Pseudohallucinations – OK to see things?

By David Joel Miller.

Pseudohallucinations – sometimes we expect people to “see things.”

Sometimes it’s okay to see things that are not really there. When someone is under

Pseudohallucinations

Pseudohallucinations.
Photo courtesy of Pixabay.com

the influence of drugs, particularly hallucinogens or powerful stimulants, it is common for them to see things that others don’t.

When crack cocaine first became common, the emergency rooms in large cities experienced a rash of people who were “seeing things.” Many of these people received a diagnosis of schizophrenia or a related psychosis.

The same phenomenon occurred again when methamphetamine became cheap and readily available. More recently we are seeing people under the influence of “bath salts,” who are hallucinating.

None of these drug-induced hallucinations should be used as symptoms for making the diagnosis of schizophrenia or related psychosis.

True hallucinations can be a feature of several mental illnesses. In addition to schizophrenia, people with severe major depressive disorder, bipolar disorder, and other mental illnesses may experience hallucinations. Sometimes people with severe mental illness also use drugs which can create Pseudohallucinations. Sorting out the meaning of hallucinations is a job for a professional.

Some authorities differentiate between Hallucinations, Pseudohallucinations, and Parahallucinations.

If someone is experiencing hallucinations and they know it is the result of “good drugs,” this is a Pseudohallucination and likely will be diagnosed as a drug intoxication disorder, Hallucinogen Persisting Perception Disorder F16.983 or stimulant-induced psychotic disorder if the hallucinations continue after withdrawal from a stimulant.

Alcohol can also cause hallucinations.

When chronic alcoholics are withdrawing from alcohol that can experience a condition called delirium tremens or the DT’s for short. DT’s consists of shakes and hallucinations when the level of alcohol in the bloodstream declines. This is a very serious condition and can lead to death. If someone has ever had the shakes or hallucinated while withdrawing from alcohol they should be sent to a hospital to detox. Friends don’t let friends die from DT, s.

Staying connected with David Joel Miller

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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What if you go to the hospital drunk or high?

What if you go to the hospital drunk or high?
Photo courtesy of pixabay.

By David Joel Miller.

Hospital emergency rooms are filling up with people under the influence.

This is causing a whole lot of problems for hospitals, the emergency room staff, and society in general. There is no special reason why someone needs to go to a hospital because they are drunk or high unless they also have a medical or psychiatric emergency.

They end up there because of the other problems drug and alcohol use cause to the person and to society. Often this happens because there is just no other place to send them. Hospitals do not function as an extension of law enforcement and patient privacy is strongly enforced so unless you are in prison when the emergency occurs don’t worry about seeking help because of the legal consequences.

People who are drunk or high are a lot more likely to slip, fall or otherwise injure themselves. The emergency room staff is used to this and unless you broke some major law like hitting someone while driving drunk and you are already in custody, their goal is to get you patched up and out of there.

Some under-the-influence people really really need to be in the hospital.

If someone has the Delirium Tremens (DT’s), they need to be in the hospital, this is life-threatening. But most drunks are just a pain to the workers in the ER. They argue, try to go places and do things that just get in the way.

Heroin and other opiate abusers need an injection to reverse the effects of the overdose, but most enlightened emergency responders carry the injection to do this on the ambulance so that by the time the patient reaches the hospital the emergency is over.

Drunks are most problematic because the alcohol impairs their judgment. They are often suicidal or violent. No not everyone who drinks gets suicidal or violent but many suicidal people abuse substances. A binge drinker is 55 times more likely to attempt suicide than a non-drinker.

Substance abusers make up a significant proportion of admissions to psychiatric facilities. While they are under the influence they are prone to be violent and irresponsible. Some of them are still suicidal or violent after the drugs and alcohol wear off and need further treatment.

Since we don’t know if the current psychiatric problem is only a result of the substance or do they have these issues at other times. Most suicidal, self-harming or violent people who are under the influence end up staying until the drugs and alcohol wear off and they can rationally answer questions about their behavior and intent.

One very effective approach to this overflow of under-the-influence people filling up the hospital ER’s has been the creation of sobering centers.

Situated close to the hospital and under the supervision of medical staff, trained Para-professionals such as substance abuse counselors and mental health professionals can screen patients for medical necessity and supervise detoxification. These systems have worked well. Unfortunately, when budgets get tight, detox, as well as other services for substances abusers and the mentally ill, get cut.

At the time the need is the greatest detox and sobering centers are the most likely to get cut and throw their work back on the already overused ER’s.

Hospitals are also seeing a surge in irrational people as a result of synthetic drug use. (See 7 new drugs parents should be aware of.) Sometimes that psychosis goes away once they detox but other times it seems to be long-term and results in a psychiatric hospital admission.  Professionals are debating whether the new drugs are creating the psychosis or just a stressor that causes the first occurrence of the disorder.

I am convinced that drug use is damaging some brains and creating mental illness which would not have occurred without the drug use. I understand not everyone agrees with this position.

So the conclusion to all this is that if you or someone around you is drunk or high and there appears to be a medical or psychiatric emergency you should go to the hospital and get checked out and do not worry about the police finding out about this as a result of your visit. If there is no medical or psychiatric problem and no past history of problems most people do not need to go to the hospital. When in doubt call 911, the doctor or hospital first, not your therapist or the social worker.

 

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Pink elephants kill – Dangers of Delirium Tremens (DT’s)

By David Joel Miller.

Seeing bugs when drinking?

There are lots of jokes about people seeing things while drinking. Having Delirium Tremens (D.T.’s) is no joke.

Withdrawal from Alcohol can be fatal. When we mention withdrawal from drugs most people think of the physical symptoms of heroin withdrawal. Kicking Heroin can make someone wish they were dead, but alcohol withdrawal is far more likely to kill.

Deaths directly related to alcohol each year exceed all the deaths from other drugs, legal and illegal.

DT’s occur when the drinker is withdrawing from alcohol as the blood level is declining. Before modern medicine was available up to one-third of alcoholics with DT’s died during withdraw. Modern medical treatment has cut that rate dramatically but people do still die while sobering up.

If the drinker has EVER had hallucinations or a seizure when drinking or detoxing they need medical attention and should be detoxed in a hospital.

Other symptoms of DT’s can include fever, shakes, and formication. Tactile hallucinations, bugs or snakes crawling over the skin are commonly associated with the DT’s. These symptoms are sometimes worse at nights and can begin to occur days after the last drink as the body attempts to adjust to the absence of alcohol.

Any unusual symptoms that occur when an alcoholic stops drinking should be checked out by a medical professional.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.