Middle School in the 21st Century

Middle School in the 21st Century

As a psychotherapist who treats adolescents who are in high school, I often hear parents concerns about what teens face in high school. For example, many parents worry about drugs and alcohol. There are numerous other issues too. The parents do need to be concerned because these are issues in high school. If they have a child in middle school too and I mention they need to address theses issues with their child in middle school, many parents look surprised.

I hear parents say every day that they don’t need to worry about drugs or alcohol with their child in middle school because their child is too young for that right now. Well the reality is that Middle School Students are drinking, using drugs and having sex. Many parents are unaware of what is happening in Middle Schools these days. Drugs and alcohol are just the tip of the iceberg. Children that are in the age group of middle school are now involved numerous dangerous activities such as selling drugs.

To begin with, most campuses are better pharmacies than your pharmacy. I have had middle school kids say they can get Vicodin, Concerta, Ecstasy and of course weed and alcohol on their school campus. Some kids use at school and some use after school and on the weekends. More and more middle school kids are deciding to experiment with drugs and alcohol due to the pressure to feel successful as a teenager and so they fit in with friends.

Also many middle school kids are sexually active, but they don’t think they are sexually active. They think because they are not engaging in intercourse and they are engaging in oral sex that it doesn’t count. The kids say they are just “messing around” with each other and do not consider this sex. They also have no idea about sexually transmitted diseases or how to protect themselves for STDs or getting pregnant. However, the number of middle school kids engaging in oral sex and intercourse has increased significantly over the last few years. The rate is now high enough that some middle schools, such as the San Francisco School District, are providing condoms to middle school kids. Yes, Middle Schools are giving condoms to children in the sixth grade. These kids are only 11 years old.

Another common issue in middle school is bullying. However, we are not just talking about one kid teasing another kid at school anymore. Today there is for a group of kids teasing one kid and it is not just at school. Now kids are using Facebook, Twitter, Instagram, Snapchat and texting by cellphone to tease and harass other kids. And as many of you may recall there have been a number of kids who have committed suicide due to the teasing at school. I recently wrote an article about a middle school girl who committed suicide and in her obituary she left a note to the other students just asking them to be nice to each other. Another issue with teasing, is that a number of middle school students have been arrested for photos they text and for harassment. Besides teasing, texting a nude photo of a student in middle school means the middle school child violated child pornography laws. Something many parents and students are not aware of is that when a child texts a nude photo of a middle school student, who is under 18 years old, it violates child pornography laws and the child who texts it and received it can both be arrested.

Also many kids in middle school, especially boys, don’t feel safe and are afraid of someone trying to beat them up before or afraid school. They say they have to fight because other kids are recording it and posting it on YouTube. Boys are bragging about their fights on YouTube and comparing how many people have watched their fight with their friend’s fight. Therefore, boys feel they must fight, otherwise if they don’t fight the other kids will think they are a “whimp” so they have to fight. Due to this fear many middle school students carry knives, metal pipes, guns or anything they can think of to protect themselves. This is very sad that kids have to live in fear for their lives and safety at school. Also parents and students don’t realize, if a student is caught with any of these items on campus they can be removed from their entire school district and required to go to continuation school. In addition, the school can have the student arrested. Due to terrorist activities, schools take anyone possessing items that can severely hurt someone very seriously.

These are just a few of the issues that are occurring at all middle schools and they are very serious. Your child is not going to come to you to ask about these issues or tell you about them because they feel embarrassed and they are afraid of getting in to trouble. So parents even though you may feel embarrassed or awkward discussing these issues with your 11 year-old child, please do so. If you notice anything about your child’s behavior that seems different to you and you feel a sense of concern, ask your child about what is happening at school and with friends. Mention they are getting older so are the issues in their lives and mention drinking, sex or being teased and ask if they need to talk about it. You may be saving their lives because they are dealing with things they know nothing about and these things can kill or have life long effects.

Here is a YouTube video that might help:

Dr Michael Rubino is an expert dealing with adolescents and adolescent issues. He has over 20 years experience treating adolescents. For more information about Dr. Michael Rubino’s practice check his website http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/Drrubino3.

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I Love My Child, but I Don’t Like My Child

I Love My Child, but I Don’t Like My Child

What should I do when my teen is driving me crazy. Here are ideas for those days when you love your child but don’t like your child. Every parents has those days. It’s normal. I Love My Child But Sometimes I Can’t Stand Him! https://www.empoweringparents.com/article/i-love-my-child-but-sometimes-i-cant-stand-him/?utm_source=Empowering+Parents+Newsletter&utm_campaign=4a33f0d3da-Newsletter_2019-03-01&utm_medium=email&utm_term=0_5bbf2964fe-4a33f0d3da-112844061&goal=0_5bbf2964fe-4a33f0d3da-112844061&mc_cid=4a33f0d3da&mc_eid=e93a7440c4

Ways for Parents to Cope with School IEP Meetings

Ways for Parents to Cope with School IEP Meetings

The school year is coming to a close soon. Therefore, students with IEPs or 504 plans must have their yearly review deciding if a child still qualifies for an IEP (Individualized Educational Plan) or a 504 plan. Also for parents who requested their child be evaluated for an IEP, they will soon be having their initial IEP meeting to determine if the child qualifies for an IEP. I have posted this article before, but it appears I need to post it again. Once again, I have been hearing from parents all over the country who are afraid about lies they are hearing from their child’s school. Many of these parents are panicked and overwhelmed. They know their child needs help at school, but they do not want to ruin their child’s future. Additionally, many parents do not know what their child is legally entitled to and the school districts take advantage of this fact.

The issue that parents are feeling confused about is should their child have an IEP or a 504 plan. An IEP is for children who are having difficulty learning subjects in the classroom. They do not have an IEP because they are not intelligent. They have an IEP because they have a different learning style. I have seen numerous parents and received numerous emails from parents stating their child’s school has told them an IEP would mark their child for life as unintelligent and possibly bankrupt the school district. None of these remarks are true.

An IEP will not stop your child from getting into a college or getting a job as an adult either. Not having a decent education can stop your child from getting into college or getting a job. Therefore, if your child needs an IEP and not a 504 Plan in order to benefit from their education, not having an IEP could stop your child from getting into college or a job because they failed to receive a proper education.

Also think about when you applied for college or a job, did they ever ask for your middle school or elementary school records? The answer is no. Therefore, there is no way for a college or job to know if your child ever had an IEP unless your child volunteers the information when they apply for college or a job. Once again, colleges and jobs never ask an applicant if they ever had an IEP. Actually, an IEP can help students receive additional time taking the SAT and ACT and assist them in college if they need it. So actually, it can help a child applying to college.

As for the idea that an IEP will bankrupt the school district, this is absurd. The school districts have plenty of money to provide children who need an IEP with an IEP. A 504 plan costs the district nothing and if the district fails to comply with the 504 plan, you really have no legal recourse. However, an IEP is a legal agreement and the laws governing IEPs are the same in every state in the United States. Also if a school doesn’t comply with an IEP, you have a number of options including legal options.

Also parents please do not pay to have your child psychologically tested or undergo any educational testing by a private mental health clinician. Legally, the school district does not have to accept these tests results. The school has the right to do all testing first. If you disagree with the school’s tests results, you can contest the results and request that your child be re-evaluated by an independent clinician. If you request an independent evaluation, you can select who does the testing and the school district must pay for the independent evaluation not you.

The only testing schools currently are not doing are assessments for Attention Deficit Hyperactivity Disorder (ADHD). Too many children were being diagnosed with ADHD and now these assessments need to be done by a mental health clinician in private practice. These evaluations you do have to pay for.

Another issue I am receiving a large number of emails about is that the school is not doing anything. Parents are saying they are hearing from the school that their child is distracted in the classroom and not doing well on tests or homework. However, the school is not doing anything. If you feel your child needs to be assessed, you need to submit a written letter requesting the evaluations to the principal. Requesting it verbally does nothing. Legally you must submit a written letter to the school principal in order to start the IEP process.

Another suggestion, parents before you panic or feel guilty about not signing that you agree with the assessments by the school because the school is pressuring you to accept their recommendations, stop and think. Look at the proposed plan and decide do you think this is really what your child needs or is the school bullying you into signing their proposed plan. If you have doubts, don’t sign the agreement and seek a second opinion. You are the one in charge not the school. The school district cannot do anything until you sign the agreement. I have seen many parents made to feel guilty if they do not sign the school’s plan. You are not a bad parent if you do not sign right away, you are a cautious parent. If you do not agree with the proposed IEP plan, you can sign that you disagree and do not accept the proposed plan. There is a space on the form for you to do so. If you reject the plan, you will not ruin your child’s education. If you reject the plan, it simply means the school district needs to do more work to develop an acceptable plan. However, I have seen many school districts doing what is best for them financially not what is best for your child and making parents feel guilty. There is no need to feel guilty if you do not accept, the first option presented. Think about it when you are selling or buying a house, you do not automatically accept the first offer and you do not feel guilty.

If parents are divorced, you face some additional challenges especially if you are having difficulties co-parenting with your ex-spouse. Some districts have called the parent who is more willing to sign and gets them to agree to sign and close out the IEP. I have also heard stories where the district encourages the arguing between the parents to get the parents to drop the process or for one to become so angry the parent signs the IEP to irritate the other parents. Yes it sounds unbelievable, but I have seen it happen many times.

I encourage any parent dealing with the IEP process or a 504 plan to take things slow. Ask all the questions you need and seek a second opinion if you feel you need one. You do not have to sign any documentation right away. Remember, you can sign that you do not agree and need more time. School districts are going to push you to sign right away, but legally you have every right to take some time and consider their proposal. Please do not be afraid to assert your rights. You are doing what best for your child’s education and future by taking time to review everything.

For more information about IEPs and 504 plans visit the website http://www.lucascenter.org.

Dr. Michael Rubino is a psychotherapist and has worked with children and families for over 20 years. He also worked as an Intern at AB3632 for 2 years. AB3632 is a California program that provides counseling services for children in Special Education. They also participate in IEPs on a regular basis. Dr. Rubino has been an IEP Advocate for over 20 years. For more information about Dr. Michael Rubino’s work or private practice visit his website http://www.rcs-ca.com or http://www.RubinoCounseling.com or http://www.Lucascenter.org.

Preparing for College, If you have an IEP in High School or Elementary School

Preparing for College, If you have an IEP in High School or Elementary School

Working with children and adolescents I have had many parents ask about 504 plans and Individual Educational Plans (IEP). Parents tend to focus on the assistance their child may need in elementary or high school due to a learning disability or mental health issues. Over 20 years as a psychotherapist, what I have observed is that children who need assistance in elementary and high school typically need assistance in college. Since we are coming to the end of the school year and as seniors in high school prepare for graduation and decide on plans for college, IEPs need to be addressed with colleges that students will be attending.

From my experience, most families assume there is no assistance in college. However, typically if a child has an IEP, they are also entitled to assistance in college. Most colleges in their Counseling departments have programs designed to help disabled students. A student with a physical or learning disability or mental health issue such as ADHD or depression would qualify for assistance by the Disabled Students Program at a college. I have recently been receiving many questions from Parents about what happens to their child’s IEP when the go to college and questions from parents who have college freshmen asking about their child’s IEP. Therefore, I thought it would be beneficial to provide information about how IEPs are handled by colleges. In addition to an IEP, any student with a learning disability or mental health issue is entitled to accommodations because they are covered by the Americans with Disabilities Act of 1991.

Additionally, if you live in California and you have a physical or learning disability or a mental health issue and if you had or did not have an IEP while in school, you may qualify to be a client of the California Department of Rehabilitation. This Department is responsible for assisting people in California, with a disability, find a job and get the education they may need to find a job. The Department may assist their clients by providing tuition assistance for community or state colleges and provide financial assistance to buy text books and school supplies. What they are able to do depends on the State budget.

This is another reason for parents to insist when their child does need an IEP that the school district places the child on an IEP. The lies schools tell parents that an IEP will prevent their child from getting into a college, the military or getting a job is not true. Another reason to insist on the IEP, if your child qualifies for an IEP, as a result of having an IEP, your child can be granted accommodations on the SAT or ACT. These are tests seniors typically need to take when they are applying to four year universities. The common accommodation most students require is additional time to complete the tests. I have had many teens with ADHD come to me seeking accommodations on the SAT or ACT. A common requirement that the testing boards require is that a student needs to have had an IEP if they are seeking accommodations on these tests.

Therefore, many students who have disabilities or mental health issues can receive assistance in college. While many people may be surprised, it is true. However, for many college students finding the assistance can be confusing and overwhelming. For a Freshman in college dealing with heath or mental health issues the confusion and embarrassment people deal with because of society stereotypes can cause students to give up. However, I was contacted by bettercollege.com with a resource guide they developed for college students with mental health issues. While their guide was created for students with mental health issues, it can also be used as a guide for students with physical or learning disabilities.

Since I feel this is a valuable guide to Freshman students and their families, I am including a link to this resource guide below:

Guide to College Planning for Psychiatrically Impaired Students – https://www.bestcolleges.com/resources/college-planning-with-psychiatric-disabilities/

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with children, teenagers and college students. For more information about Dr. Rubino’s work and private practice visit one of his web sites http://www.RubinoCounseling.com or http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3.

The New High School Drugs

The New High School Drugs

High school students are out of school for the next two weeks for Winter Break. They are looking forward to spending time with their friends at school and those returning from college. This usually means a lot of late nights and parties. Many parents are concerned about the challenges their children will experience in these environments. A common one is peer pressure and drugs. 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.

Winter break is only two weeks so many teens will want to get in as many parties as they can. During winter break for many teenagers this means partying with old and new friends. Drugs are often part of these parties. 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 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 http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/Drrubino3.