“Prayers are not Enough”

“Prayers are not Enough”

Yesterday we had another mass shooting at a newspaper in Maryland. Five more people killed senselessly and more family and friends lives were torn a part. This time an assault weapon was not used, a shotgun was used. The gunmen had a history of problems with the paper and planned this out. I made a point of mentioning that a shotgun was used not an assault weapon. I did this to make the point that all guns can kill not just assault weapons.

Mass shootings have become an epidemic in the United States and every year more people are being killed in mass shooting. How many people have to die before we pay attention to this epidemic. Some reporters were commenting yesterday that victims of these shootings are now saying that mass shootings are so common that we will talk about the event today and then forget until then next incident. Unfortunately, I think they may be right.

The news reported that the President and First Lady has been briefed about the shooting. The news also reported that the President and First Lady were praying for the victims. However, I think we need to listen to one of the survivors from yesterday shooting. She stated she was hiding under her desk and she was praying. She had no idea if she was going to live or die. This victim stated she did not care about the President’s prayers. She stated it was nice to hear, but his prayers were not going to help her and she did not care about his prayers. She wanted action to prevent these mass shootings.

We keep hearing this same sentiment from other victims and families. They do not want the President and Congress to pray. They want the President and Congress to take action to prevent these shootings. We need sane gun laws and more access to mental health services. However, the government fails to act. In fact the budget proposals by Congress and the President eliminate support for mental health services.

The First Lady stated she was going to focus on cyber bullying and emotional health for children. However, mental health services continue to be cut for children. In my area there use to be a decent number of community mental health clinics to serve children and teenagers. However, over the past two years most of the community resources have been eliminated. I have had severe problems getting a suicidal teenager hospitalized because the County and private hospital in our area, do not have enough beds to help suicidal teenagers. As a result, the teenager goes home and the parents have to stay awake watching their teenager.

Talk sounds nice, but it does not solve the problem. Prayers do help, but God is not going to solve the problem if we don’t make it a priority. We must take the situation seriously and act.

Therefore, parents consider who you vote for this November very seriously. Vote for someone who is willing to take action and enact sane gun laws and put more resources into mental health. Imagine if you were that woman hiding under her desk wondering if she was going to be killed in the next ten minutes, would you care if the President was praying? If your child was killed in a mass school shooting, would you care if the President was praying? The answer is no! You would want the President and Congress to take actions to prevent this epidemic.

Some people may say I have no right to speak out as a psychotherapist. However, I have an ethical and legal obligation to speak up and inform people if someone is suicidal or if a child’s safety is in danger. Since I am seeing resources cut daily which interferes with my ability to help someone who is suicidal or a child who may be a victim of child abuse, I am exercising my ethical duty and speaking up. Hopefully more people will speak up in November with their votes.

Dr. Michael Rubino has over 20 years experience in private practice and community clinics treating children and teenagers. For more information regarding Dr. Rubino’s work or private practice visit his website http://www.RubinoCounseling.com

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The Danger of Flavored Tobacco Products

The Danger of Flavored Tobacco Products

Parents read this report about how many teens & kids as young as 10 are using flavored tobacco products. They think there is no danger because it is flavored.

Many teens have stated they started smoking because they see no threat to flavored tobacco. Also recent research studies show adolescents are likely to turn down a cigarette from a friend, but if it is flavored they are likely to accept.

We are not talking about cigarettes. Federal law prohibits manufactures from flavoring cigarets. Instead, teenagers are using flavored E-cigarettes, vaping pens, cigars and hookah. They have flavors such as cotton candy, chocolate and gum balls. These names are common names adolescents associate with candy. Also research shows adolescents are drawn to sweet tasting objects. Therefore, these flavored tobacco products are very appealing to adolescents.

These items are not difficult for teens to buy online and they are being advertised online too. Therefore, adolescents are once again trying tobacco products in middle school and continuing because they have become addicted. However, most would not have tried the tobacco in the beginning if the name did not sound like they were using candy.

I have included a link to a detailed report about flavored tobacco products so you can understand how wide spread this issue is in the adolescent population . https://truthinitiative.org/news/flavored-tobacco-use-among-youth-and-young-adults via @truthinitiative.

Dr. Michael Rubino is a psychotherapist who specializes in the treatment of children and teenagers. For more information about his work or private practice visit his website http://www.RubinoCounseling.com.

Gaming Addiction is Real

Gaming Addiction is Real

The World Health Organization (WHO) took a step this week and classified “Gaming Disorder” as a formal diagnosis. Many parents have been concerned about this for years. Also it does not just impact teenagers, as many may think. I have had couples come in for marriage counseling because Gaming was destroying a marriage. For several years the American Psychological Association has said it would be adding Gaming addiction as a formal diagnosis to the Diagnostic and Statistical Manual, however, so far the APA has not been able to decide on the specific criteria for this diagnosis. What the WHO has done is they have acknowledged what many parents have been reporting for years and helping us to take a step so it is acknowledged as a diagnosis.

The United States appears to be behind other countries in identifying that video game addiction does exist and does create problems for individuals and families. During the Winter Olympics this year, NBC showed centers in Tokyo, Japan and Seoul, South Korea, where people were going for gaming addiction. These rehabilitation centers have been open for years and have treated thousands of people over the years. Therefore, other countries have acknowledged Gaming addiction that United States parents have been reporting for years.

As a psychotherapist who treats teenagers, I would have to agree with the parents and I say Gaming addiction is real. I have seen teenagers become violent, punching holes in walls or physically threatening their parents, if there video games or cellphones are taken away as a punishment. Teenagers I told me they cannot function without their video games or cellphones and will do anything to get them back. This sounds like and look like a problem to me. A cellphone or PlayStation should not be a teenager’s life line.

The statement from the WHO states that the Gaming must be interfering with activities of daily life, such as homework, and be present for at least a year. These guidelines seem sensible to me. Also the WHO cautions that issues such as depression and anxiety need to be ruled out before assigning the diagnosis of Gaming Addiction. Many teenagers who are depressed or dealing with severe anxiety do self-medicate with video games. Finally, the WHO states your child needs to be evaluated by a mental health clinician who specializes in treating and assessing children and teenagers. This is very important because typically children and teenagers do not always have the typical symptoms we associate with depression or anxiety. A clinician experienced in assessing children and teenagers can make the appropriate diagnosis.

I have included a link to a segment on Good Morning America which discusses the diagnosis and other issues I have discussed to assist you in understanding what the WHO is referring to with Gaming Addiction, https://youtu.be/axG1tLdutmY.

The World Health Organization has taken an important step in helping us understand and define a problem many parents have been reporting for years. This is not a bad thing. I view it as a positive step. Technology is moving very fast. In fact, it is moving so fast we cannot keep up with all the new issues we need to deal with as a result of new technology. The more we understand this technology the more we all can benefit and avoid potential serious problems.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating and assessing children and teenagers. For more information about his work visit his website www.RubinoCounseling.com or Facebook page www.Facebook.com/drrubino3.

World Health Organization declares Video Game Addiction a Mental Health Diagnosis

World Health Organization declares Video Game Addiction a Mental Health Diagnosis

Parents the World Health Organization has officially stated that addiction to video games is a mental health issue. Many parents have felt it was a mental health issue for years. Today the WHO finally took the step to formally declare it a mental health issue.

I have heard many parents report how violent their teenager becomes without their video games. I have also had teenagers tell me they would become violent if their parents removed their games. I believe the WHO made the right decision.

Watch this segment of GMA on ABC news to learn more. ‘Gaming disorder’ now designated as mental health condition https://youtu.be/axG1tLdutmY via @YouTube

Father’s Day is not always a happy day

Father’s Day is not always a happy day

Today and Mother’s Day tend to be a happy day for people where they can honor their father and mother. However, it is not a happy day for everyone. Some people their father or mother may have died when they were children. For some people their father or mother may have left them when they were children. Therefore, today may not be a happy day. Also for children who were raised in foster care all their lives, today also may not be a happy day.

While this may not be a happy day for adults, it also can be a very difficult day for children too. Many children have fathers and mothers who have passed away or left the family and are not involved with them any longer. Seeing the television commercials or having other family members tell them that it still can be a good day can be difficult for them.

I work with many of these children in psychotherapy. Many don’t express their feeling, but they tend to deal with the emotional pain by acting out. They may be very oppositional during the week and today as away to express their feelings. Other children may isolate and not want to be involved with anything having to do with Father’s Day or Mother’s Day.

I have had parents ask me how they should handle Father’s Day or Mother’s Day when a parent has passed away or left the family. They understand that it is a difficult day, but they do not know what to do in order to help their children.

My recommendation is let the child cope with the day in the way they need. Try not to make an issue about the day. The other thing I recommend to a parent is to talk to their child. Acknowledge that Father’s Day or Mother’s Day may be difficult but it is just one day. They may have a rough day today but tomorrow is another day. I also recommend to parents is to ask the child if there is anything they may want to do. A child may want to release a ballon with a note, they may want to visit the cemetery or they may want to do something for an uncle or aunt or another male or female role model in their life. If they do have an idea, go with what they want to do. If they don’t have an idea, let them know that is okay. If they come up with an idea then you can do it. If they do not have an idea, then remind them it’s just one day that you all need to get through and tomorrow will be better.

Hopefully this will help parents understand the issues their children may be dealing with on Father’s Day and make it easier for everyone.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children and teenagers. For more information about Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or on Twitter @RubinoTherapy.

Helping Children Cope with Stress

Helping Children Cope with Stress

Many times parents can see that their child is dealing with stress or worry that a situation may cause a child to be stressed. Many parents will ask me what they can do to help their child cope with stress or if they can prevent a stressful situation before it occurs. These are valid concerns and questions for parents to ask. Given the state of the world with mass shootings occurring at schools on a regular basis and many children are now homeless in the United States, children are experiencing many stressful situations that never existed before. Since children’s brains are not fully developed, they process information differently and coping with stress can be difficult for children. Also parents are having less control to the stress their child is exposed to due to technology we now have instant coverage of events and 24 hour media coverage which makes it difficult for parents to help their children. I recently read an article by Lori Lite with some good tips for parents to help children cope with stress. I have included these tips and information below.

Children do not think, act, or manage stress like adults; the younger the child the smaller the stressors. Help children cope with stress by realizing you can empower your children.  Arriving at school to find a  rearranged classroom or a substitute teacher can be big stressors to kids.

Young children do not yet have the ability to identify or express their own feelings of stress. They struggle with their own emotions and they pick up on their parents tension. The American Psychology Association noted that 39% of children feel sad and worried when their parents are stressed. Often a stressed out child can be detected when a teacher or parent  observes changes in a child’s  behavior.

Frequent melt-downs, sleeping problems or nightmares, clingy behavior, refusal to go to school, acting younger than their age, bed-wetting, stomachaches and headaches are  signals that your child may be experiencing too much stress. The main thing to look for is a change in behavior. Trust your instinct.

Tips to Help Stress:

1. Help children put words to their feelings. Ask them if they feel nervous, scared, or worried. Ask them what is making them feel that way.

2. Acknowledge your child’s feelings and encourage the use of positive statements. Often children do not understand the outcome of an action or change. Instead of realizing their favorite teacher will be back tomorrow..they might think she is gone forever. Create positive statements for the situation.

“I am safe. My substitute teacher is fun. My teacher will be back soon.”

3. Introduce stress management techniques to  children. Parents and teachers can easily teach and use techniques like breathing, positive statements, and visualizing on a regular basis. Lesson Plans are available.

4. Establish a bedtime routine that helps kids relax. Soothing music or relaxing stories.  Indigo Dreams: Kids Relaxation Music promotes sleep and relaxation.

5. Spend reassuring quality time with children. Parents and teachers can  laugh and play together. Singing songs like This Is The Way We Laugh And Play and If You’re Happy And You Know It can be a liberating and fun stress reliever that you and your children can enjoy together.

I hope these tips are helpful. Parents it is important to remember all you can do is your best to try to help your child. However, as I stated above, with the advancement of technology and events such as mass school shootings happening on a regular basis, you cannot protect your child from every stressful event.

Dr. Michael Rubino is a psychotherapist with over 20 years experience and he specializes in treating children, teenagers and trauma victims. For more information about his work or private practice visit one of his websites www.rcs-ca.com or www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3.

School is out and New Drugs are out too

School is out and New Drugs are out too

As a psychotherapist who treats teenagers, I hear about what is going on with teenagers and what they are doing. I have been hearing from many teens about new designer drugs they are taking. Many people assume teenagers are primarily using marijuana. However, teenagers are looking for new drugs and ways to modify how they use marijuana. These new drugs can be very dangerous, even deadly. However, many teenagers are not aware of the dangers and risks they are taking.

It is now summer and school is out so for many teenagers this means partying and using drugs. One major problem facing teens is the fact that many Emergency Room physicians cannot keep up with all the new drugs teenagers are using. Therefore, if a teenager ends up in the Emergency Room due to overdosing or having a bad reaction to one of these new drugs, a teenager may die before an Emergency Room physician determines what the teenager took and how to treat it. The show The Good Doctor recently had an episode which addressed this issue. The teen had used, Molly, not a new drug but because there were so many options, the teenager almost died before they could determine how to treat him.

Recently I read an article by Angela Chen. The article discusses these new dangerous drugs and how deadly these drugs can be. I have included her article below so parents can be aware of the dangers facing their teenagers. Hopefully, parents will also take this opportunity to discuss this issue with their teenagers.

On a July day a little over a year ago, over 30 people collapsed on a street in Brooklyn. They lay on the ground, vomiting down their shirts, twitching and blank-faced. Some, half-naked, made jerking movements with their arms, eyes rolled back. Others groaned and clutched onto fire hydrants to try to stay upright. Witnesses said the scene was like The Walking Dead. Headlines claimed that people had turned into “zombies,” while police said that the 33 affected were lucky to be alive.

All had smoked an “herbal incense” product called AK-47 24 Karat Gold. Eighteen people were sent to the hospital by ambulance. The situation had all the signs of a drug overdose, and so doctors ordered the usual tests: blood count, urine analysis, heart rate monitoring.

The first patient tested was a 28-year-old man who was slow to respond, but otherwise showed few clear signs of trauma. Heart sounds: normal. Blood count: normal. His lungs were clear and there were no major neurological problems, no excessive sweating or skin lesions. He tested negative for opiates, cocaine, amphetamines. Nothing came up.

The case went to the Department of Homeland Security and the Drug Enforcement Agency. They knew who to call to get a second opinion. They packed blood and urine samples on dry ice and shipped them to a small lab 3,000 miles away in San Francisco, run by toxicologist Roy Gerona. If anyone in the country could figure out what was in 24 Karat Gold, it would be him.

Forty years ago, drugs had easy names: cocaine, meth, heroin. Today, the names can read like an ingredients list for a chemistry class: 5F-AMB, PX-2, MDMB-CHMINACA. Today’s designer drugs are made by synthesizing chemicals and hoping they give you a high that’s strong enough to be worth it, but not strong enough to send you to the hospital.

Designer drugs are volatile. If you tweak just one molecule, you can get an entirely differently substance, one you hadn’t bargained for. They’re also easy to get. There’s no shortage of “research chemicals” vendors on the dark web are willing to sell. And they’re growing more popular. These so-called “novel psychoactive substances” entered the mainstream in 2009. That year, according to the United Nations Office on Drug and Crime, there were about 100 of these substances reported; six years later, there were nearly 500. Because designer drugs don’t show up on traditional drug tests, they’re hard to track and identify. It’s a public health problem that requires a special set of skills to handle.

One of the most prominent categories of designer drugs are those intended to mimic marijuana, called synthetic cannabinoids. Marijuana, or cannabis, is widely considered one of the safest drugs, but synthetic cannabinoids are some of the most dangerous synthetic drugs. The Global Drug Survey (GDS) found that last year, for the fourth year running, the risk of seeking emergency medical treatment was higher after using synthetic weed than for any other drug.

When you smoke a regular joint, a chemical called tetrahydrocannabinol (THC) travels through your blood. It binds with receptors called CB1 and CB2. Because of the structure, there’s “kind of a limit on how stoned you can get,” says Adam Winstock, a London-based psychiatrist who administers the GDS. If you’re smoking a popular cannabinoid like K2 Spice, a chemical travels through your blood, but this time, it’s not THC. It’s something else that also binds with CB1 and CB2 — but unlike with regular weed, we don’t know exactly how these chemicals bind, especially when they’re illicit drugs from the black market. This mystery makes synthetic marijuana likely to lead to “much more extreme responses,” like seizures and psychosis, according to Winstock.

Synthetic cannabinoids originated in a quest to create a better pain medication. A Clemson University chemist named John W. Huffman synthesized hundreds of compounds in an attempt to find a better painkiller, but often created incredibly psychoactive substances with no medicinal properties at all. When he published the results of these compounds — called JWH compounds, after his initials — he made the information available to be copied.

There are more than 300 JWH compounds alone, and around 2004, labs in China began studying old research papers, synthesizing the compounds and distributing them as “herbal incense” products. K2 Spice itself — often partly based off the JWH-018 compound — started in China, became popular in Germany around 2008, and entered the US around 2009.

Labs can also turn to the expired patents — patents that are rich fodder, even if (or perhaps because) there was a good reason said drugs never made it to market. It’s nearly impossible to figure out how to shut down the overseas labs producing these drugs. As soon as you ban one substance, the labs move on to another.

Gerona, a toxicologist with gray hair styled in an undercut, was the one who received the biological samples from the DEA. From a small lab in the Medical Sciences Building at the University of California, San Francisco, Gerona says he and his team are playing a “cat and mouse game” with illicit international drug manufacturers. When an overdose happens, Gerona’s team tries to identify the drug in question — often synthetic substances no one has seen before. But the lab goes one further: Gerona’s lab attempts to identify and classify these substances before the mass overdoses even happen.

Inside, the lab is meticulously neat: rows of spotless tables are covered in bottles with orange rubber caps, all labeled with orange duct tape, and small gray centrifuges. A window overlooking a courtyard has molecular structures scribbled over it in pink and green marker. Near the door sits an enormous freezer, filled with thousands of brightly colored, frost-covered boxes of drug samples kept at -112 degrees Fahrenheit.

Gerona launched his toxicology lab in 2010, in partnership with the San Francisco Poison Control Center. The date wasn’t a coincidence; he says that 2010 was the year that a designer drug called “bath salts” began flooding the market. “Bath salts” is a blanket term for a group of designer drugs made from stimulants; they create a euphoric high like MDMA, sometimes with hallucinations thrown in. The drugs usually come in powdered and capsule form, and can cause freak-outs that were well-documented on YouTube at the time. The most famous of these was a viral story of a 31-year-old Miami resident attacking and then eating a homeless man. (Scientists dispute the drugs’ role.)

For users and the DEA, the spike in bath salts use was a nightmare. For Gerona, the increased interest in designer drugs led to more work and more samples from around the country. Eventually, the lab caught the notice of both Michael Schwartz, a toxicologist at the Centers for Disease Control and Prevention, and DEA pharmacologist Jordan Trecki. A collaboration between Gerona’s lab and the DEA was formed. (Neither the DEA nor the CDC responded to repeated requests for comment.)

The first step in doing an analysis at Gerona’s lab is getting the sample — urine, blood or, rarely, a tiny bit of drug itself — shipped over on dry ice. In traditional drug testing, you check to see if the sample matches any of the known substances: marijuana, heroin, cocaine, and so on. They match, or they don’t. Designer drugs, almost by definition, are made of chemical combinations we haven’t seen before. They almost never match traditional databases, and the chemists often don’t know what they’re looking for. So Gerona’s lab gathers as much information about the substance as possible.

A tiny vial of the biological sample — usually plasma, the colorless part of blood — goes into a bulky, printer-like machine. That machine is called a liquid chromatography mass spectrometer, and very crudely put, it separates out all the different parts of the plasma by mass. (Think of it like an extremely sensitive centrifuge.) That process makes it easier to identify chemicals, and the mass spectrometer then spits out the different measurements in a computer chart with peaks and valleys called a chromatogram.

Then, says Axel Adams, a graduate student in Gerona’s lab, you turn to the so-called “prophetic library.”

“ RESEARCHES LOOK FOR POSTS ABOUT DRUGS ON SUBREDDITS LIKE R/RESEARCHCHEMICALS

Gerona’s “prophetic library,” about three years in the making, is a detailed catalog of already synthesized variants that his team believes is going to be the next big street drug. The library was made possible with the help of Samuel Banister, a synthetic chemist at Stanford University. Banister synthesizes variants of popular street drugs and takes down their chemical information to create “reference standards.” Synthesizing can take anywhere from a few days to a couple of weeks; the lab now has almost 150 variants on file. It’s a side job for Banister, but at one point, he says, “I was pumping out five to 10 a week.” The final products look like white crystalline solids and are kept in drawers in the lab, ready for when a case like AK-47 24 Karat Gold comes along.

In addition, lab members spend hours each week on drug forums, researching trends. It’s more of an art than a science. Researches look for posts about drugs on subreddits like r/researchchemicals. They reference surveys like the Global Drug Survey and survey “trip reports” from experiential documentation sites like Erowid and PsychonautWiki.

They look for terms like synthetic pot, K2, Spice, and sometimes, scientific terms like “cannabinoids,” or a specific popular class of cannabinoids, like “FUBINACA” or “JWH compounds.” Often, the posts themselves will include the name of the chemical. Gerona has ordered drugs off the dark web. In one case, the invoice billed him for “cosmetics,” and the package included lipstick, fake eyelashes, and tabs labeled “powder.” The “powder,” unsurprisingly, turned out to be drugs. But most of the time, the drugs in the powder were not the drug that was ordered.

“ THE INVOICE BILLED HIM FOR “COSMETICS,” AND THE PACKAGE INCLUDED LIPSTICK, FAKE EYELASHES, AND TABS LABELED “POWDER”

If there is a match because the compound is already in the library, finding the right variant is “only going to take 15 minutes,” says Gerona. “Otherwise, it could take a week, or it could not be solved.”

Adams checked the results of a blood sample tied to AK-47 24 Karat Gold against the prophetic library. The computer pulled up a chart that indicated a line — jagged, up and down — that shows the mass of the components of AK-47 24 Karat Gold, versus the same information for AMB-FUBINACA.

Drugs don’t pass through the body untouched. Once they’re ingested, the body processes the compounds. So by the time they’re in the blood or urine, it’s not exactly the same compound as the drug that was ingested. It’s hard enough to find a reference standard for the original compound; it’s even more difficult to find a reference standard for the possible variants. In the case of AMB-FUBINACA, the chemical in the biological sample from Brooklyn wasn’t the parent compound. It was a derivative. Luckily, Banister had already synthesized that variant, too.

The peaks and valleys of the two lines of AK-47 24 Karat Gold and AMB-FUBINACA matched up precisely. It took the team only seven days to identify the substance in the Brooklyn case — and most of that time was spent waiting for the sample to get there.

Gerona’s lab has worked on cases across the country, from New York City to Sacramento to Colorado. The number of cases varies. Sometimes, they’ll get 15 to 25 samples a month. One Mississippi case involving synthetic cannabinoids resulted in over 400 samples. The average turnaround on results is about six months, says Adams. That’s not good enough for Gerona.

And it’s not likely that the problem will go away. Marijuana legalization advocates claim that people will stop with the synthetic stuff once the real thing is okay. But that’s not true in the experience of Andrew Monte, a clinical toxicologist at the University of Colorado School of Medicine who collaborates with Gerona’s lab. Recreational marijuana is legal in Colorado, but he sees patients who are on these synthetic compounds anyway. Monte’s team has surveyed people who come into the ER and even set up at music festivals to ask attendees questions. Synthetic drug users are “taking it for a different reason, to get a different high,” Monte says. “They’re really looking for something different than what pot gives, the same way you might choose cocaine over pot or meth over pot.”

“ ONE MISSISSIPPI CASE INVOLVING SYNTHETIC CANNABINOIDS RESULTED IN OVER 400 SAMPLES

To help address this problem, in 2016 Gerona started a new research consortium called P SCAN, or the Psychoactive Surveillance Consortium and Analysis Network. (Yes, the double entendre is intended.) They’re working with about 10 poison control centers in places like Kansas and Colorado. They’ve had more than 100 cases referred to them and are writing up case reports and manuscripts. (The 24 Karat Gold case was published by the New England Journal of Medicine.)

P SCAN will continue to do the surveillance work Gerona has been doing for years, but also create a database of clinical data connected to the specific synthetic drugs they track and discover. Think of it like a medical version of Erowid. This way, the next time there’s an outbreak like the one in Brooklyn, investigators and researchers can look at specific physical indicators (heart rate, respiratory information, neurological information, and more) and say, “Ah, this matches the symptoms of AMB-FUBINACA” — all without shipping samples across the country.

But even with P SCAN and the prophetic library, the task is huge. “The identity of a lab needs to constantly expand and rework in order for it to stay relevant,” says Gerona.

Gerona is a biochemist by training. Before launching his lab, he didn’t know anything about Spice, or AK-47 Gold, or the dark net. But now, Gerona says, “I have no other choice but to really learn about it, so that I am relevant and retain my relevance in the field.” He’s hoping to work with people in technology to automate this “market research” to glean new insights and make the prediction process even faster. “It would be so great if we could predict the drugs coming in with more accuracy, instead of after people are hurt,” he says.

Weeding out designer drugs is a Sisyphean task, Gerona admits. It may be impossible to shut down the overseas labs, but he wants to have even better methods for predicting what’s going to get big and then, instantly identifying the substances. He compares the endless drug variations to nature: the cold virus is still around because it changes all the time. HIV has never been cured because it continues mutating. “In a sense, they’re reinventing themselves all the time, so reinvention is key to persistence. As long as you’re reinventing yourself, you can persist.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers. He treats teenagers with drug issues and has seen many end up in the Emergency Room because teenagers think they are the experts. For more information about Dr. Rubino’s work or his private practice visit his website www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3.