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Forum Name: Psychiatric Topics

Question: Addiction going out of control


 kpv78 - Sat Feb 23, 2008 1:41 am

I have a very good friend who I am pretty sure has a severe drug and alcohol abuse problem. When I say drug I mean prescription pills (especially Adderall),cocaine, ecstacy, marijuana, and constantly talking about being intoxicated or taking hallucinogens. She constantly mixes all of these too in one night (including lots of alcohol) and this is going on pretty much every weekend and even sometimes during the week (we are currently college students). I am beginning to get very worried because I think she may also be depressed since she's told me numerous times that she can not be alone with herself or she gets really depressed and thinks about suicide (she constantly needs to be around someone). I've also noticed weight loss which I think may be because of the cocaine and adderall.
 Dr. E. Seigle - Sat Feb 23, 2008 3:03 pm

Dear kpv 78,

It sounds like your friend may be likely to have a substance abuse problems, which may either be causing a depressive disorder with suicidal thinking, or be in addition to a depressive disorder with the suicidal thinking. The suicidal thinking is of particular concern; you should strongly consider:

1. taking your friend to a hospital emergency room
2. calling 911
3.encouraging your friend to set up a mental health evaluation on an urgent or emergency basis.
4. talk openly with your friend about her suicidal thinking and drug abuse. Ask her if she ever thinks about suicide, and if so, what does she think about. Ask her if she has ever had a suicide plan and if she has ever attempted suicide. If she has a plan or has made a past attempt, the situation is more urgent.
5. many regions (and in fact, your college may have) have 24 hour community mental health emergency services, which you and your friend can call for an immediate evaluation in lieu of calling 911 or going to an emergency room.

It's better to take this very seriously than not seriously enough; she may be giving you a "cry for help". Don't let being afraid stop you from asking her about all of this. You are right to be concerned! Remember that this is not a psychiatric evaluation, I'm trying to guide you carefully in response to your questions.

-Dr. Seigle

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