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)
Borderline personality disorder (BPD) is defined "as a prolonged disturbance of personality characterized by depth and variability of moods." The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; chaotic and unstable interpersonal relationships; unstable self-image, identity, and behavior; and a disturbance in the individual's sense of self.
In extreme cases, this disturbance in the sense of self can lead to periods of dissociation, or mental breakdown.
Borderline personality disorder can have a long-term negative impact on many aspects of a person's life. This includes sometimes extreme difficulties in relationships at work, home, and in social situations. Self-harming is also a symptom, with attempted (or complete) suicide a possibility, especially without proper care and effective therapy.
The negative emotional states of BPD are grouped into four categories:
- Destructive or self-destructive feelings,
- Extreme feelings in general,
- Feelings of fragmentation or lack of identity, and
- Feelings of victimization.
Individuals suffering from BPD tend to view the world generally as dangerous and malevolent, and tend to view themselves as powerless, vulnerable, and unacceptable.
They can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative, generally after a disappointment or perceived threat of losing someone.
Self-image can also change rapidly from extremely positive to extremely negative. Impulsive behaviors are common, including alcohol or drug abuse, unsafe sex, gambling and recklessness in general.
Individuals with BPD engage in high levels of intimacy- or novelty-seeking, and yet are very alert to signs of rejection or not being valued. They tend toward insecure, avoidant or ambivalent, or fearfully preoccupied patterns in relationships.
It is very important to locate professionals who are experienced and qualified in the treatment of borderline personality disorder.
Many professional studies recommend against the use of medication for treating BPD. Antidepressants, antipsychotics and mood stabilizers such as lithium are often used to treat co-occurring symptoms such as depression.
Dialectical Behavior Therapy (DBT) has been show to be very effective in the treatment of borderline personality disorder.
Several types of psychotherapy for BPD have developed in recent years. Studies suggest that people with BPD can benefit on at least some outcome measures. Supportive therapy alone may enhance self-esteem and mobilize the existing strengths of individuals. Psychotherapy can often be conducted either with individuals or with groups. Group therapy can aid the learning and practice of interpersonal skills and self-awareness by individuals with BPD.
Dual Diagnosis/Co-Occurring Disorder
Borderline personality 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 BDP being secondary. In either case, both disorders must be treated simultaneously to achieve an effective outcome.
Methaqualone (brand name Quaalude) is a sedative and hypnotic drug with central nervous system depressant effects similar to barbiturates. It was most commonly prescribed in the 1960s and 1970s as a treatment for insomnia, and as a sedative and muscle relaxant.
Methaqualone is currently listed as a Schedule I controlled substance in the United States.
The common side effects of Methaqualone include euphoria, drowsiness, reduced heart rate, reduced respiration, increased sexual arousal, and numbness in the fingers and toes. Large doses can cause respiratory depression, headache, and sensitivity to light.
Methaqualone overdose symptoms include delirium, convulsions, extreme muscle contractions and spasms, vomiting, renal insufficiency, coma, and death through cardiac or respiratory arrest. Methqualone overdose resembles barbiturate poisoning but with increased motor difficulties and a lower rate of cardiac or respiratory depression.
Methaqualone became a popular recreational drug in the 1960s and 1970s because it heightened sensitivity and euphoria.
Smoking Methaqualone, by itself or added to legal and illegal smoking blends, became popular in the U.S. during the mid-1970s. This created a serious health risk due to ingredients that became toxic when smoked.
Smoking Methaqualone can lead to emphysema and other chronic lung disorders including talcosis.
Nembutol (Pentobarbital) is a short-acting barbiturate that is most commonly prescribed for treatment of seizures, preoperative sedation, and other sedation. It is also sometimes prescribed for sleep disorders.
Nembutol side effects include slurred speech, shallow breathing, sluggishness, fatigue, disorientation, lack of coordination, and dilated pupils. Nembutol, like other barbiturates, mimics alcohol inebriation, causing mild euphoria, lack of inhibition, relief of anxiety, and sleepiness.
High doses of Nembutol cause impairment of memory, judgment and coordination, as well as irritability, paranoia, and suicidal ideation.
Long-term effects include tolerance which develops quickly. Larger doses are used to create the same effects, which increases the danger of an overdose. Alcohol, opoids, antihistamines, other sedative-hypnotics and other central nervous system depressants will greatly increase the sedation effects and risk of accidental death.
Pentobarbital is a drug that has been used recreationally under the slang term "yellow-jacket."
Pentobarbitol abuse can occur with recreational use, where the drug is taken to achieve a high, or out of prescription misuse, when the drug is continued long term against medical advice. Short-acting barbiturates like Nembutol are the most frequently abused barbiturates, and are often used on the street in combination with stimulants such as cocaine, amphetamines, and crystal methamphetamine.
Withdrawal symptoms include tremors, elevated blood pressure and pulse, sweating, and possible seizures.
Nembutol, especially when taken with other drugs or alcohol, can result in death due to respiratory depression.
Dextropropoxyphene, manufactured by Eli Lilly and Company, is an analgesic in the opioid category. It is used to treat mild pain and is additionally an anti-tussive and local anesthetic. It is also helpful in relieving symptoms of restless legs syndrome. Dextropropoxyphene is sometimes combined with paracetamol or acetylsalicylic acid under the trade names Darvocet and Darvon.
Dextropropoxyphene, like codeine, is an opioid that is known to cause dependency among recreational users.
Dextropropoxyphene is commonly used to ease the withdrawal symptoms in people addicted to opioids. Being very weak in comparison to the opioids that are commonly abused, dextropropoxyphene acts as a partial substitute during wthdrawal. While it does not have much effect on mental cravings, it can be effective in alleviating physical withdrawal effects.
Darvocet overdose can occur both from liver toxicity from the paracetamol poisoning and from dextropropoxyphene overdose. Many abusers experience toxic effects when increasing the dose due to tolerance. They suffer acute liver toxicity, which causes severe stomach pains, nausea, and vomiting (all of which are increased by light or stimulation of the sense of sight).
An overdose of dextropropoxyphene may lead to depression of the central nervous system, respiratory depression, miosis, and mood altering effects.
A U.S. Food and Drug Administration panel recently recommended that dextropropoxyphene be removed from the market due to its weak pain killing abilities, addictiveness, and its association with drug deaths and heart problems including arrhythmia.
Because of its potential for side effects, dextropropoxyphen is on the list for High Risk Medications in the elderly.
Darvocet addiction treatment requires a medically supervised detoxification followed by psychosocial treatment. Severe addiction may require medications to calm withdrawal symptoms and regulate disturbed brain function. After physical cravings for the drug have ended emotional dependence can be significant. Most people benefit from continued support.
Dextropropoxyphene remains one of the most abused drugs in the U.S. because it has a chemical structure similar to methadone, making it extremely difficult to end long-term abuse and dependence.
Concerta (methylphenidate) is a psychostimulant drug approved for treatment of Attention Deficit Hyperactivity Disorder, Postural Orthostatic Tachycardia Syndrome, and narcolepsy. It may also be prescribed for treatment-resistant cases of lethargy, depression, neural insult, obesity, and Obsessive Compulsive Disorder.
Methylphenidate belongs to the piperidine class of compounds, which increase the levels of dopamine and norepinephrine in the brain. Methylphenidate is structurally similar to amphetamine, and its pharmacological effects are closely related to those of cocaine.
In the United States, Concerta (methylphenidate) is classified as a Schedule II controlled substance, the designation used for substances that have a recognized medical value but present a high likelihood for abuse because of their addictive potential.
Concerta is approved by the FDA for the treatment of Attention Deficit hyperactivity disorder because of its effects of increasing or maintaining alertness, combating fatigue, and improving attention. The long term effects of methylphenidate on the developing brain are unknown, and it is not approved for children under six years of age.
Methylphenidate has shown some benefits as a replacement therapy for methamphetamine addiction. Methylphenidate and amphetamine have also been investigated as a chemical replacement for the treatment of cocaine dependence, in the same way that methadone is used as a replacement for heroin. Methylphenidate is actually more potent than cocaine in its effect on dopamine transporters.
Methylphenidate has a high potential for drug abuse and drug dependence due to its pharmacological similarity to cocaine and amphetamine.
Methylphenidate abuse is higher among college students compared to non-college attending young adults. College students abuse methylphenidate as a so-called "study drug" to improve concentration or stay awake. Methylphenidate has been dubbed "kiddie coke" due to its low price and high availability among young people. It is one of the top ten stolen prescription drugs in the United States.
Increased alcohol consumption due to abuse of stimulants such as Concerta has additional negative effects on the health, particularly in young adult abusers.
Concerta long term use, and use in high doses, has been associated with higher levels of psychiatric admissions, drug dependence, paranoia, schizophrenia and psychosis. Psychotic symptoms from Mehyphenidate can include hearing voices, visual hallucinations, urges to harm oneself, severe anxiety, euphoria, grandiosity, paranoid delusions, confusion, and increased aggression.
Tolerance may occur with long-term use of methylphenidate, including cross tolerance with other stimulants such as amphetamines and cocaine.
Withdrawal symptoms of methylphenidate can include psychosis, depression, irritability and a temporary worsening of the original symptoms for which the drug was prescribed, known as rebound.
According to the World Health Organization and others, codeine is the most widely used opiate in the world. It is one of the most effective orally-administered opioid analgesics. It is about one-fifth the strength of morphine. It is commonly mixed with other analgesics such as aspirin or acetaminophen, and in this combination it is listed as a Schedule III or V drug in the United States.
In the United States codeine is listed as a Schedule II controlled substance for products containing codeine alone or in a dose higher than 90 mg.
Beyond its analgesic effects, codeine's effects include euphoria, itching, nausea, vomiting, drowsiness, dry mouth, depression and constipation. Some people may also be allergic to codeine, with skin swelling and rashes.
Another side effect of codeine abuse is lack of sexual drive and increased complications with erectile dysfunction.
Tolerance to codeine develops with prolonged use, and this tolerance includes its therapeutic effects. A potentially serious adverse drug reaction is respiratory depression and the potential for a fatal overdose.
Codeine is metabolized into morphine, and morphine can be passed through breast milk in potentially lethal amounts, fatally depressing the respiration of a breast fed baby.
Codeine is often used as a recreational drug, and has similar potential for abuse with other opiates such as oxycodone or hydrocodone. In some countries cough syrups and tablets containing codeine are easily available without prescription.
Codeine is also available in a syrup with the anti-nausea medication promethazine (brand name Phenergan with Codeine). This medication is quickly becoming one of the most highly abused codeine preparations.
As with other opiate pain killers, chronic use of codeine can lead to physical dependence. When physical dependence has developed, withdrawal symptoms may occur if a person suddenly stops the medication. Withdrawal symptoms include: drug craving, runny nose, yawning, sweating, insomnia, weakness, stomach cramps, nausea, vomiting, diarrhea, muscle spasms, chills, irritability, and pain.
Heroin addicts will take codeine to minimize the effects of heroin withdrawal, which will create additional withdrawal symptoms when codeine is no longer used.
To minimize withdrawal symptoms, long-term users should gradually reduce their codeine use through medical detox under the supervision of a doctor or addiction professional.
Adderall is the brand name of a stimulant drug made up of a proprietary blend of amphetamine and dextroamphetamine. It is believed to work by increasing the neurotransmitters dopamine and norepinephrine in the brain.
The effects felt when using the drug include loss of fatigue, increased alertness and concentration, better cognitive ability, and heightened libido. It is commonly prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), narcolepsy, and sometimes for depression.
Adderall is listed as a Schedule II drug under the Controlled Substances Act. This means that it has a high potential for prescription drug abuse and drug addiction.
Prolonged use can lead to increased tolerance (needing more of the drug to achieve the same effect) and withdrawal (an intense craving for the drug along with physical and psychological distress) when use is stopped. Continued use, especially over-use, can lead to the pathological conditions of drug abuse and drug dependence.
Extremely high doses, or high doses over a prolonged period of time, can result in a very serious condition known as amphetamine psychosis.
Adderral abuse and dependence often occurs when the drug is over-used for the treatment of commonly prescribed conditions such as fatigue, obesity, and depression. Adderall has also become a favorite “study drug” in colleges and universities because of its ability to help the user focus their concentration and study for very long periods of time.
Many abusers were originally prescribed the drug for childhood ADHD, and then continued to use the drug in later life for reasons other than those for which it was prescribed, such as concentration, weight loss, and performance enhancement.
One study estimates that as many as 14% of college students abuse some form of ADHD drug like Adderall.
Withdrawal from chronic abuse of Adderall can include anxiety, depression, fatigue, excessive sleeping, increased anger and rage, and even psychosis and suicidal thoughts. Physical effects can include heart palpitations, irregular heartbeat, uncontrollable tremors, sweating, and more serious cardiac symptoms.
As with most stimulants, users who take high doses of the drug over a prolonged period of time will eventually “crash.”
This occurs when their bodies and minds are simply too fatigued to continue, sometimes after days and even weeks of continuous use. Heavy users will often turn to other drugs such as benzodiazepines, barbiturates, and even illegal opiates such as heroin, to help soothe the effects of withdrawal.
Treatment for chronic Adderall abuse or dependence often requires medical detoxification, a period of rehabilitation from the physical effects, a period of psychotherapeutic counseling to deal with the mental and emotional effects, and possible psychopharmacological treatment to assist in re-regulating the effects of disrupted brain function.
Chloral hydrate is a sedative and hypnotic. It is commonly prescribed for the short-term treatment of insomnia and as a sedative before minor medical or dental treatment.
It was largely displaced in the mid-20th century by barbiturates and then by benzodiazepines, but is still used as a recreational drug and as a so-called "date rape" drug.
Chloral hydrate is still used today as an ingredient in the veterinary anesthetic Equithesin, and as a sedative prior to EEG procedures because it is one of the few sedatives that does not suppress the nerve impulses recorded during the EEG.
Chloral hydrate is a Schedule IV controlled substance in the United States, and possession is illegal without a prescription. Its quick acting sedative properties and its liquid gel capsule form, which makes it easy to pour into an alcoholic beverage, have sometimes led to its use as a so-called "date rape" drug.
Therapeutic doses work well for insomnia, becoming effective within 60 minutes. Higher doses can depress respiration and blood pressure. Long-term use creates a rapid development of tolerance to its effects as well as adverse physical effects including rashes, gastric discomfort and liver failure.
Overdose of chloral hydrate presents symptoms of confusion, convulsions, nausea and vomiting, severe drowsiness, slow and irregular breathing, cardiac arrhythmia, and possible coma.
A benzodiazepine is a psychoactive drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring. The first benzodiazepine, chlordiazepoxide (Librium), was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed diazepam (Valium) since 1963.
Benzodiazepines are commonly misused and are often taken in combination with other drugs of abuse.
Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) which results in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, muscle relaxant and amnesic effect. These properties make benzodiazepines useful in treating anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal and as a premedication for medical or dental procedures.
In general, benzodiazepines are safe for short term use, although cognitive impairments and paradoxical effects such as aggression or behavioral disinhibition occasionally occur.
Long-term use has adverse psychological and physical effects, decreasing effectiveness, physical dependence, and benzodiazepine withdrawal syndrome.
Benzodiazepines overdoses can cause dangerous deep unconsciousness. However, they are much less toxic than barbiturates, and death rarely occurs when a benzodiazepine is the only drug taken. When combined with other central nervous system depressants such as alcohol and opiates, the potential for toxicity increases.
The long-term adverse effects of benzodiazepines include a general deterioration in physical and mental health and tend to increase with time.
Adverse effects can include cognitive impairment such as feelings of turmoil, difficulty in thinking constructively, increased anxiety, and depression. Behavioral problems also occur, such as loss of sex-drive, agoraphobia and social phobia, loss of interest in leisure pursuits and interests, and an inability to experience or express feelings. An altered perception of self, environment and relationships may also occur.
The most frequent symptoms of withdrawal from benzodiazepines are insomnia, gastric problems, tremors, agitation, fearfulness, and muscle spasms. Other effects include irritability, sweating, depersonalization, derealization, hypersensitivity to stimuli, depression, suicidal behavior, psychosis, seizures and delirium tremens.
Severe symptoms usually occur as a result of abrupt withdrawal, so medically supervised detoxification is recommended.
Approximately 10% of patients will experience a protracted withdrawal syndrome, which can last for many months or longer. This phenomenon is known as "benzodiazepine withdrawal syndrome." Symptoms do gradually lessen over time, eventually disappearing altogether.
Benzodiazepines are considered to be major drugs of abuse.
Benzodiazepines are used recreationally and by drug abusers, with abuse mostly limited to individuals who abuse other drugs. Benzodiazepine abuse ranges from occasional binges on large doses, to chronic and compulsive drug abuse of high doses. Mortality rates are higher among drug abusers that use benzodiazepines, particularly among heavy alcohol users.
Both long-term and short-term use have the potential to cause physical and psychological dependence and severe withdrawal symptoms.
Dependence and tolerance can also develop rapidly, with benzodiazepine withdrawal syndrome occurring after as little as three weeks of continuous use. Withdrawal symptoms include depression, anxiety, panic attacks, and agoraphobia, among others.