What is Post Traumatic Stress Disorder?

Something horrible has happened to you or someone close to you. For example a near death experience, a car accident, war experiences or being a victim of a violent crime.

The disorder can be divided into four parts the first is trauma, the second is re-experiencing the trauma, the third is avoiding anything which is a reminder of the trauma and finally the fourth is increased arousal.

Traumas are usually violent and deadly in nature. That overwhelms a person’s ability to cope. A complicating factor is the sense of being helpless or out of control. Being shot at is a common example. Being robbed, raped, beaten or tortured. Violent natural or man made events where death is possible.

The re-experiencing the trauma involves nightmares or flashbacks. People feel they are re-living, every aspect of the trauma. They may experience illusions and hallucinations of the traumatic event. Continue reading

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What is Subutex/Suboxone?

They are medications used to detox people from opiates like Roxycodone, Oxycodone and Loretab. These medications can also be used over long periods of time like months or years to continually block the cravings for opiates.

This is extremely important valuable. You can take someone who is addicted to Roxycodone also known by the street name “blues”, and detox them painlessly with Subutex /Suboxone. In days past the treatment would end at that point. The individual would detox and then be sent home, but what happen was a post acute withdrawal syndrome. The individual would crave opiates and these craving periods have been described as unbearable which would lead people to relapse. Individuals become irritable, anxious, insomniac, fatigued, and obsessed with getting and using drugs. The street term for this is called “jonesing”.

The advantage of Subutex/Suboxone is the drug Buprenorphine. These pills stimulate the brain into thinking it has an opiate on board. The difference is the individual does not get high, drowsy, have any risks of overdose, and does not engage in drug seeking behaviors. They no longer obsess about drugs, the desire and wanting to use them is diminished. They remove themselves from the drug world. Their lives can normalize and their thinking clears so they can make better decisions. This medication has changed many lives in which other people thought those individuals were hopeless.  The Subutex/Suboxone can be tapered and stopped when the individual is confident of his/her sobriety.  This medication itself is habit forming but much less so. Most people come off it easily. Twenty to thirty percent have problems coming off. This is nothing like the problems of coming off an opiate like Roxicodone, Oxycodone, Lorcet, and Loretab. Continue reading

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What to do when your anti-depressant stops working?

Patients ask me all the time “What to do when your anti-depressant stops working?” For example you have depression and have been on Zoloft for seven years and done well, but the past six months you feel more depressed.

First thing to ask is “are you using alcohol?” That’s the worst thing you could do. Alcohol is a depressant and maybe interfering with the efficacy of the antidepressant. Marijuana, Opiates, Benzodiazepines and Antihistamines aren’t much better either.

For example drugs like Roxycodone, Oxycodone, Oxycontin, Oxycodone, Loritabs, Hydrocodone, Xanax, Alprazolam, Ativan Lorazepram, Benadryl, and Diphenhydramine these drugs have a similar effect and may function as depressants.

Substance dependency usually results in depression, whether it is a physical or psychological affect. Often times an antidepressant isn’t working the first thing people do is self medicate. Don’t do that because it makes matters worst. Continue reading

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Marijuana has a reputation as harmless but its not.

Marijuana has been used by so many people and is so immersed in our culture that people don’t respect it dangers. Working with adolescents with mental illness, marijuana is the biggest problem, I face as a psychiatrist.

Every adolescent tells me the same thing: “It’s natural”, “They are going to make it legal”, “Marijuana helps me sleep”, “Marijuana relaxes me”, Marijuana is harmless”, “Nobody gets in trouble on marijuana”, “It’s not as bad as alcohol” and “Nothing is fun without marijuana”.

Then there is always the arguments what it’s not: “Marijuana is not addicting”, “People can stop anytime they want”, “Marijuana doesn’t make you violent or aggressive”, “You cant over dose on marijuana”, “You can smoke all the marijuana you want and nothing happens”, “Nobody steals to get a marijuana fix”, “Marijuana is not a hard drug”, and “No one gets rushed to the hospital because they used marijuana”.

Groups of people are organized around using marijuana. The glue that holds these people together is smoking marijuana and listening to musical groups like Dave Matthews, Phish and Grateful Dead. Those things are maybe true but that’s not the whole truth. Marijuana is subtle and effective in addicting people. The addiction is psychological in nature but powerful. Marijuana users usually become regular users. People tell me, “I use once a week, maybe every ten days.” That means you have marijuana in your blood stream most of the time. Marijuana may take 7-10 days to leave the body. Chronic smokers may have marijuana in their system for up to six week, so even infrequent use results in marijuana/THC in your system all the time. Continue reading

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How to Help a Family Member who is an Addict?

http://dragresti.com ~ (561) 386-7743

Dr. Mark Agresti, West Palm Beach Drug & Alcohol Detox Specialist – Psychiatrist, explains how, as a family member, you can help your loved one with drug & alcohol addiction.  He explains how to stop enabling drug and alcohol addicts.  Learn how to cut off the drug & alcohol detox from being enabled to stay in their addiction.

Call Dr. Agresti today to get help with Drug & Alcohol Addiction.

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33 Reasons to Stop Alcohol

  1. Behavior changes for the worst. Individuals become disrespectful.
  2. Feel sick all the time.
  3. Never get good nights sleep.
  4. Break laws.
  5. Spends a lot of money.
  6. Hurts your body.
  7. Look stupid.
  8. Waste time.
  9. Aggravate everyone around you.
  10. Socially inappropriate. Continue reading
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Disease or Decision – What if the answer does not matter?

The first question most people ask when visiting a doctor is “What’s wrong with me?”  As a psychiatrist I usually beat them to the punch by asking them, “Why are you here?”  That question itself is diagnostic in nature.  It speaks volumes of an individual’s perception and self assessment of their problem.  If the patient is presenting with an addiction issue, invariably there are several assumptions they have already made.  Most of the time they assume that they have a disease.  That it is chronic.  That it is incurable.  And that after a period of detoxification their disease will be managed by daily doses of 12-step activity.  This in spite of overwhelming statistic that traditional 28 day treatment programs have about a 16% success rate.

This has always been a great curiosity to me.  If one in six patients who attend these conventional treatment programs remain abstinent for one year post discharge, why would anybody waste the time, money and psychic investment required by these programs.  I would not buy a car that started one out of six times.  More importantly, I would not buy a car that stopped one out of six times I applied the brakes.

What if we were treating a disease that does not exist?  In my profession that is called a misdiagnosis.  What if we spent our time, energy and money trying to stop “addiction” rather than trying to understand addiction?  An entire industry has developed around causation rather than cessation.  If you had a choice of either understanding why you drink or stopping your drinking the decision would be obvious.  Even if you are a comprehension junky for whom the process trumps the product, at some point all growth starts with stopping. Continue reading

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Why is it important to have a Psychiatrist help you with drug detox?

http://dragresti.com ~ (561) 386-7743

Dr. Mark Agresti, West Palm Beach Drug & Alcohol Detox Specialist – Psychiatrist, discusses why people it is beneficial and best to work with a psychiatrist when detoxing from drugs.  Many times drug abuse and drug use come to help with mental illness.  If you don’t work on the symptoms of what causes the use of addictive drugs (i.e. depression), you’ll find it difficult to detox completely from addictive drugs.

Call Dr. Agresti today to get help with Drug & Alcohol Addiction.

 

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Why do people use drugs and alcohol?

http://dragresti.com ~ (561) 386-7743

Dr. Mark Agresti, West Palm Beach Drug & Alcohol Detox Specialist – Psychiatrist, discusses why people use drugs and alcohol.  He explains three different reasons that people use drugs and alcohol.  Drugs & Alcohol can be used by people due to learned behavior, genetics or mental illness.

Call Dr. Agresti today to get help with Drug & Alcohol Addiction.

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How does a person become an Opiate Addict?

http://dragresti.com ~ (561) 386-7743

Dr. Mark Agresti, West Palm Beach Drug & Alcohol Detox Specialist – Psychiatrist, explains normal steps of how a person becomes an Opiate Addict.  He explains the beginning stages of receiving a prescription opiate drug and how the person feels taking them.  Opiates bring a state of euphoria and the tolerance level of the pill builds, meaning more pills to reach the initial state of euphoria are required.  Dr. Agresti discusses the symptoms of physical symptoms of withdrawal for an opiate addict.

Call Dr. Agresti today to get help with Opiate Addiction.

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