additional problems.

Substance Abuse and Social Anxiety Disorder

People with social anxiety disorder may use alcohol or other drugs to attempt to reduce their anxiety and alleviate depression, which can lead to substance abuse.  It is estimated that one-fifth of patients with social anxiety disorder also suffer from alcohol dependence

In addition, many who "self-medicate" an undiagnosed social anxiety disorder may not seek the professional help they need.  Because of this many people suffering from social anxiety disorder are only diagnosed after they seek treatment for their substance abuse or substance dependence problems.

Dual Diagnosis/Co-Occurring Disorder

Social anxiety disorder often occurs together with substance abuse and substance dependence disorders.  Often the substance use is the result of an attempt to "self-medicate" but just as often substance dependence is the primary disorder with social anxiety disorder being secondary.  In either case, both disorders must be treated simultaneously to achieve an effective outcome.

Summit Malibu offers the following drug addiction, drug dependence, and drug abuse tests and assessments to help people in determining the seriousness of drug and alcohol problems they may be facing.

These tests are not meant to replace a professional evaluation.

As with any potentially life-threatening medical condition, a professional medical assessment is highly recommended.

Summit Malibu is available 24 hours a day, 7 days a week to provide a no-cost, no-commitment, confidential evaluation for problems with drug and alcohol addiction and abuse.

Click the links below to view the following addiction, dependence, and abuse tests:

• Diagnostic and Statistical Manual of Mental Disorders (DSM IV)
• International Statistical Classification of Diseases (ICD 10)
• 20 Questions (Johns Hopkins)
• Alcohol Use Disorders Identification Test (AUDIT)
• Drug Abuse Screening Test (DAST)
• Michigan Alcohol Screening Test (MAST)
• Severity of Alcohol Dependence Questionnaire(SADQ)

12 Step Fellowships such as Alcoholics Anonymous are widely recognized as one of the best community resources available for recovering from alcoholism, drug addiction, and other compulsive disorders.

The 12 Steps of Alcoholics Anonymous and the AA Fellowship are a complete program of recovery for people suffering from alcoholism and drug addiction.

12 Step meetings are traditionally open to anyone who wants to attend.  They offer peer support in one-on-one and group settings, as well as other social and recreational activities.  12 Step Fellowships such as Al-Anon are also available for family, friends, and colleagues of the recovering person.

12 Step programs for people recovering from chemical dependence:

Alcoholics Anonymous (AA)
Alcoholics Anonymous is the original 12 Step Fellowship, founded in 1935 by its first two members Bill Wilson and Dr. Bob Smith.  AA membership is estimated to be near 2 million people, with meetings in nearly every country.

Cocaine Anonymous (CA)
Cocaine Anonymous is a fellowship of recovering cocaine addicts based on the principles of Alcoholics Anonymous.

Crystal Meth Anonymous
Crystal Meth Anonymous is a fellowship of recovering from drug addicts, particularly crystal meth addicts, based on the principles of Alcoholics Anonymous.

Dual Recovery Anonymous
Dual Recovery Anonymous is a fellowship of people who are chemically dependent and are also affected by an emotional or psychiatric illness.

Marijuana Anonymous (MA)
Marijuana Anonymous is a fellowship of recovering marijuana addicts based on the principles of Alcoholics Anonymous.

Narcotics Anonymous (NA)
Narcotics Anonymous is a fellowship of recovering drug addicts based on the principles of Alcoholics Anonymous.

Nicotine Anonymous
Nicotine Anonymous is a fellowship of recovering nicotine addicts based on the principles of Alcoholics Anonymous.

Pills Anonymous
Pills Anonymous is a fellowship of people recovering from prescription drug addiction based on the principles of Alcoholics Anonymous.

12 Step programs for family, friends, and colleagues of people recovering from chemical dependence:

Al-Anon
Al-Anon helps families and friends of alcoholics recover from the effects of living with the problem drinking of a relative or friend.

Alateen
Alateen is Al-Anon for young people.  Alateen groups are sponsored by Al-Anon members.

Narcotics Anonymous Youth Committee (NAYC)
Narcotics Anonymous Youth Committee is Narcotics Anonymous for young people.  NAYC groups are sponsored by NA members.

Nar-Anon
Nar-Anon helps families and friends of drug addicts recover from the effects of living with the problem drinking of a relative or friend.

12 Step programs for people recovering from compulsive behaviors:

Debtors Anonymous (DA)
Debtors Anonymous is a fellowship of recovering compulsive debtors based on the principles of Alcoholics Anonymous.

Gamblers Anonymous (GA)
Gamblers Anonymous is a fellowship of recovering compulsive gamblers based on the principles of Alcoholics Anonymous.

Overeaters Anonymous (OA)
Overeaters Anonymous offers a program of recovery from compulsive overeating using the Twelve Steps and Twelve Traditions of OA.

Sex Addicts Anonymous (SAA)
Sex Addicts Anonymous is a fellowship of people recovering from sexual addiction or dependence based on the principles of Alcoholics Anonymous.

12 Step programs for people recovering from mental and emotional problems:

Depressed Anonymous
Depressed Anonymous is a fellowship of people recovering from depression based on the principles of Alcoholics Anonymous.

Emotional Health Anonymous (EHA)
Emotional Health Anonymous is a fellowship of people recovering from emotional illnesses based on the principles of Alcoholics Anonymous.

Emotions Anonymous (EA)
Emotions Anonymous is a fellowship of people recovering from emotional problems based on the principles of Alcoholics Anonymous.

Obsessive Compulsive Anonymous
Obsessive Compusive Anonymous is a fellowship of people recovering from Obsessive Compulsive Disorder (OCD)based on the principles of Alcoholics Anonymous.

12 Step programs for people recovering from marriage, romantic relationship, sexual, and related problems:

Co-Dependents Anonymous (CoDA)
Co-Dependents Anonymous is a fellowship of people developing healthy and loving relationships based on the principles of Alcoholics Anonymous.

Domestic Violence Anonymous
Domestic Violence Anonymous is a fellowship of people recovering from domestic violence based on the principles of Alcoholics Anonymous.

Recovering Couples Anonymous
Recovering Couples Anonymous is a fellowship of people recovering from dysfunctional patterns in relationships based on the principles of Alcoholics Anonymous.

Sex and Love Addicts Anonymous (SLAA)
Sex and Love Addicts Anonymous is a fellowship of people recovering from sex and love addiction based on the principles of Alcoholics Anonymous.

Sexual Compulsives Anonymous
Sexual Compulsives Anonymous is a fellowship of people recovering from sexual compulsion based on the principles of Alcoholics Anonymous.

Survivors of Incest Anonymous
Survivors of Incest Anonymous is a fellowship of people recovering from the effects of surviving incest based on the principles of Alcoholics Anonymous.

Summit Malibu offers the following partial list of governmental resources for information on addiction and other treatment related resources.

The U.S. Government has created the following resources for addiction treatment and support.

• The National Clearinghouse for Alcohol and Drug Information (NCADI):
  • Comprehensive source of information and searchable databases on substance abuse prevention.
• National Institute on Alcohol Abuse and Alcoholism(NIAAA):
  • Supports and conducts research on causes, consequences, treatment and prevention of alcoholism and alcohol related problems.
• National Institute on Drug Abuse (NIDA)
  • Lead the nation in bringing the power of science to bear on drug abuse and addiction.
• Office of National Drug Control Policy (ONDCP)
  • Establishes policies, priorities, and objectives for the nation's drug control program.
• The Substance Abuse and Mental Health Services Administration (SAMSHA):
  • Assures that quality substance abuse and mental health services are available to people in need and strives to ensure that prevention and treatment knowledge is used more effectively in the general health care system.

Depression is a major psychiatric disorder that affects millions of Americans and their families, friends, and colleagues.  The National Institute of Mental Health reports that 18.8 million adults, or about 9.5 percent of the U.S. adult population, suffer from some form of depressive disorder.

The linkage between depression and physical illnesses makes it, in the words of the World Health Organization, "the world's second-most disabling disease after heart disease."

Symptoms of depression

• Ongoing sad, anxious or empty feelings
• Feelings of hopelessness
• Feelings of guilt, worthlessness, or helplessness
• Feeling irritable or restless
• Loss of interest in activities or hobbies that were once enjoyable, including sex
• Feeling tired all the time
• Difficulty concentrating, remembering details, or difficulty making decisions
• Not able to go to sleep or stay asleep (insomnia); may wake in the middle of the night, or sleep all the time
• Overeating or loss of appetite
• Thoughts of suicide or making suicide attempts
• Ongoing aches and pains, headaches, cramps or digestive problems that do not go away.

What is Depression?

The American Psychiatric Association's Diagnostic and Statistical Manual, Fourth Edition (DSM-IV) lists nine symptoms for major depression, five or more which must be present over the same two-week period, including one of the first two:

• Feeling depressed most of the day, nearly every day.
• Markedly diminished pleasure.

The other seven symptoms include:

• Significant weight gain or loss.
• Insomnia or hypersomnia.
• Psychomotor agitation or retardation.
• Fatigue or loss of energy.
• Feelings of worthlessness or inappropriate guilt.
• Diminished ability to think or concentrate.
• Recurrent thoughts of death, suicidal thinking, and suicide attempts.

How is depression treated?

Medications and counseling are the cornerstones of depression therapy.  Reacting to depression as soon as it is noticed is important. With prompt treatment, a depressed person can return to a happier lifestyle and more balanced outlook on life.  There are effective treatments for depression, including antidepressants and talk therapy.  Most people do best by using both.

How long will the depression last?

This depends on how soon you get help. Left untreated, depression can last for weeks, months or even years. The main risk in not getting treatment is suicide. Treatment can help depression lift in 6 to 8 weeks, or less.

Reasons to get help for Depression

• Early treatment helps keep depression from getting worse or lasting a long time.
• Thoughts of suicide are common in people with depression.
• The risk of suicide is higher if you don't get treatment for your depression.
• When depression is successfully treated, the thoughts of suicide will go away.
• Treatment can help you return to your "normal" self, enjoying life.
• Treatment can help prevent depression from coming back.

Other Types of Depression

Dysthymia Depression

Dysthymia is chronic mild to moderate chronic depression, as opposed to major depression. The DSM-IV mandates the same symptoms as for major depression, except for suicidality, but requires only three symptoms in all, so long as they have persisted over two years. Mild to moderate is a misnomer, as dysthymia can make a person’s life as miserable as major depression.

Melancholic Depression

Melancholic depression is major depression with an emphasis on lack of pleasure or lack of reactivity to pleasure. Other characteristics include (three or more): Depressed mood, depression at worst in the morning, early morning awakening, psychomotor agitation or retardation, significant weight loss, and inappropriate guilt.

Atypical Depression

Atypical depression is a misnomer, as more outpatients suffer from atypical depression than from other forms of depression. Atypical depression is major depression that differs from melancholic depression in that patients react positively to external events, plus (two or more): Significant weight gain (as opposed to weight loss), hypersomnia (as opposed to insomnia), leaden paralysis, and sensitivity to personal rejection.

Bipolar Depression

Bipolar depression is a feature of bipolar disorder, also known as manic depression, an illness characterized by mood swings from depression to mania. The diagnostic criteria for bipolar depression are the same as for major depression, but bipolar patients tend to have atypical features. Bipolar patients who rapid cycle can be up and down in a matter of minutes, and in mixed states depression and mania are present at once.

Psychotic Depression

Psychotic depression is a rare form of depression characterized by delusions or hallucinations, such as believing you are someone you are not and hearing voices.

Catatonic Depression

Catatonic depression is a rare form of major depression characterized by (at least two): Stupor, excessive motor activity, extreme negativism, peculiarities in voluntary movement, and repetition of other people's words or actions.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder is major depression that appears in the fall or winter and goes away in spring, thought to be caused by lack of sunlight.

Postpartum Depression

Postpartum depression occurs within four weeks of a women giving childbirth. Most new mothers suffer from some form of the “baby blues.” Postpartum depression, by contrast, is major depression, thought to be triggered by changes in hormonal flows associated with childbirth.

Dual Diagnosis/Co-Occurring Disorder

Depression disorders often occurs together with substance abuse and substance dependence disorders.  Often the substance use is the result of an attempt to "self-medicate" but just as often substance dependence is the primary disorder with depression being secondary.  In either case, both disorders must be treated simultaneously to achieve an effective outcome.

Disclaimer: This assessment is not intended to diagnose or treat any medical or emotional condition. It is advised that you consult your physician with any concerns regarding this condition.