Category Archives: What is

What are the 11 drug categories in the DSM-5?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What are the 11 drug categories in the DSM-5?
Photo courtesy of Pixabay.

How does the DSM-5 classify drugs?

There are lots of ways to categorize drugs depending on why you are doing the categorizing. In the DSM-5 the drugs are primarily classified by the way they affect the body of the person who is using the drugs. This perspective is a medical one and the doctors likely have a different perspective on this than substance abuse or mental health counselors.

This classification of drugs appears in the substance use disorder section. Substance Use Disorders largely excludes the effects or side effects of prescribed medications. This classification system emphasizes drugs with similar effects on the body and which might be medically treated with similar medications. Counselors will likely see some of this from a somewhat different treatment perspective.

It is important to note that to get a diagnosis in the section the person does not have to intend to use the drug. Someone exposed to fumes or accidental exposure, say to pesticide, could meet criteria for a diagnosis if the chemical resulted in symptoms that fit one of these classifications.

Here are the 11 categories. Listed in the DSM in alphabetic order.

Alcohol F10.XX

Caffeine F15.9X

Cannabis (Primarily Marijuana) F12.XX

Hallucinogens F16.XX

Inhalants F18.XX

Opioids (Heroin and RX pills) F11.XX

Sedatives, Hypnotics, and Anxiolytics. F13.XX

Stimulants. (This combines Cocaine F14.XX and Amphetamines F15.XX, the DSM does not separate Meth from other amphetamines the way substance abuse treatment does.)

Tobacco F17.XX

Other or Unknown Substance Use Disorder F19.XX

Each particular drug may or may not have additional specifiers after the initial F number. Some have three digits after and some have only two available.

This DSM-5 classification system is only marginally related to the Federal Drug Schedules used here in the U. S. to regulate the sale and prescription of drugs. Various groups and authors have classified drugs, both drugs of abuse and prescribed drugs, using a number of other systems. Some things we know are drugs are often not regulated because they are sold with a label “not for human consumption.” Herbal products and supplements fall into a gray area and regulation of these products along with classification are more problematic.

Substance use disorders are included in the DSM-5 and hence qualify as a “mental disorder.” As with the other things we are calling a mental illness or disorder this problem needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities, or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is a preference, not a problem.

One major reason people get this diagnosis is that they get arrested for breaking a drug-related law. This qualifies as a problem with some sort of functioning. With other mental illnesses, there is an exclusion if your problems only happen when you are under the influence of drugs or medicines or because of some other physical or medical problem. For substance use disorders we do not need to rule out drug use or exposure as causes.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

You might also want to check out these other counselorssoapbox posts.

Drug Use, Abuse, and Addiction

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Generalized Anxiety Disorder. (GAD Was 300.02 now F41.1)

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

In Generalized Anxiety Disorder, everything is scary.

The key feature of Generalized Anxiety Disorder (GAD) is that in this disorder the worry-weed just keeps growing. Worry in GAD is all out of proportion. Clients with this problem worry the majority of their time. While you need to have been worrying for at least six months to get this diagnosis, most people with GAD have been worrying far longer. It is common to hear from someone with GAD that they have been worrying all their lives or that they can’t remember a time before they began worrying.

Generalized Anxiety Disorder is a relatively common disorder despite being very disabling for so many. In any given year here in the U. S., it is estimated 3 million people will receive this diagnosis. Cumulatively this amounts to between 27 and 35 million people who are estimated to be living with GAD.

Generalized Anxiety Disorder can begin at any age but many people first realized they were worriers or over-anxious in childhood or adolescence. There used to be a diagnosis for over-anxious children but that one got merged into the GAD diagnosis. While Generalized Anxiety Disorder can strike at any age and often stays with you, your whole life what people will worry about changes as you age.

Common worry themes in GAD are punctuality, natural disasters, being a victim of crime, and the need to do things perfectly and be perfect. With all these worries it is common for someone with Generalized Anxiety Disorder to seek reassurance. If they adopt rituals to keep themselves safe it can be a short hop to OCD or a related disorder.

What separates GAD from other anxiety disorders is the length of the list of things you worry about. People with GAD worry about many things most or all the time, not simply a few things occasionally. Someone with Generalized Anxiety Disorder is frequently apprehensive about what might happen and they tend to expect the worse. The anxiety bully whispers in their ear (figuratively) that something bad is about to happen and over time they come to believe these thoughts.

In GAD it is not that they hear these thoughts, as in an auditory hallucination, but the thoughts can take on a life of their own and they start believing that if they think this thought it must be true. One characteristic of GAD is the loss of control over the worry. It happens whether you want or need to worry or not.

Physical symptoms are very common with mental illnesses. This does not mean things are just “in your head.”  The increase in stress hormones results in physical signs and symptoms in the body. Adults will have at least three of the six symptoms below. Less than 3 probably mean that one or more of the other anxiety disorders would be a better fit for the problem than GAD. Here are the six physical and emotional problems, 3 of which should be present in GAD.

  1. Motor racing – Feeling keyed up or restless.
  2. Tired, worn-out, or fatigued for no good reason.
  3. The mind goes blank, can’t focus or concentrate.
  4. Grouchy, irritable.
  5. Muscle tension.
  6. Poor sleep, reduced, disturbed, or otherwise disrupted for no discernible reason.

Note that some of these symptoms are combinations of emotional and physical issues. This is why before giving someone a diagnosis a therapist always wants to be sure that you have recently seen a medical doctor and ruled out a medical condition. We also have to ask about drug and alcohol use, not because we want to pry, but because if you are doing drugs, especially stimulants, this may be causing or aggravating the anxiety.

An important consideration, for this to be Generalized Anxiety Disorder, is that the anxiety needs to be way out of proportion to the actual life risks. A significant part of your thinking brain will be used up on worry leaving less to use in actually living life.

Much of the worry in Generalized Anxiety Disorder can be directed towards what you “should be” doing as opposed to what you are actually doing. People with GAD are likely to have exaggerated startle responses. Most of us will jump if a gun goes off close by, or we probably should. Someone with GAD will jump when a car door slams on the next block.

If you or someone you know has symptoms of GAD, seek professional help. There are treatments that can reduce or eliminate the symptoms of Generalized Anxiety Disorder.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Aftercare?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Aftercare?
Photo courtesy of Pixabay.

How does aftercare relate to treatment?

Aftercare is continuing or follow-up care that is received after the initial intense round of treatment. This is common in counseling those with a substance use disorder. It should be more common for those with most types of mental illness also. Aftercare is intended to prevent a return to active symptoms of the disorder. In the case of substance use disorders, this means aftercare should reduce the risk of relapse.

This term probably originated back in the days when the 28-day rehab was common practice. You got your initial drug or alcohol treatment in a residential treatment center and then after that initial period, you went home. Remember that while medical treatment for physical health problems has been around for centuries, treatment for substance use disorders and mental illness are relatively new procedures.

It is easier staying clean and especially sober when you are in a residential program. It is possible to get drugs and alcohol into a rehab facility but many of the people who are there are really trying to quit and they will report that kind of thing. Programs try their hardest to keep drugs out, kind of like jails do.

What often happened when people left the program was that they ended up back in the same environment as before. Everywhere you go there are people using drugs, drinking, and so on. The temptation to revert to the old ways of behavior is tremendous. Think of the alcoholic in early recovery. Everywhere they go there is alcohol. Why even the grocery store is out to get them. You have to walk past the wine to get produce and the beer is in front of the meat case.

To help people who had done a residential drug treatment program stay sober aftercare of some kind is a big help. This may be as little as one time a week or it could be more. Some aftercare’s are even a meeting every night.

Having this ongoing connection to other clean and sober people helps keep the person focused on their recovery and reduced the temptation to do what others were doing and get high or drunk. If you hang out with sober people you are less likely to drink.

Recently we have seen this same aftercare advantage with those with a mental illness. You can go see a therapist, get and take meds but if at the end of a few weeks you go back to your old way of living and nothing changes then you can end up feeling the way you used to feel. The depression has returned.

Staying connected to meds and therapy longer reduces the risk of relapse. One study I read reported that those who stayed on antidepressant meds for two years had fewer relapses even after discontinuing the medications.

Whatever you do to change your life. Keep doing it after that initial change effort starts working. That is aftercare in practice. Maintaining your changes is the primary purpose of attending an aftercare program.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

You might also want to check out these other posts Drug Use, Abuse, and Addiction 

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Agoraphobia? (300.22, now F40.00)

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Agoraphobia?
Photo courtesy of Pixabay.

Agoraphobia is about fear.

Agoraphobia is often translated as “fear of the marketplace.” This disorder involves being overwhelmed when you encounter people outside your home or “nest.” People with this problem become fearful when they have to venture out. It is not required that the person actually leaves their house and experience the situation, just thinking about the possibility, and then having symptoms can qualify as Agoraphobia. For some people, these symptoms and their efforts to avoid feeling these feelings can result in their becoming home-bound.

This disorder has been associated with panic attacks and panic disorder. We used to diagnose this as Panic Disorder with or without Agoraphobia. The new trend, as dictated by the DSM-5, is to separate Panic Disorder from Agoraphobia as some people can have either one without the other, some people have both in which case they get both diagnoses put on their chart.

Current estimates are that between five and six million Americans have Agoraphobia. Somewhere between one-third and half of these also have panic attacks. Many do not receive treatment because they are too fearful to leave their homes and go for treatment. Agoraphobia is a major cause of disability with over one-third of those with Agoraphobia being home-bound and unable to work. There are treatments for Agoraphobia if you are able to access them.

Some people report that when they experience settings that would qualify them for the diagnosis of Agoraphobia they have “Anxiety Attacks.” Having a brief increase in Anxiety as in an “Anxiety Attack” can be a part of other illnesses such as any Anxiety disorder, trauma, and stressor-related disorders, depression, and so on.

To be Agoraphobia, by definition, you need to experience these fear-based symptoms in two or more specific situations. This helps separate the Agoraphobia condition from a narrower specific fear or phobia. These fears also need to be excessive or unrealistic. Fear of leaving the house does not count if you live in a war zone or a high crime neighborhood.

The 5 specific fears of Agoraphobia you asked?

  1. Being on public transportation.
  2. Open spaces.
  3. Closed or confined spaces.
  4. Standing in a line or being in a crowd.
  5. Being outside your home alone.

To get the diagnosis of Agoraphobia it is not enough that you just be scared or nervous in these situations. People with Agoraphobia avoids these and possibly related experiences. This interfering with the rest of your life is one of the hallmarks of a mental health issue that should get diagnosed and treated.

People with Agoraphobia also worry excessively that they may not be able to escape or won’t be able to get help in these situations. It is these two key characteristics, not being able to escape and the belief that something terrible will happen that make Agoraphobia so debilitating.

For this diagnosis to “fit” this intense fear can’t be just a one time or occasional occurrence. It has to happen most or all the time you encounter these situations.  People with Agoraphobia often insist on having a companion to reassure them when they leave the house and they can only endure these situations by ensuring intense fear.

Symptoms for Agoraphobia are a little wider than the psychical ones seen in Panic Disorder. Other possible symptoms would include the risk of having an embarrassing or incapacitating incident such as loss of control over bodily functions or falling, passing out, or getting lost. In the elderly, it is hard to separate real concerns from excessive ones that would count towards Agoraphobia.

As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities, or cause you personal distress. Otherwise, you may have the fear but you may not get the diagnoses if this is a preference, not a problem. If the only time this happens is when under the influence of drugs or medicines or because of some other physical or medical problem this fear needs to be more than your situation would warrant. These other issue needs treating first, then if you still have symptoms you could get the Agoraphobia diagnosis.

For more on these topics see Anxiety Disorders,

Stress and Trauma-Related Disorders,

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Drug Tolerance?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

What does it mean to develop drug tolerance?

The term tolerance or to develop tolerance has been a common concept in substance use disorder treatment for a long time. Tolerance has one meaning in that context but can have a number of other meanings in the field of medicine or pharmacology. None of these types of tolerance have anything to do with the idea of acceptance of diversity the way the word tolerance is used in political or social contexts.

Tolerance in Drug Treatment.

In Alcohol and Drug Counseling and CD (Chemical Dependency), thinking Tolerance is one of the first signs that someone’s body is being altered by the use of chemicals. Tolerance for drugs, and in this context Alcohol is a drug, means needing more of a drug to get the same effect or getting a smaller effect if you use the same amount you had been using.

Tolerance, along with Withdrawal symptoms have long been the hallmarks of addiction. Recently, in recognition that people can and do develop tolerance for prescribed drugs, even those with low abuse potential, we have also begun adding the concept of cravings to the characteristics of a substance use disorder.

A simple example of tolerance to alcohol.

When someone first starts drinking one or two beers may have a significant effect on them. After years of practice, that person may need to drink 6 or even 12 beers a night to get the same buzz. Someone who drinks a lot and develops substantial tolerance may be able to talk coherently or even act “sober” after substantial consumption of alcohol. They may think they have learned to “handle their liquor.”

Despite developing this tolerance if we were to put that person on a driving simulator they would fail the test. They may be able to make some compensations in their behavior to fool themselves and others but their brain’s reaction times and coordination are not fooled.

Drugs of abuse are not the only ones that build tolerance.

Many prescribed drugs need to be started at low doses until the body or brain “adjusts” to the new medication. Even drugs with little or no abuse potential still develop tolerance. As time passes that person’s dose will need to be increased because tolerance has developed.

One aspect of tolerance is that you might develop a tolerance to the side effects of a drug over time while not developing a tolerance to the medicinal effects. This explains the need to sometimes gradually increase the dose of these drugs until the level in the body reaches a “therapeutic level.”

Technically there are multiple types of tolerance.

In pharmacology texts or AOD counseling books with sections on pharmacology, they describe three types of tolerance. These are sometimes subdivided. In substance abuse counseling we also talk about “selective tolerance” the concept that it may be possible for the body to develop tolerance for some effects of a drug but not others. Personally, I think of “tolerance” as the body’s natural adaption to the presence of a specific chemical. Sometimes that developing tolerance can be beneficial and sometimes it is harmful.

Tolerance can develop slowly to some drugs and rapidly for others. For example tolerance to many hallucinogens develops from a single dose. Try to use that drug again tomorrow and it will have little or no effect.

Functional Tolerance involves changes in the body’s behavior.

Functional tolerance can be further subdivided into Acute and Protracted Tolerance. Acute involves changes to the body’s reaction to that one first dose of drugs over the time that dose is in the body. Protracted tolerance is a change in the results from the second or third dose on the same using occasion.

Acute Tolerance develops during a single use of a drug.

In Acute tolerance, the body responds more significantly as the level in the blood is rising. As long as it keeps going up the effect is maintained. Once the blood level drops the adverse effects kick in. With alcohol as long as the level in the blood is rising the hangover is held at bay. Regardless of how high the level, once it starts to drop, the withdrawal effect, the hangover with alcohol, kicks in.

Protracted Tolerance

The second type of functional tolerance called protracted tolerance is best demonstrated by stimulant drugs like cocaine. The first dose produces a strong effect but after that first dose, each subsequent one produces less and less of an effect.

Metabolic or Dispositional Tolerance is how long the drug lasts.

How rapidly the drug is metabolized and eliminated changes over time and also varies from drug to drug.  For many, but not all drugs, the more you take or do the faster your body metabolizes and eliminates that drug. Some drugs, LSD for example, develop metabolic tolerance very rapidly.  Other drugs like Alcohol maintain a pretty constant rate of metabolism while the tissues and nerves alter their response.

Behavioral or Learned Tolerance.

People who frequently consume alcohol learn to slow down their walk and alter their stance to hide that they are under the influence. Many other adaptions of behavior to compensate for frequently having a particular drug in your system are possible.

Selective Tolerance.

When you develop tolerance to some of a drug’s effects but not others this is called selective tolerance. Heavy coffee drinkers find it stimulating in the morning but may develop a tolerance to caffeine’s sleep preventing effects.

Reverse Tolerance.

This form of tolerance involves becoming sensitized to a particular drug or substance so each time you take that drug there is a stronger effect than the previous time.

Cross-Tolerance.

Cross-tolerance is when someone who has been using a particular drug will develop a tolerance to other similar drugs. Someone who drinks alcohol will develop a tolerance to Barbiturates or surgical anesthetics even though they have never had those drugs in the past.

Terms and their meaning can differ with the profession using them. The literature from the Rehab or AOD (Alcohol and Other Drug) field may be very different from that in the mental health field. There is still a large gap between recovery programs and AOD professionals and the terms and descriptions used in the DSM.

Related posts: Drug Use, Abuse, and Addiction      Recovery

More “What is” posts will be found at “What is.”

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is the ICD?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is the ICD?
Photo courtesy of Pixabay.

International Classification of Diseases by the WHO.

The ICD stands for the International Classification of Diseases, a compilation by the World Health Organization of the various diseases and disorders that might be diagnosed. The ICD has undergone a number of updates and revisions. Currently, we in the U. S. are using the ICD-10. The ICD-11 is expected to be available for implementation by October of 2018.

The ICD includes a large number of diseases that are outside the scope of practice of mental health professionals. In the U. S. mental health professionals are used to using the DSM (see the post on the DSM.) What tends to get overlooked is that while the descriptions in the DSM come from the APA (American Psychiatric Association) the numbers in the DSM are from the ICD. This resulted in the most recent DSM, the DSM-5 including two sets of numbers, those from the older ICD-9 and the newer numbers from the ICD-10.

Under the ICD-10 system, each specialty has a letter followed by numbers for each disease or disorder.

Using the new numbers all mental, emotional and behavioral disorders a counselor might expect to treat will begin with the letter F while the other life issues, like partner relational conflict, will all be prefaced with the letter Z. Beyond that, there are very few issues a counselor might treat.

The early ICD’s were mainly a list of causes of death prior to the issuance of the ICD-6. Starting with the ICD-6 in 1949 causes of illnesses were included along with causes of death.

By 1975 the WHO had reached version ICD-9 and in 1978 the ICD-9-CM (clinical modification.) The rest of the world adopted the ICD-10 in 1990 but the U. S. delayed adoption until October of 2015. Any treatment that is reimbursable under HIPAA covered insurance must use the ICD-10-CM.

The ICD-11 is expected to be released in 2018. When the U. S. will adopt the ICD-11, who will use it and what they will use it for remains to be seen.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older counselorssoapbox.com posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What are the 5 drug schedules?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

How the Federal government regulates who gets which drug.

Here in the United States, the federal government regulates the status of drugs, who gets which drugs and how based on their listing on one of five “drug schedules.” These schedules were created by the “Controlled Substance Act of 1970.”

This act separates drugs into schedules based on their potential for addiction, their acceptance for medical treatment, and their safety. Prior to 1906, the U. S. had almost no laws regulating drug use or sales. Beginning with the Narcotic Control Act in 1956 laws regulating drugs have become a common topic in legislatures both federal and state.

Drugs can be moved up or down schedules as more data comes in. Clearly, some classification decisions have been based more on political sentiment than any hard research evidence. Some drugs that had little or no potential for abuse or dependence were left off the schedules. Herbal products and many over the counter medications are either regulated in a different way or not at all.

Two drugs that are the most destructive of human health, Nicotine and Alcohol are not listed on any of these drug enforcement schedules. Some other drugs, antipsychotics, and many antidepressant drugs are also not listed. Newer synthetic drugs, the methcathinone’s or bath salts, were not added until 1992.

Schedule I drugs.

These drugs have a high potential for abuse, these drugs are not commonly accepted for medical treatment in the U. S. and there is a lack of safety data to suggest these drugs would be safe for human consumption. Drugs on this schedule are considered some of the most dangerous of the abused drugs and may not be prescribed by a physician in the U. S. Unfortunately some drugs made this prohibited schedule mostly on the basis of opinions rather than evidence. Currently, Marijuana is a Schedule I drug. (I know medical and recreational marijuana is “legal” in some states but the feds still have it on Schedule I. The feds do not license doctors so they can’t keep doctors with state licenses from prescribing marijuana but they can take that doctor’s DEA number. This issue probably needs another post.)

Schedule II drugs.

These drugs have a high potential for abuse. Use or abuse of this drug can lead to addiction as in physical or psychological dependency. These drugs do have a recognized medical use. The question for the doctor is, does that use justify the risks of the patient using the drug. Many of the opioids fall into this category. They work well on pain but they are very likely to produce addiction. These drugs require the prescribing doctor to have a DEA number and to write triplicate prescriptions. One copy stays with the doctor, one goes to the patient to carry to the pharmacy and one goes to the DEA. Hard to believe they miss pill mills considering they get these copies. Still, many of these meds do get diverted into illegal use and result in a significant amount of addiction and deaths.

Schedule III drugs.

Drugs on Schedule III are less likely to be abused than those on Schedules I and II. The medical value is high enough that there are fewer restrictions on prescribing these drugs including who is allowed to prescribe the drugs on this schedule. These drugs are not terribly physically addicting but may be very psychologically addicting.

Schedule IV drugs.

Drugs on this schedule are safer than those on Schedules I, II, and III. These drugs have accepted medical uses and are lower in addiction potential.

Schedule V drugs.

Lowest abuse potential and safest of the scheduled drugs.

Hope this helps explain how the Controlled Substance Act of 1970 with all its subsequent amendments is supposed to help reduce the prescription and use of dangerous pharmaceutical drugs. You may see that there are still some problems with the scheduling of specific drugs and scheduling them does not keep them off the street but on balance I think things would be worse if there were no regulations of this kind.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

You might also want to check out these other counselorssoapbox posts.

Drug Use, Abuse, and Addiction

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is the ACA?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is an adult child of an alcoholic?
Photo courtesy of Pixabay.

How many ACA’s are there?

These initial things don’t always mean what we think. Different groups of people mean different things by the same set of initials and the same group or condition may get more than one shortened reference. Currently, we are struggling with a sudden shift in the meaning of ACA. I will give you some possible meanings for ACA in a moment.

Context matters.

There is a lot of research out there and more being published every day. Sometimes I think that I read way too much of that research. Is there a treatment for excessive research preoccupation?

The convention in research is that the first time a writer uses a term in their article they give the full name of the condition, theory, or test instrument they used followed by the abbreviation they will be using in parentheses. Thereafter they use only the abbreviation.

For example, older articles on Pervasive Developmental Delay used to read Pervasive Developmental Delay (PDD.) Thereafter the article would only talk about PDD. With the DSM-5, Pervasive Developmental Delay became a part of the Autism Spectrum Disorder (ASD.) There is now a new disorder Persistent Depressive Disorder (PDD.) Persistent Depressive Disorder is pretty much like the thing we used to call Dysthymia.

So if you see PDD in an article look back to the beginning of the article and see what the original term was that is being shortened to PDD.

So what is ACA?

In the mental health field, ACA has several meanings. Most likely these days ACA refers to the Affordable Care Act (ACA.) This is big here in America, right now, in that it expanded medical coverage to a lot more people. Unfortunately, this does not mean that everyone here in the U. S. has medical insurance. There are still a lot of poor people who do not have medical insurance. We still have a long way to go to get everyone health insurance.

This does not mean those uninsured people do not receive medical care. They still show up in hospital emergency rooms and get free care there. The difference is that without insurance there is no provision for who will pay for that care and so the public gets the bill. Sure if you have no insurance they mail you a bill, but if you are homeless you are not likely to pay that bill.

The result of this system is that the uninsured are discouraged from seeking care if they have anything at all until they are dying and then the rest of us get that bill. This presumably saves money by avoiding preventative care and only having publicly funded care after there is a serious medical emergency. I will step off my large soapbox now and resume my place on the smaller soapbox.

ACA means something special to Professional Counselors.

The American Counseling Association (ACA) is a major organization in the counseling field. Most professional counselors, clinical counselors, mental health counselors, and so on are members of the ACA (American Counseling Association.)

If you are a counselor you should be a member of the ACA and/ or its local affiliate. Here in California that would be CALPCC. Some people are members of both.

If you are a counselor that sees people with Behavioral Health coverage under the ACA (Affordable Care Act) you should especially be a member of the ACA (American Counseling Association.) I am still not sure why we call emotional and mental illnesses “Behavioral Health.”

ACA is also for people in recovery.

Adult Children of Alcoholics (ACA.)

American Council on Alcoholism (ACA.)    

Adult Children Anonymous (ACA.)

And that’s not all the ACA’s.

One internet source (http://www.acronymfinder.com/ACA.html) lists 241 different ACA’s. This includes groups in Australia, Austria, Alaska, and Arizona. They also list groups of Accountants, Actuaries, and other “A” occupations. Just reading that list has started to make my head hurt.

We will leave our discussion of ACA there.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Route of Drug Administration?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs.

Drugs.
Photo courtesy of Pixabay.

How many ways can you get drugs into your body?

While many therapeutic drugs are intended to work at various locations throughout the body drugs of abuse primarily exert their influence by their effect on the nervous system and the brain in particular. For drugs to affect people’s thinking, feeling, and behavior, to result in the classic substance use syndromes, the drug needs to somehow enter the brain.

The effects of a particular drug on the body and the user are hugely affected by the way in which the drug is placed into the body. Below are the primary ways drugs, therapeutic and drugs of abuse, are placed into the body, and some brief thoughts about the way in which these routes of administration affect the drug using experience.

Oral, swallowing, drinking, or eating drugs.

In the older drug use literature, drug eating was used as a term for many oral usages.  Tonics, elixirs, and soothing syrups often contained Opioids and alcohol in a drinkable form. Many drugs are still commonly taken orally. Alcohol is probably the drug that has the largest oral consumption.

Oral use is generally the safest way to take a drug as a portion of the dose is neutralized by digestion in the stomach. The drug will then be largely absorbed from the intestine into the bloodstream and then make its way through the liver before reaching the brain.

Smoking (inhalation) of drugs is common.

Smoking cigarettes is probably the first thing that comes to mind when we say smoking unless you are involved in smoking something else. Smoking results in a rapid uptake of the drug. Those lungs have lots of capillaries that were designed to take in oxygen but can be used to get drugs into the body also.

Many other drugs can be smoked. Marijuana is a close second to cigarettes. It may well move into first place soon. People also smoke crack cocaine and some forms of methamphetamine are smoked. Even heroin can be smoked. The trouble with smoking most of these drugs is that a lot of the chemical is lost in the process.

The result is that many, but not all, who start off smoking a drug eventually graduate to the needle.

Smoking can result in addiction very quickly. One puff and the level in the blood jumps up. It goes from the lungs to the brain and you really feel the hit. But the level quickly drops and leaves the smoker, of whatever drug, craving another hit.

There are other ways to inhale. Anything that becomes a gas can be sucked into the lungs and then to the blood and brain. Inhalants, sniffing fumes of gas, solvents, or other volatile chemicals is a type of inhaling.

Some things can be turned into a vapor without the burning part. Think vaping here but also there are ways to vaporize alcohol and breathe it in. Not recommended for home use as vaporized alcohol is also flammable and setting yourself on fire is a serious side effect of any drug use.

Snorting or intranasal drug use.

Cocaine leaps to mind here but other drugs can be snorted including heroin. Tobacco started out that way with people using powdered tobacco snuff. Snorting tobacco does not appear to make it any less harmful to your health.

Three ways to inject drugs.

When we say inject most people think the stereotyped heroin addict hunting for a vein to put the drug in, but there are plenty of other drugs and ways to inject them. Some of these are largely medical use but many drugs with a medical use are at risk to be abused recreationally.

Intravenous (I. V.)

I. V. Drug use puts a large dose of drugs into the bloodstream very rapidly. Beyond the risk from the drug, this method increases the risk of infection from breaking the skin and from the use of dirty needles. Sharing needles happens from necessity but also it is a part of the culture of some drugs that are used IV. This is the most common method for injecting drugs of abuse.

Intramuscular (I. M.)

This gets the drug directly to a muscle group. It is used medically for a number of reasons. In drugs of abuse, this is most often the way Steroids are abused.

Subcutaneous (Sub Q.)

Sub Q. sometimes called skin popping involves putting the drug under the skin. The drug, in solution, dissolves slowly and enters the bloodstream a little at a time. This works in a medical setting if the drug is very irritating and might be thrown up or when the volume of the drug is large.

Sublingual.

Some meds can be made fast-dissolving or even given as liquids. This is helpful for patients who are too ill to swallow pills. It is also used for some drugs to be taken at home when the patient cannot use needles.

Sublingual is the way chewing tobacco gets the nicotine into the system. Chewing drugs was the way native populations used Cocaine and Khat before refining and stronger forms came about.

Transdermal.

A few drugs or preparations of drugs can be rubbed on the skin and will be absorbed. For medications that really irritate the stomach and would be thrown up this works well. It also can be used when a particular area needs drugs applied locally.

Other (suppository.)

Where ever there is a pink mucous membrane there is a place where drugs can be inserted into the body. Who discovered you can abuse drugs this way? Maybe we do not want to know that one.

That is my quick summary of the various ways people place drugs into their bodies. Some are valuable ways to medicate people with serious illnesses but they can all also be routes of administration of drugs of abuse.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching, and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Antidepressant Discontinuation Syndrome?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

What is

What is Antidepressant Discontinuation Syndrome?
Photo courtesy of Pixabay.

Suddenly stopping antidepressant medications can be a problem.

Antidepressant Discontinuation Syndrome is one of those issues that may bring a person in to see a psychiatrist, medical doctor, or occasionally even a therapist which is not technically a mental illness but it can cause all sorts of problems. Disclaimer here, I am a therapist, not a medical doctor. I bring this topic up because clients have a way of wanting to talk with their counselor about symptoms and possibly letting you know this could happen to you will put you on the alert for when you need to have another conversation with your doctor.

Antidepressant Discontinuation Syndrome is a group of symptoms that result when there is a sharp decrease in dose or when someone is suddenly take off antidepressant medication. This can occur when someone thinks their depression is better and they decide to just stop taking their meds. Clients have also reported this problem when they lost insurance coverage or could not get a prescription filled in a timely manner.

The DSM (See APA DSM) describes this as occurring when someone has been taking an antidepressant for over a month, presumably this means they have built up some level of tolerance to this particular medication.

The symptoms caused by this sudden drop in the blood level of antidepressant medication can include thinking, feeling, and perceiving problems. This is described in technical language as Sensory, Somatic, or perception problems. Clients have described this as seeing flashes of light, feelings of Electric shock, nausea, or sensitivity to lights.

An increase in or the occurrence of acute anxiety, generalized anxiety or dread are also reported symptoms.

This underscores the concept that tolerance and withdrawal can occur with many medications including over the counter and prescribed medications. Tolerance and withdrawal are not restricted to illegal drugs or drugs of abuse. The major difference between withdrawal from prescribed drugs and withdrawal from drugs of abuse is the presence of cravings.  Clearly, many prescribed drugs can also result in cravings when you are withdrawing from them.

Most people who would be withdrawing from antidepressants would not be expected to feel cravings other than in the sense of having unpleasant feelings they wish would stop.

If these symptoms are caused by side effects while on a constant dose, or as the result of being under the influence of a substance of abuse or withdrawing from that substance then Antidepressant Discontinuation Syndrome should not be diagnosed.

Some substance abusers have tried to use antidepressants to reduce the crash from drug withdrawals. This is not what we are talking about when discussing Antidepressant Discontinuation Syndrome.

How significant the Antidepressant Discontinuation Syndrome will be, depends on a lot of factors. The higher the dosage you are on, the longer you have been taking the medication the more the risk of experiencing Antidepressant Discontinuation Syndrome. Most antidepressants can cause this condition.

Antidepressant Discontinuation Syndrome is not the same thing as side effects.

This syndrome is the result of changes in the dose which results in a sudden drop in the blood level. Side effects happen while taking the prescribed dose as prescribed. If you have any unpleasant or unexpected side effects call your doctor right away.

The Antidepressant Discontinuation Syndrome take away?

You should never suddenly stop taking a prescribed medication. If you want to get off your meds or reduce your dose talk with your doctor first. Some medication needs to be tapered off slowly over time. A further worry is that suddenly stopping a medication that has been working for you may result in it not working later if you need to restart your meds.

P.S. were you looking for a number for Antidepressant Discontinuation Syndrome?

Used to be 995.29

Now is T43.205 the first time, T43.205D if it happens more than once, and T43.205S if Antidepressant Discontinuation Syndrome causes another problem (sequelae.)

More “What is” posts will be found at What is.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel