Drug Use Among Med Students

Discussion in 'Medical Students - MD' started by Syndicate, Feb 13, 2018.

  1. Syndicate

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    Im quite shocked to find out so many of my classmates do drugs (I’m not just talking about weed - everyone does that - I’m talking about cocaine, ecstasy, lsd, etc). I’m just wondering if this is common at other med school.


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  3. Syncrohnize

    Syncrohnize PGY-1
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    I’d imagine it’s only slightly less common than the general 21-29 year old population. I used to hold the naive expectation that medical students would all fit a certain mold, a moral elite if you will. The truth though is that people who maintain 3.5+, volunteer, shadow, and do well on the MCAT come in all different flavors. Now nearly done, I’ve gone through setbacks and hit personal lows I never thought I would as a pre-med. While on my end it’s been nothing illegal or anything to be too ashamed of, I could see how medical school could lead to depressive cycles and exacerbate some dangerous addiction habits especially if they’re already present.

    Also in terms of the most commonly abused drug outside of alcohol, I’ve got a hunch it’s stimulants. Many of my classmates used them and I only understood the reality of it when I saw at least 3 drug deals go down during the first week of anatomy lab when we were all forced to be together. At first I thought it was a practical joke, like they were acting out Breaking Bad lol. Even those who I’ve seen prescribed stimulants rarely take them as directed, but moreso on a PRN-need-to-study basis.
     
    #2 Syncrohnize, Feb 13, 2018
    Last edited: Feb 13, 2018
  4. Crayola227

    Crayola227 The Oncoming Storm
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    yeah, I've seen people get unhinged with cocaine

    alcohol, weed, cocaine, LSD, mushrooms, opiod pills, Rx stims, benzos, modafinil (I'm talking all un-prescribed), salvia, probably the only thing I didn't see was bath salts, meth, and heroin. Am I missing anything here?

    I won't talk about about my pre-med years.

    I will say in med school I definitely drank way more than I should have the first two years.

    No real time for that 3rd and even 4th year, for me.

    I didn't smoke weed in med school. Not worth it. I have a lecture I'll spare you about getting a needlestick, getting a UDS, then getting stuck with insurance not paying for your HIV meds, not to mention maybe getting tossed out of school, or if not that, issues getting a license and residency.
     
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  5. Crayola227

    Crayola227 The Oncoming Storm
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    Anyhoo plenty of drugs in med school, residency, attendinghood.

    And from way otherwise straightlaced conservative clean cut folks.

    I don't mean to normalize this behavior. It's stupid and it can frak your life or even worse your patients.

    Drugs are bad, mmmm'kay?
     
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  6. zero0

    zero0 everything i hug dies

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    Yeh it's a thing, even at my flagship Christian school. I guess part of it is learning about drugs in med school demystifies them. You stop seeing them as bad and they just become a means to an end, something taken to achieve a desired effect, that's all. Some people go overboard.
     
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  7. NickMT-RN

    NickMT-RN The Grumpiest Of Them All
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    I don't know if everyone smokes weed, lol, i don't. I'm sure there are people in my class who abuse stuff. Especially ETOH/Benzos and with those come the need for uppers.

    I'm old with a wife and a kid. So i abuse the heck out of ice cream and caffeine. If snorting dip and dots would make them taste better - i would do it. :confused::wacky::heckyeah:
     
  8. Anicetus

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    Adderall “recreationally” is pretty popular. Especially when the people who use it for the first time rip out a 265 on step 1 and tell the tale then it just promotes the cycle. Taking it for prescription use is another. I could estimate about 40% of my classmates railed it for step 1/2.
     
  9. NickMT-RN

    NickMT-RN The Grumpiest Of Them All
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    Wow.... wow to the 40%, not the 265.
     
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  10. libertyyne

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    did 40% end up with a 260+
     
  11. Anicetus

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    Absolutely not lol
     
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  12. The Knife & Gun Club

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    I tried to use adderall to help me study in undergrad (legally prescribed)...I actually found it remarkably counter-productive.

    You may get more done on the front end, but retention goes to sh!t and the constant up and downs lead to some gnarly emotional dysregulation.

    Ended up having my doc take me off it after about a year.
     
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  13. libertyyne

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    Have you tried the Aldi premium chocolate icecream?
     
  14. NickMT-RN

    NickMT-RN The Grumpiest Of Them All
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    No, I'll ask my dealer if it's in stock. :)
     
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  15. Kkshake

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    I expected the students in my class to abuse drugs, but I honestly didn't expect them to brag about it...like really, is it that much of an accomplishment to get a good grade on a test via use of stimulants if others can get those grades without substance abuse?
     
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  17. lenspx

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    Don't they do random drug screen at your school? The school I'm going to attend this Fall does, and you can get in trouble for it.

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  18. NickMT-RN

    NickMT-RN The Grumpiest Of Them All
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    I'm surprised boards doesn't make you pee in a cup when you show up to test. Maybe they should.
     
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  19. Syncrohnize

    Syncrohnize PGY-1
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    There’s no need. Adderall doesn’t give you higher scores, make you smarter, or get you better at remembering. I remember people being put on this medication. They studied like crazy for the first exam in medical school but after that it was downhill. If you try to make the argument that it's a short term success-thing and take it before Step, I wish you the best if you decide to try that. You'll probably speed through the test and think you did amazing when you're done and then underachieve drastically.

    They should. No one should be abusing drugs as medical school’s stressful enough.
    Ya’ll are acting like Adderall is some sort of steroid. It’s really not. I’ve had friends nearly kicked out of medical school because for behavioral issues as they’ve abused this drug. It does you no favors. If you think you have ADHD and want it, I recommend you go to a Psychiatrist and they’ll happily prescribe it...or else you’ll always wonder what if...but then when you realize that it doesn’t make you smarter you’ll stop using it. It doesn’t make you smart, it makes you cocky. If you have DSM-V ADHD, it has been shown to help with executive tasks for the first two years I think, but I don't remember the study.
     
    #17 Syncrohnize, Feb 13, 2018
    Last edited: Feb 13, 2018
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  20. OtterSpace

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    Assuming the drug testing policy varies from med school to med school, I'm sure those that abstain from recreational drugs will continue to do so & those who don't will just do it less.

    But I'd wholly agree with @Syncrohnize in that it's prolly only a little less than ppl in that age bracket. I differ only in believing that most med students (who I think it's fair to say are generally pretty smart ppl) will use but not always abuse illicit drugs.

    I think its been that way with the general population too for many years & some ppl are just better at being responsible users (of whatever) and keeping it on da low :ninja:
     
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  21. psychMDhopefully

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    Dude, I had a dental procedure during M2 and got opioids for pain. I was falling into addiction without even knowing it. I had no idea something could make you feel so good, so confident. I ended up flushing the last prescription I got, I knew if I kept taking them I would never stop. I have no idea what anybody else in my class did, med schools tend to be pretty tolerant except for stuff like drugs and other criminal offenses.
     
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  22. Dermpire

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    I was shocked too! My classmates do literally everything except for meth/PCP. I've never been offered drugs before, until I came to medical school, which is kind of insane.
     
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  23. psychMDhopefully

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    Isn't Adderall just Meth Light
     
  24. operaman

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    I saw quite a bit of it, but most of it was confined to alcohol, various cannabis products, and stims. Some kids microdosed LSD and analogues and I'm sure others tripped their nuts off but were overall rather quiet about it. We didn't have random drug testing that I can recall but did have scheduled drug tests at least once before starting on clinicals. I tend to view scheduled drug tests as more of an IQ test than a drug test, but there ya go.

    Stims were the big one by a long shot. I've never felt they made a huge difference used recreationally other than give people more energy to stay awake and study. They don't make anyone smarter, and if you have good sleep hygiene and diet/exercise habits, you probably have plenty of energy and study time as it is. I think there are definitely people with ADHD for whom it's absolutely vital to study and take tests effectively. People were all pretty open about it, often taking them openly in the library and other places whenever they needed.

    Alcohol is probably one of the more destructive habits people develop in med school. There's substantial literature showing future impaired physicians typically started their habits as medical students. Whats funny is that medical school seems so daunting when you get there, the workload and stresses pretty substantial. There's definitely a mindset of "I just have to do this to get through this time and then I'll back off," but the kicker is that it only gets tougher! Compared to residency, medical school was a total cakewalk! Whatever poor coping skills and addictions are developed during the MS years will almost surely carry over into the PGY years.
     
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  25. Goro

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    Our therapists report that weed and alcohol are the majors drugs of abuse at our school...mainly after exam blocks.
     
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  26. prettylittlebird

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    I don't understand why y'all are so shocked. Not everyone who goes to medical school fits the same mold. It takes all types and some of those types like to use recreational drugs. I'm not saying it's right but (apart from being, you know, illegal) but I'm not saying it's morally wrong as long as patient care/your work isn't affected. What people do in their spare time shouldn't matter. Now, students using stims to study for exams is just plain stupid, not always that helpful and ultimately can get you into a ton of trouble so I don't understand why anyone would take that risk...
     
  27. intubesteak

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    I have every flavor. Its sort of like a wine/bourbon collection.
     
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  28. Scrubs101

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    2 questions, 1. People tell the med school therapists about this? 2. The med school therapist relays this info onto people?

    Dont get me wrong im all for being 100% honest with therapists, but like idk about being that honest with someone that works for you school. Hell even if it was an anonymous survey from the school i couldnt imagine disclosing that information

    Like all it takes is a few too many people telling the med school therapist about their occasional use of a drug and that getting passed on to higher ups to get the whole class “randomly tested” right?
     
  29. Potentia Virtus

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    That's privileged information between a patient and healthcare worker. It's super illegal to "relay that on to people."
    Unless things have drastically changed.
     
  30. lenspx

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    Doctor-patient confidentiality.

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  31. Scrubs101

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    Thats what i had thought, which is why im so confused. Unless that information goro is talking about came from some sort of willfully done survey(not one of those do this survery or lose “professionalism points ones)
     
  32. Goro

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    Obviously, privacy issues abound and take precedence. But when our school's therapists come talk to the Faculty about overall mental health issues, this is what they've told us. So yes, students share with them.

    No names are ever mentioned. Obviously, students who don't seek out counseling, and who don't share when they do, will leave all of us in the dark. I would surmise that serious drug use among students will impair them to the point of serious consequences. We may have had 1-2 students dismissed due to drug use since I've been teaching...but I'm very hazy on the details.

    I've never heard anything about drug issues being so severe that random drug tests would have to become a thing. Doesn't this happen in residency? Or is it a requirement for residency?
     
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  33. Chelsea FC

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    You have a bunch of rich,privileged kids, drug use isnt suprizing to me (I have never seen so much cocaine/LSD/molly until I came to Med school and its mostly the kids from higher socioeconomic class doing it.
     
  34. Jojos

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    argentine IMG here. SUPER common. Everything from modafinil and ritalin to study to any party drug you can imagine. People don't know how to handle med school and this is their release.
     
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  35. Durty-Trixxx

    Durty-Trixxx Probationary Status

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    I've seen a couple attendings that were pretty serious heroin addicts.

    Go read the minutes from any state medical board monthly disciplinary hearings --- there's plenty of docs hooked on all kinds of chemicals these days :(
     
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  36. FutureMD2107

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    Just to throw in my two cents here. I have worked in the chemical dependency field as a therapist for over 8 years now and continue to see patients regularly in an outpatient setting as I prepare to go to medical school. I am also in long term recovery myself from addiction. The fact is that it physicians and other health care professionals (nurses, pharmacists, therapists, social workers) are a well represented demographic in chemical dependency treatment settings as are many other professionals (lawyers, veterinarians, businessmen, etc.). I have worked with personally and seen more doctors come through treatment for a variety of chemical issues than I can possibly recount at his time. Same can be said for students of all backgrounds and majors including medical students. I will say that the overwhelming similarity between a high percentage of students I have worked with regardless of their main drug of choice is that many of them are prescribed and abuse stimulant ADHD medications (although few identify this as problematic despite issues with other chemicals). The truth of it is that intelligence has little to do with addiction as you are dealing with genetics and neurochemical processes that are beyond direct individual control. The truth is also that not everyone who uses drugs is going to abuse them. I would posit that the important thing as aspiring physicians is that we learn to recognize the signs of someone needing help, know the available resources to provide such help, and put that help forward to individuals without judgment. But that’s just my experience so take it for whatever.
     
  37. Labkid

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    Ran into one student who took adderall for the day and then sleeping pills to go to bed. Not prescribed either, they basically got hooked onto it in undergrad to do well on tests and that's apparently how it's been since.

    They've apparently been doing that for about 4 years now every single day.

    A good chunk of people in my class using some sort of prescription drug for studying pretty much constantly. Though they don't tend to be the best performers.
     
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  38. CherryRedDracul

    CherryRedDracul The Sunlight Burns
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    Weed, cocaine, MDMA, nicotine, alcohol, caffeine and Adderall were the common suspects among my classmates.

    I know residents who used the above mentioned plus LSD/shrooms.

    Attendings aren't immune. There was a NYC pulmonologist who recently OD'd and died on heroin.

    Drugs are an American way of life.
     
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  39. Kewell35

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    retention goes to ****? heard it usually makes you concentrate and because of that retain more material...how does it make your retention go to ****?
     
  40. Kkshake

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    Idk man, everyone I know who take stimulants do really well with testing when using them. So for some, it clearly gives an advantage...and it makes them skinny, so something less to stress about....It's just obviously not healthy and will wear on them over time.
     
  41. NickMT-RN

    NickMT-RN The Grumpiest Of Them All
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    I was rx'd adderall back in the day (2007-2008). The only thing positive it did was make me lose weight. It did however make me have panic attacks during tests... that was slightly counter productive. I think i took it for a month.
     
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  42. Syncrohnize

    Syncrohnize PGY-1
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    Somewhere, sometime on this forum we need to have an Adderall #realtalk discussion. I’ll start by saying anyone legally prescribed and feels they have DSM-V ADHD, please disregard. There’s so many misconceptions behind the medication. First off for anyone reading this who hasn’t tried it once or twice and wants to, it induces a euphoria in addition to making you focused for the first few hours. It does make you focus more too and you’ll get this beautiful harmony of enhanced focus, increased energy, and increased motivation for a short period. While this sounds good, it’s also deceptive in that it makes you think you’re doing better than you are (and an argument can be made that that helps short term). If you’re depressed ( which commonly leads to decreased concentration) this can potentially give you a lift but be prepared for increased anxiety and if you’re prone to sudden mood changes, be very alert for that as well. If you’re already skinny, this medical will make you look unaesthetically skinny by suppressing appetite. As a guy, you might get some hairloss and older looking skin (which goes away when after you stop using it). Also, if you have palpitations/flutters during the onset, talk to a doctor.

    As for benefits, it’ll make the material feel more interesting for a little while but there’ll be a euphoria that will leave you just sitting and gaping about how happy life is for a while. This effect though is short lived and wears off after a month or so and you can go get a higher dose, but you’re just chasing that initial period which will wear off much quicker this time. I’d imagine if you were to take it for the first time during the Usmle, you’ll get this overwhelming sense of cockiness and think the test is super easy and blow through it but do mediocre.

    As for people doing super well, people using it tend to overstate their grades moreso than other people and have an increased sense of grandiosity. Also, you may have caught them in that 1-month window period but things tend to go downhill thereafter. The lesson I hope to hit home here is you need to be honest with yourself. Whether or not you were legally prescribed, do you really think you need the medication? There’s no real upside if you’re not ADHD.
     
    #40 Syncrohnize, Feb 14, 2018
    Last edited: Feb 15, 2018
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  43. The Knife & Gun Club

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    This. 1000x this.

    I remember walking out of a test during my sophomore year of college, having taken adderall and thinking I did incredibly well. 2 weeks later, I was dumbfounded to find out I’d actually gotten a 72. That was the moment I asked my doc to take me off it.
     
    #41 The Knife & Gun Club, Feb 15, 2018
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  44. FutureMD2107

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    Stimulant medications can provide a boost to individuals focus as they act not he dopamine receptors which are instrumental in that process. However, unless you truly have ADD which leads to a significant deficit in your natural focus/retention than the boost is relatively small. For example, someone who is truly ADHD might see improvement from being a C student to a high B student, however, the high B student might see improvement to a low A in the short term (complete overgeneralization I know but an easy way to conceptualize the relativity of improvements seen). Sustainability of these improvements is also problematic. One of the best comparisons I think of stimulant use of for studying/academic enhancement was told to me by an Addiction Medicine physician friend of mine. It like someone taking steroids in order to work out and gain muscle mass. The steroids are definitely going to help this process as this is what these substances are designed to do. However, being able to maintain ones health and the changes they achieved is not very likely leading to reliance upon these substances to maintain, thereby greatly increasing heath risks. One the other hand you Mohave people that have true hormonal deficits that need things like testosterone or other things that some people may abuse in oder to achieve normal functioning.
    Considering the prevalence of ADHD is somewhere between 7-10% in children (it has increased with change to DSM V) I would say there is a vast over representation of the diagnoses amongst college students. A lot of what I see in my practice is individuals who see a slight boost in focus when they have taken it therefore use that as justification that they have ADHD, when they truly do not have a functional deficit. I know a physician in the town I live in who has billed himself as the ADHD medical center for college students. Fridays is new script re-up day but they close at noon. I have watched as students lined up around the block waiting for their prescriptions, and even some try to literally kick the door in when they got there too late to get it.
     
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  45. sovereign0

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    Do you consider it drug abuse if people are drinking or smoking to "unwind" after an exam block?
     
  46. Crayola227

    Crayola227 The Oncoming Storm
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    The threshold for declaring drug "abuse" is quite low. If they are smoking marijuana and it is illegal, you could make the argument that is abuse on that basis, as well as a few others.

    If people are drinking to excess (the range that is medically appropriate is small) than that is abuse.

    If people are using these substances as a coping mechanism for life stressors to an extent that places them at risk of harm (getting kicked out of medical school for smoking, drunken behavior) then that meets criteria for abuse.

    The label of abuse is not meant to be terribly specific.

    Abuse is not addiction. Addiction is not abuse. Abuse can lead to addiction. That is why a broad definition of the behavior is useful for prevention.
     
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  47. FutureMD2107

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    Well said. With the revisions from the DSM IV to V changing from two distinct diagnoses (i.e. abuse & dependence) to a continuum (substance use disorder; mild, moderate, severe) the threshold for meeting criteria for the mild diagnoses is not terribly high. Engaging in high risk use behaviors, using when it risks social, familial, scholastic/employment responsibilities and other such things could lead to use being labeled as meeting criteria for the diagnosis. However, as Crayola said abuse is not the same as addiction. Having a drink at the end of the to unwind or to celebrate any other such things is not problematic. There are a couple questions I use to help patients reflect on their use: 1) On a consistent basis can you guarantee how much you are going to use once you start (I say I am going to have only one and actually only have one). The key word in that is consistent. 2) Have I been given a sufficient reason to stop yet I continue to use. This is more subjective because it focuses on the specific values of the the individual. These questions also require that the individual is able to be honest with themselves, because sadly in addiction a lot of times the individual is still convinced that use is not problematic when objective observation would demonstrate that they fail one of the two questions.
     
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  48. Goro

    Faculty

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    If it causes people to go seek out a therapist's help, it is.
     
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  49. CherryRedDracul

    CherryRedDracul The Sunlight Burns
    Physician

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    Substance abuse is largely culturally defined.
     
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