Anonymous wrote:

Anonymous wrote:Different psychiatrist here. Agree benzos have their place and can be tremendously helpful, but there are very few cases where daily use is warranted. I have had a much easier time tapering off daily benzos (for inherited patients either from elderly psychiatrists or undertrained, overaggressive nurse practitioners) than tapering off daily THC in any form. When I see a new patient who is smoking weed or using gummies daily, I know from experience there's almost nothing I can do to help them with their problems until they stop using, and even if they want to (which is rare), there just aren't any resources out there to help them stop, and it's so hard. The few who do eventually stop do much better.

Unfortunately, this is not surprising. People who come to see you as daily THC users are seeking dissociation. Psychiatrists—newrly all mental health practitioners, really—are astoundingly bad at identifying dissociation even when it is right in front of them (it is often confused with depression or anhedonia, or with the negative symptoms of psychosis), often do not do the complete trauma histories that would point to it—and when they do recognize it, rarely have the luxury of the time to root out why a person prefers to be dissociated.

It’s good that you recognize your limits.

Where did you go to medical school?

Anonymous wrote:

Anonymous wrote:Different psychiatrist here. Agree benzos have their place and can be tremendously helpful, but there are very few cases where daily use is warranted. I have had a much easier time tapering off daily benzos (for inherited patients either from elderly psychiatrists or undertrained, overaggressive nurse practitioners) than tapering off daily THC in any form. When I see a new patient who is smoking weed or using gummies daily, I know from experience there's almost nothing I can do to help them with their problems until they stop using, and even if they want to (which is rare), there just aren't any resources out there to help them stop, and it's so hard. The few who do eventually stop do much better.

Unfortunately, this is not surprising. People who come to see you as daily THC users are seeking dissociation. Psychiatrists—newrly all mental health practitioners, really—are astoundingly bad at identifying dissociation even when it is right in front of them (it is often confused with depression or anhedonia, or with the negative symptoms of psychosis), often do not do the complete trauma histories that would point to it—and when they do recognize it, rarely have the luxury of the time to root out why a person prefers to be dissociated.

It’s good that you recognize your limits.

Actually trauma was my primary area of focus for a number of years. While you are using the term dissociation incorrectly, it is true that many/most daily substance users are seeking to escape their baseline state because it is too unpleasant - sometimes hyperarousal from trauma, but certainly there are lots of other reasons too (including garden variety anxiety, which is the topic of this thread). Regardless, the treatments like medication, therapy, and lifestyle change that we would normally use to address their problems (including hyperarousal) just don’t work as well when someone is stoned all the time.