Camouflaging – Teenagers losing their identities and values

Camouflaging – Teenagers losing their identities and values

A behavior becoming common in teenage and tween girls has been identified by an adolescent psychologist. The behavior that has been identified is called “Camouflaging.” This behavior left unidentified can lead to low self-esteem, depression, cutting etc. It is becoming very common. When I was a guest co-host on the Street Solider Radio Show on KMEL, and the teens were talking about how they change how they dress or their opinions based on their friends. They were describing Camouflaging.

Camouflaging is when an adolescent girl changes how she looks, her opinions or things that she does in order to be accepted by the other girls. The real problem occurs when the girl is changing so much about herself or does it for so long that she forgets or losses track of her real self. Besides changing how she feels, she may forget her chore beliefs and do things she doesn’t believe in.

While this behavior has just been identified in girls and the research appears correct, I believe this behavior applies to boys too.

Many adolescent boys change the way they dress, their beliefs and the way they act to be accepted by their friends. I hear many of these boys telling me in therapy that they feel lost. They tell me they no longer have an idea of who they really are or believe or feel. These boys often turn to alcohol, drugs and cutting. Usually to numb out their lost feeling or to feel something. Often they turn to these in order to forget somethings they have done in order to fit in with their friends.

As a result, many teens start acting like someone they are not just to be accepted. This fear of not being accepted and forgetting their real self because they has been covering their true self up for so long or denying their true feelings for so long can result in boys and girls having low self-esteem and/or feeling depressed.

This low self-esteem and depression can result in such behaviors as cutting, eating disorders, drug use, becoming sexually active etc. Often boys and girls cut just so they can feel as I stated above. The constant denying of their emotions or values can cause boys and girls to lose a sense of their true feelings. Therefore, cutting can occur so boys and girls feel or cope with denying themselves. Denying their feeling or who they are can result in boys and girls feeling very confused. Therefore, they look for behaviors that help them remember who they are and help them identify their true feelings. They also seek behaviors that help them deal with denying their feelings or changing their behaviors. This can trigger eating disorders, drug abuse or other self-destructive behavior. This helps numb out the confusion and disappear of denying their feeling and trying to forget their true self. This can cause feelings of depression and anxiety too.

What should parents look for in their teens? If your son or daughter tries to stop wearing his or her glasses or if he or she all of a sudden changes how he or she dresses or acts these are possible warning signs. Another change could be not doing as well in their classes because they are afraid of looking too smart. Basically, if you see signs indicating that your teenager is trying to deny who they are so they will be accepted by others. It’s more than the common issue of trying to be accepted by friends, they are forgetting themselves and beliefs to fit in.

While it is normal for teenagers to make changes in their attitudes or how they dress, we are talking about something that goes far beyond normal self-expression. We are referring to changes where a teenager is trying to deny who they are because they feel they are unacceptable.

This is what we are talking about. If teenagers are changing their hair or how they dress as a way to express themselves that is normal teenage behavior. However, if teenagers are doing it just to fit in and they end up losing a sense of their true self this is camouflaging.

As I stated, Camouflaging results in depression or low self-esteem because the teenager is forgetting their true self. If they are doing it as a way of trying to experiment with their self expression, the teenager is happy and confident as stated above. This is the main point to understand. Experimenting with their dress and beliefs etc. is normal for teens and helps teenagers identify themselves, however denying or camouflaging their feelings results in teens losing themselves and many behavior problems. This is the main thing for parents to watch for in their adolescents behavior.

If you go onto Yahoo and look up Camouflaging you will find a segment on Good Morning America about Camouflaging. In fact, here is the link to the GMA segment https://gma.yahoo.com/video/parents-worry-tween-teen-camouflaging-122935763.html?soc_src=copy. Also if parents look at the February issue of Teen Vogue, you will find an article about Camouflaging.

Dr Michael Rubino has over 20 years experience working with teenagers and their families. Dr Rubino is considered an expert psychotherapist in the treatment of teens. For more information about Dr Rubino and his private practice visit his website at http://www.rcs-ca.com or http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.

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Why Teens are Feeling Lonely and Isolated

Why Teens are Feeling Lonely and Isolated

“What are we doing to our kids?” is a quote from Cameron Crowe, who wrote the movie Fast Times at Ridgemont High a movie from 1982. Cameron Crowe was discussing the movie with CNN for their special report on movies. He explained he went undercover in a high school as a high school senior to write the movie. He stated he was shocked at how sexually active these kids were in high school. He stated between the focus on sex and working, the kids were being denied their adolescence. They were going from kids to adults very quickly. Sadly what Cameron Crowne noticed in 1982 has continued and has only become worse.

Cameron Crowe was commenting on high school students in 1982. However, what he noticed occurring in high school in 1982 is now occurring in middle school today. In middle school today it is not uncommon for kids to be sexually active. In fact, many middle schools now provide condoms to sixth graders. In addition to sex, kids in middle school are using drugs. They are not just using marijuana. Many middle school students are using concerta, ecstasy and other designer drugs.

In addition to being sexually active and using drugs many middle school students are worrying about how much money they will make at their jobs. Kids are looking at different careers and thinking about how much they will get paid and what they will be able to afford. They wonder about, how big of a house or what type of car will they be able to afford as adults? Mr. Crowe’s observation was correct in 1982 and today. Kids are losing their childhood too early and they are losing their childhood earlier and earlier. In 1982 it was high school now in 2019 it is occurring in middle school. When will it start occurring in fifth grade?

A result I have observed working with teens and kids as a psychotherapist is that kids are feeling lonely and isolated. In 2000, I was noticing this in a few teenagers now in 2019 a majority or teens and middle school students report feeling lonely and isolated. I am also beginning to hear this from fifth grade boys too. Besides loneliness increasing in middle school and high school, the number of kids feeling depressed is increasing significantly. It makes sense. If a child is feeling lonely and isolated those feeling tend to lead to depression.

You may ask with their focus on friends and sex, how are they feeling lonely or isolated? With this focus on friends, sex, drugs and the future comes a great deal of competition. Everyone wants to look like they know exactly what they are doing. Therefore, they may be talking and texting each other, but they focus more on shallow issues. No one really opens up about their true fears and worries. As a result, they feel lonely and isolated.

A very good example of this are teenage boys. Most teenage boys are trying to live up to the outdated stereotype about what it takes to be a man. According to the stereotypes men don’t cry, don’t focus on emotions because they are weak and must be sexually active to be a man. There is a documentary, The Mask You Live In, which focuses on boys conforming to this outdated stereotype. Overwhelming the boys in the documentary reported feeling lonely and isolated. They shared they had no one who they could talk to when they felt overwhelmed or confused by life. They always had to have the right answer and they did not always what was the right answer. As a result, they made mistakes and they felt lonely not being able to ask for help. They felt like they had to hide their true feelings which makes them feel lonely.

I have seen the same thing with teens texting or communicating while playing video games with friends. All the teens say this is the only way they can communicate with their friends. Many teens become angry or violent if you take away their phones. However, the teens I work with in psychotherapy tell me they often feel lonely and isolated. The admit to texting with friends for hours. However, they also explain they don’t really talk about important things such as feeling afraid. Also they admit texting is not the same as talking to someone face to face. They continue with texting because that is what everyone is doing and they don’t want to look different or weak.

Another aspect to teenage boys and girls trying to live up to an image is what they are missing. As a result of closing themselves off emotionally, they never know if someone cares and who to trust. They never know if they are cared for or loved. This can create major issues for teens. In the Disney movie Frozen, they point out how people will act out in pain and make mistakes when they don’t feel loved or cared for by people. The movie also points out how opening yourself up so you can feel love will help people change and make better choices. The lead character, Elsa, when she felt lonely and afraid could not control her power and it only caused destruction. When she finally opened herself up and saw she could be loved she discovered the good her powers could do. When she was afraid she isolated and when she felt loved she opened up and interacted with others. I see this happen daily with teens. When they feel no one cares, they isolate themselves and say hurtful things to keep themselves isolated. When they discover people care, they allow themselves to open up and start to share their true feelings and interact with others. They are very happy and surprised when they make this discovery.

In 1982 the world was much easier. In today’s world things are moving fast and make it easy for people to isolate by texting or using social media to communicate. Also teenage boys and girls feel pressure to outdated stereotypes about men and women. There are few people telling teens they don’t need to follow these stereotypes. We also need to set examples about communication. Adults need to not text so much and rely on social media enough. Parents need to take time talking with their children as soon as they are born. Technology can be a great thing but it is making many people feel lonely and isolated. Teens as well as adults. We need to study technology and look how it is impacting our lives and the lives of our children. One thing for sure, I have seen technology increasing the amount of teens feeling lonely and depressed. We don’t want our kids to lose out on their childhood. Therefore, we need to study the impact technology has on us and teach our children how to use it responsibly. Also we need to teach teenage boys and girls that they don’t need to live up to the outdated stereotypes about men and women. We need to encourage our kids to be themselves and to accept themselves. Hopefully this will help our children reclaim their childhood and be kids.

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

Alarming New Facts about Teenagers and Heroin Use

Alarming New Facts about Teenagers and Heroin Use

Many teens die from suicide and drug abuse. Suicide is now the second leading cause of deaths for children 10 to 24 years old. One thing that contributes to teenage suicide is drug use. Specifically, the use of pain killers and heroin. In this article I attempt to describe both issues for parents. It is important for parents to be aware of these issues if we are going to stop them.

ABC 20/20 did a very good show last year about the epidemic of heroin use in the United States. If you did not see it, you can probably find it on YouTube. Parents this is a show you need to see because many teenagers I work with are not afraid or concerned about how dangerous heroin can be. In fact in 2017, the CDC estimated 494,000 people 12 and older used heroin. The minimum age the CDC is citing is 12 years old. Think about that fact there are 12 year old kids using a highly addictive drug such as heroin.

According to ABC 20/20, 129 people die every year from a heroin overdose. A majority of these deaths are teens and people in their twenties. Heroin is used by people in the lower income level and by people who are the wealthiest in the country. It is used by whites, blacks, Hispanics basically every ethnic group. It is also used by males and females. Therefore, for the families in Lafayette, Walnut Creek and Danville who say we don’t have that problem here, yes you do. Also for parents and educators who think that if their child is in a private school so they are less likely to use, you are wrong too. Heroin crosses all ethnic and economic boundaries. The epidemic is so severe some schools are teaching children in the 6th grade how to use Narcan. This drug can reverse an overdose of heroin if administered in time.

Therefore, parents in the Bay Area, you need to pay attention to this issue and these facts. You might be saving the life of your child or someone else you love.

As stated Heroin use to to be a drug of the past but it is now very popular with teens. Heroin is a cheaper alternative to many other drugs. For $10 a teenager can buy a capsule of heroin. This is much cheaper than other drugs.

Heroin is still mainly snorted or injected. Because it is injected teens are exposing themselves to HIV and Hepatitis C. Both are life threatening conditions with no cure. Also many girls who use heroin get pregnant but don’t realize they are pregnant until the 4th or 5th month. The girls stop using but stoping when you are five months pregnant it is too late for the baby. The babies will be born drug addicted and if they live through withdrawals, these children will have on going health issues and learning disabilities. In addition to exposing themselves to diseases most teens use Heroin with other drugs such as alcohol. This makes the probability of overdosing on Heroin even higher. Heroin lowers a persons breathing rate and the drugs they are combining it with lower the breathing rate even more making an accidental over dose more likely. The person’s rate of breathing becomes so low and they die. If your body doesn’t have enough oxygen to keep your brain a live, your brain stops working and so does your heart and all your other organs. The rate of deaths due to a heroin overdose has increased by a factor of 5 from 2010 to 2017 (CDC). This is a shocking and alarming statistic. Remember 12 year old kids are using heroin so many of those deaths are 12 year old kids.

Why is Heroin coming back and very popular with teens? Heroin is very similar to the Opioid based pain killers that teens have been using for years. However, with the cost of pain killers rising on the streets and becoming harder to get due to new prescription laws, heroin is easier to get and cheaper. Also teens tend to like the high better. It is not uncommon for someone to get addicted after using heroin one time. Also with the Opioid epidemic in our country, teens are now more likely to try heroin because it is easier to get and cheaper.

In the last few years heroin use has doubled in teenagers. What teens are at the highest risk? Those who have been using Opioid pain killers, those abusing marijuana and males. Remember it is very common for teens to combine heroin with other drugs and they are unaware of the impact it has on their breathing. They may collapse and not know why and by the time their friends get them to an emergency room it’s too late. Also teens may go to sleep after using and their breathing rate is so shallow they never wake up.

This is a very dangerous drug. If it doesn’t kill when the teen uses it the drug can kill when the teen is an adult if the teen contracts HIV or Hepatitis C. The rate of teens using this drug has doubled and the amount of people dying from an overdose has increased by a factor of 5 since 2010. Again, parents you cannot ignore this issue. Heroin is being used by upper class children and poor children, athletes, and all races. So it is impacting all teens.

The other major issue with this drug is stopping. Someone cannot just go off heroin. People can die from withdraw. However, finding a treatment center that is affordable or with an open space is very difficult. They may have to wait four months to get into a rehab center. This is very dangerous. When someone decides to stop heroin, they need to enter rehab immediately. If they have to wait even 2 days, they may not make it because they cannot stand the withdrawal symptoms.

If we get involved we can hopefully stop teens from using this highly addictive killer. I have attached a link to a handout by the CDC with facts, warning signs and suggestions to help your son if you think he is using heroin. http://www.cdc.gov/vitalsigns/heroin/

http://www.cdc.gov/vitalsigns/heroin/

In addition to these issues, Heroin and drug abuse is linked to teenage suicide. These drugs besides creating a high, create depression. At times a depression so severe that a teenager decides they would be better off dead and they commit suicide. For the age group 10 to 24 years old, suicide has gone from the third leading cause of death to the second leading cause of death now (CDC). Therefore, we need to pay attention to the pain killers and other drugs kids are using. And yes 10 year old kids are using these drugs too.

Many times the teen has decided they want to get clean and stop using the drug. However, as I mentioned above, finding an affordable treatment program with an open bed can be very difficult. Some teenagers may need to wait 2 months. This can be two months two long. The teenager may be so depressed and tired of living the drug life that they decide to kill themselves rather than endure the emotional and physical pain of waiting two months.

Another point is for some teenagers they have to try four or five times in rehab before they are successful. Again most teenagers are usually dealing with severe depression at this point. For them the thought of trying again and not succeeding is to much to tolerate. Therefore, they chose the option of suicide to eliminate their pain.

Finally, I mentioned a number of teenagers can overdose by accident, however it may not be an accident. Many teens know these drugs very well so they know how to stage what will look like an accidental overdose. Therefore, we really don’t know how many teenagers are committing suicide due to being sick and tired of using drugs and living a drug life. Many of the accidental overdosages could really be suicides. There is no way to tell.

What we know is drug use and suicide are at an epidemic rate for teenagers. It is at a point where we need to get aggressive and provide better access to rehabilitation programs and better access to psychotherapy so the depression can be treated. We need a multi-disciplinary approach to this issue and we need to make it easy for teenagers and parents to use it. We also need to remove the negative stigma and judgement, if someone admits they are addicted and need help. Admitting you need help is an essential first step and it is extremely difficult to do to. Therefore, we don’t need people shaming them for taking that step.

Dr. Michael Rubino is a psychotherapist who has been working with teens for over 20 years and he is considered an expert in this field. For more information about Dr. Michael Rubino and his private practice visit his website at http://www.rubinocounseling.com or his Facebook page at http://www.Facebook.com/DrRubino3.

The Drugs Teenagers are Using Now

The Drugs Teenagers are Using Now

High school students are out of school for the next two months for Summer 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.

Summer break is only two months so many teens want to get in as many parties as they can. During summer 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.

Fourth of July Activities and Teenage Injuries

Fourth of July Activities and Teenage Injuries

The 4th of July weekend is around the corner and many teenagers will be involved in various activities. It’s a popular weekend for teenagers to be out drinking and also swimming with friends. Most people assume these are every day activities and everyone will have a good time.

However, this is not reality. Every year 5,000 teenagers are killed in motor vehicle accidents and 400,000 are injured (CDC statistics). These injures may range from cuts and bruises to someone being paralyzed.

Also regarding swimming, there are 3,500 accidental drowning every year. And out of these drownings 1 out of 5 are teenagers (CDC statistics). This is the number who die. It doesn’t include brain injuries due to lack of oxygen to the brain or breaking a neck by diving. A broken neck can result in death, paralysis or being in a Halo Brace for 6 months. Again this is an activity we assume is safe and nothing would happen swimming in a friend’s pool.

With the Fourth of July weekend coming up, there are going to be a lot of parties and drinking. There are also going to be a lot of drunk driving accidents, drownings and accidental overdosing. You have no way to know if you or your family might be one of the unlucky families this weekend. It could be your teen who is killed or it could be you. Therefore, talk to your teens about their plans and about safety.

You never know what is going to happen in life. Especially given everything that is happening all over the world. And if you look at the above statistics, you never know when or if something is going to happen.

A mother experienced this fact when her son committed suicide. Suicide is the third leading cause of death for teenagers. After that she wrote the following poem to her son. She also encouraged all parents of teenagers to remember to say “I love you,” to your teenager. You may not get another chance.

I Love You

How could you?

They asked you,

How could you?

But you could not answer

As you were not here.

Why would you?

They asked you,

Why would you?

But their questions fell onto

The world’s deafest ears.

I loved you!

They told you,

I loved you.

But they told you too late,

Through their tears.

I’ll miss you,

They told you,

I’ll miss you.

And in death now

They hold you more dear.

The point is don’t take the risk. Since you never know what may happen and many teens feel that their parents don’t care, take the opportunity while you have it to express your feelings. Don’t spend the rest of your life regretting I never told him I loved him or wondering if that would have made the difference.

Dr. Rubino is a psychotherapist is Pleasant Hill who specializes in treating children and teenagers. He has over 20 years of working with teens. To find out more about his work or to contact him visit his website at http://www.RubinoCounseling.com.

Summer Activities and Teenage Concussions

Summer Activities and Teenage Concussions

It is summer time and school is out. Many children are engaged in summer activities such as swimming, water skiing and diving. Others are preparing for next year’s football season and cheerleaders are preparing too. While we use to assume these activities were safe, we now know they can be dangerous.

Many parents of high school athletes are aware of the dangers of concussions. Even one concussion can cause permanent damage according to recent research studies. However, there is another condition that parents need to be aware of when their child plays sports. This disorder is CTE. CTE is Chronic Traumatic Encephalopathy (CTE) it is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.

Our brain sits in our skull surrounded by fluid. Therefore, any time anyone hits their head or their head is jarred around, the brain moves in this fluid hitting the front and back of your skull or the sides of the skull depending on what direction the force came from. When the brain hits the skull it can cause bruising and microscopic tears of very fine nerve fibers. Nerve fibers that are too small to be seen on an MRI or a CT scan.

Physicians have known that CTE effects boxers for many years, however, it was just recently that evidence showed that football players are at risk too. This was the main focus of the movie, Concussion, starring Will Smith. The NFL did everything they could to stop the filming of this movie. The movie shows how CTE results in the patient becoming severely depressed and psychotic. Many of the patients with CTE commit suicide. Also many CTE patients were football players.

Why is this important for parents to know? It is important because CTE is caused by chronic head injuries. Head injuries that date back to when a teenager was playing high school sports. Therefore, it is important for parents to ensure that their teenager’s school is using the latest safety gear, especially for the head, and to take any head injuries seriously. There is no way to tell what will happen when these teenagers become adults.

For many years, football and schools have reported that they are developing helmets that protect the head better. However, these safer helmets are not being used in high schools or professional football. Schools and professional football are monitoring players closer after a head injury, but still little to nothing is being done to protect the brain prior to an injury.

As an adolescent psychotherapist who has been practicing for over 20 years, I am seeing more evidence of this every year. Every year I am seeing more teens with Post Concussion Syndrome. This disorder may occur after a concussion and can be associated with headaches, mood swings and memory difficulties. The teenagers who experiences this Syndrome becomes very frustrated because they are aware of the changes in their mind and because no one can say how long the symptoms will continue. In fact, no one can guarantee that the symptoms will disappear.

This becomes very frustrating to the teenager and their parents. Some teenagers are so overwhelmed that they start self-medicating with drugs and alcohol. Anything that they think might help. Others become so depressed because they fear that the symptoms are permanent that they become suicidal and may attempt suicide.

For many years these head injuries in teenagers were down played because there was not enough evidence to indicate that teenagers could be impacted by head injuries. Well the research clearly indicates that teenagers can suffer long term results from a single concussion. Additionally, this can create symptoms that are overwhelming for the teenager and their family. Imagine being a parent and you see your child suffering with Post Concussion Syndrome and there is nothing you can do to stop it. Parents also become depressed and nervous that their child may never recover.

Everyone’s brain is different and so is the recovery process. This means we have no way of knowing how many Concussions or head traumas it takes before CTE is started in someone. It also means we have no way to determine how long it will take for someone to recover from a concussion or if they will have permanent impairments. We only can tell after it occurs not before.

We do know that patients recovering from Post Concussion Syndrome or dealing with CTE can benefit from psychotherapy. Often this option is not given to teenagers because again many people believe teenagers are very unlikely to suffer with these issues. However, if you look at the research it indicates that teenagers can and do suffer from Post Concussion Syndrome and teenage head injuries can cause CTE.

As a psychotherapist who treats teenagers with head injuries, I strongly encourage every parent to watch the movie, Concussion. Also before your child starts playing any competitive sports, such as football or soccer, go online and research head injuries and signs and symptoms of concussions. Also if you teenager does sustain a head injury while playing sports or just playing have them evaluated. You never know how severe a head injury is by just looking at someone. A few years ago an actress fell in the snow and her friends said to go to the doctor she said she was fine. Two hours later she was dead. When she fell she caused her brain to bleed and she died.

The lesson from this story is as your teens go swimming, camping, climbing, suffering etc., over the summer monitor if they have a head injury. It can happen as easily as two kids hitting their heads together while wrestling and playing. If you notice any changes or your teen is complaining of not feeling well have them examined by a physician. Also keep track of how many head injuries they have sustained over time. If they get a concussion by diving maybe they need to take it easy for the rest of the summer.

Above all, use your best judgement as a parent. Do not be afraid to ask for a CT scan or an MRI if your child suffers any type of head injury. If your teenager does sustain a concussion and you notice a personality change or memory issues do not hesitate to seek psychotherapy for your child and for yourselves. Also don’t hesitate to talk to your teenagers high school. If the teenager is having problems concentrating after a head injury, the school may need to provide them with accommodations until the child recovers.

This can be an overwhelming and frightening topic to consider but the more you educate yourself, the easier it will be to manage. If you have additional questions regarding the personality changes or neuropsychological changes with head injuries, please feel free to contact me.

Dr. Michael Rubino has been treating children and teenagers for over 20 years. He also has training in neuropsychology. For more information about Dr. Rubino’s work or private practice visit his website at http://www.RubinoCounseling.com or his website that deals with accommodations at school http://www.LucasCenter.org or his Facebook page http://www.Facebook.com/drrubino3

Every Parent Makes Mistakes

Every Parent Makes Mistakes

This weekend we celebrate Father’s Day and last month we celebrated Mother’s Day. These days are set aside to provide us time to tell are parents how much they helped us as children and how much they mean to us. However, not everyone feels this way about their parents. Some people have a parent who abandoned them and others have parents who were physically and emotionally abusive. Therefore, Father’s Day and Mother’s Day are not happy days for many people because they had parents but their parents were not there for them. As a result, many people are angry and hurt by their parents and don’t want to celebrate their relationship with their father or mother.

While this is true that many parents were far from perfect parents, at times there are reasons why parents acted the way they did as a parent. I do not say this to excuse their behavior and parenting style because they are responsible for how they decided to act and parent. I say this to help people, who had abusive parents or parents who were not emotionally available, understand why their parents acted the way that they did. Many people who had less than perfect parents tend to blame themselves for their parents actions. This often results in people carrying around hurt, anger and shame that they do not need to. Also they tend to make excuses for their parents behavior because they are afraid what other people will think of them not their parents. They feel people will assume they must have been terrible kids to raise so their parents actions were justified. This only adds to their hurt, anger and shame.

The truth is many parents abandoned their children or are physically and emotionally abusive because their parents were the same way, but worse. They had no role models showing them how responsible parents should act. Also our society provides little assistance or education to new parents. Therefore, they are left on their own to figure out how to act as a parent. This is a difficult task and then when you add the pressures from work and paying bills some parents cannot tolerate the stress. They use whatever is easiest for them which is usually using the same techniques that their parents used.

As a psychotherapist when I work with a patient or a teen, I do a family history. I find out from the adult what life was like when they grew up and what life was like when their grandparents grew up. If I’m working with a teen who is dealing with substance abuse or physical or emotional abuse at home, I find the pattern in the family history. Typically, the pattern goes back to the great grandparents if people can remember that far back. This means we are dealing with a problem that has been going on for over four generations and being transmitted from generation to generation.

How can this happen? It can happen very simply. In the early 1900s very, very few people believed in psychotherapy. In the 1950s people still did not believe in it except for “really crazy” people who were locked up in hospitals. This stigma still continues to this day. When people call to schedule a psychotherapy appointment for their teenager, many ask if they come to therapy will it prevent their teenager from being accepted to colleges or getting jobs in the future. If a teenager contracts a sexually transmitted disease, these questions are not asked. In fact, many middle schools give condoms to sixth graders. Our priorities are off if we don’t worry about a sixth grader’s future when we give them a condom, but we worry about their future if they go to psychotherapy to improve their lives.

Therefore, the main point is that our society to this day still places a negative stigma on psychotherapy and getting help. Therefore, many parents in the 1950s had no help when they became parents. Children do not come with instructions and there were few parenting classes at that time. Therefore, few parents knew what to do as a parent and there were few resources available to help parents who were overwhelmed.

Bottom line, your mother or father may not have been perfect and may have mad a lot of terrible mistakes, but they did the best they could at the time with what they knew. I have found this many times when I have interviewed the parents and sometimes the grandparents of a teen I’m seeing in psychotherapy. They admit they made mistakes, but they did not know what else to do at the time.

Therefore, for those of you who had abusive or neglectful parents, you are entitled to your feelings, but try to understand they did the best they could do. Maybe you can’t forgive them, but don’t blame yourself or feel ashamed. You did nothing to create the situation and there was no way you could have made it better. For teenagers today, again you did not create the problem and the problems have nothing to do with you as a person. Also you cannot change your parents. You can try to understand that they did their best in the past, however, now that you are in therapy they have an option to improve the situation. They can begin their own psychotherapy and address their own issues.

Decade after decade we are seeing the same parenting issues being passed down from generation to generation. We need to stop this pattern. We must remove the stigma associated with psychotherapy and the stigma associated with needing assistance with problems. No child comes with a parenting guide when they are born. As a result, parents will and do make mistakes. Instead of making them feel ashamed and embarrassed, we need to provide parents with options for seeking help such as more parenting classes. We need classes which focus on raising a toddler and other for adolescents. Also for parents who were abused themselves they need individual and group psychotherapy. Why do we keep repeating these mistakes and allowing the cycle of abuse to be transmitted to another generation.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children, teenagers and their families. For more information regarding his work or private practice visit his website http://www.RubinoCounsling.com or his Facebook page http://www.Facebook.com/drrubino3