Shopping Addiction

By: Deanna Damaso

Shopping Addiction is a behavioral addiction where a person buys items compulsively or a specific item repeatedly as an attempt to relieve stress. Those suffering with a shopping addiction spend more time shopping than doing other activities because of their uncontrollable urges to spend money.

The joy of shopping has a direct effect on the brain’s pleasure centers by flooding the brain with endorphins and dopamine. The buyer gets a short-lived “shopping high” from making frequent shopping trips, buying large items, or expensive purchases. However, after a couple hours, the dopamine recedes and the shopper is left with an empty, unsatisfied feeling. This can lead to hoarding, depression, anxiety, and low self-esteem. If left untreated, compulsive buyers could go deeper into debt and turn to stealing.

Some signs of a shopping addiction often include:

  • Spending more money than anticipated
  • Compulsive purchases
  • Chronic spending when angry, anxious, or depressed
  • Lying about the problem
  • Broken relationships
  • Ignoring the consequences of spending money

Financial therapy is effective in teaching how to manage finances and shop more responsibly. Cognitive and behavioral therapies are effective treatments that identify and improve the negative thoughts and behaviors surrounding the addiction. Medications can be prescribed to those who struggle with both the addiction and other mental health issues. This combination treatment helps relieve symptoms to assist in recovery.

If you or someone you know is struggling with a shopping addiction, Arista Counseling & Psychotherapy can assist you. Contact us in Paramus, NJ at 201-368-3700 or in Manhattan, NY at 212-996-3939 to arrange an appointment. For more information about our services, please visit http://www.counselingpsychotherapynjny.com/

 

Sources:

https://www.healthline.com/health/addiction/shopping

https://www.psychologytoday.com/us/articles/200603/doped-shopping

Addiction: Must be Love on the Brain.

Addiction: Must be Love on the Brain.

By: Keely Fell

Heartbreak notably causes a great deal of emotional pain, but have you ever wondered what it does to the chemistry in your brain? Experiencing heartbreak can cause pains in the chest, gut and even in our throat. Such sensations can leave one feeling broken. The brain has quite a way of reacting to the experience of a broken heart, and understanding the feelings caused by brain reactions is essential to overcoming heartbreak.

One of the most interesting brain reactions to heartbreak is the experience of withdrawal symptoms in the absence of love. Often times when experienced, the brain mechanisms that are activated are the same as if someone is withdrawing from drugs like nicotine, cocaine, etc. So you could make the connection that love is addicting, thus creating a chemical reaction when you fall in love that is similar to a “high”.

Functional Magnetic Resonance imaging (fMRI) studies have been performed showing how these mechanisms are being activated in the brain. A study conducted by Art Aron, Lucy Brown, and Helen Fisher found that the area of the brain associated with the rewards system, known as the caudate nucleus, lights up on scans when in love. This shows that love might be more than just an emotion and more of  a response searching for the reward of affection. People who use drugs such as nicotine and cocaine see similar brain activity across fMRI scans. In both cases, the brain is experiencing a spike in the release of dopamine through the caudate nucleus. It was also observed that when an fMRI scan was performed on people experiencing the first stages of a break up, the caudate nucleus was still in “motivation mode”, meaning that the individual was still searching for that “fix” of love.

Understanding that these feelings and symptoms are deeper rooted than just simply feeling sad over a broken heart, can help us through the healing process. Over time the brains need to fulfill the “fix” will subside and will move onto the next big thing.

If you or someone you know is experiencing these symptoms, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Sources:

https://greatergood.berkeley.edu/article/item/this_is_your_brain_on_heartbreak  https://www.psychologytoday.com/us/blog/the-squeaky-wheel/201801/3-surprising-ways-heartbreak-impacts-your-brain

Image Source:                                                                                    https://www.123rf.com/photo_52211182_stock-vector-cartoon-heart-and-mind-characters.html

Vape and E-Cigarette Addiction

By: Maryellen Van Atter

    

E-cigarette devices, such as the Juul, are more prevalent than ever. These devices were originally created to help established smokers stop smoking traditional cigarettes. However, because of their ease of use, portability, and sweet taste/smell, they have become popular with a generation of teens who have never smoked traditional cigarettes. This is concerning because of the plethora of health concerns surrounding the devices. They still contain nicotine, which is highly addictive. Nicotine is shown to raise blood pressure and spike adrenaline and heartrate, which can lead to increased risk of heart attack. Vaping has been linked to severe respiratory illnesses, and it may be related to pulmonary disease. It can worsen asthma, cause nausea, and irritate the mouth and throat.

While these physical health effects are often discussed, there is less discussion about the mental effects of nicotine addiction. Those who smoke have a lifetime prevalence of major depressive disorder which is more than double the prevalence in those who do not smoke. Some research has gone even farther and said that smoking may change neurotransmitter activity in the brain, leading to increased risk of depression. Despite this, the devices are still popular. While it is possible to vape something that does not contain nicotine, it is uncommon and teens often are not entirely aware of what is in what they are inhaling.

The percentage of teens that vape is increasing. Studies have found that 42.5% of high school seniors report vaping in their lifetime; this is dangerous behavior. However, it is important to remember that blame is unhelpful in helping a teen to kick their vaping habit. Similarly, reminding a teen about the risk of cancer and family addiction histories is not an effective way to get them to quit. Teens will respond best to calm conversations and discussions about how their vaping may be affecting them and the things that they consider important, such as school, extracurriculars, and sleep. Helping someone stop smoking is no easy job and it is not something that has to be done alone.

Addiction is a serious mental health concern and the sooner addiction can be treated, the better. There are both psychological and physical symptoms associated with addiction. There are many effective, FDA approved treatments for smoking cessation. These treatments include hypnotherapy, which uses guided relaxation and focused attention to change behaviors, cognitive behavioral therapy, which aims to discover the root of behaviors and works to change attitudes surrounding the behavior, psychotherapy, or talk therapy, and motivational interviewing, which aims to illuminate differences between a patient’s goals and their behaviors. There is no shame in seeking out therapy to assist in quitting smoking or helping a loved one quit smoking, and it is best to seek help as soon as the problem is recognized. The longer one waits, the more established addictive behaviors become.

 

If you or someone you know is struggling with a vaping addiction, Arista Counseling and Psychotherapy can help. Please contact us in Paramus, NJ at 201-368-3700 or in Manhattan, NY at 212-996-3939 to arrange an appointment. For more information about our services, please visit http://www.counselingpsychotherapynjny.com/

Sources:

https://www.safetyandhealthmagazine.com/articles/print/17921-number-of-teens-vaping-hits-record-high-survey-shows

https://www.psycom.net/mental-health-wellbeing/juuling-teenagers-vaping/

https://www.yalemedicine.org/stories/teen-vaping/

https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence

https://www.medscape.com/answers/287555-158503/what-is-the-association-between-nicotine-addiction-and-depression

https://psychcentral.com/lib/can-smoking-cause-depression/

 

Anxiety: Social Media Anxiety Disorder

Anxiety: Social Media Anxiety Disorder

Tatyana A. Reed

Social media is very prominent in today’s society and nearly everyone has a social media account; whether it be Facebook, Instagram, Twitter, Tumblr, etc. Although social media can be great for promoting things, it is also negatively promoting an Anxiety Disorder which is also known as Social Media Anxiety Disorder. According to ePainassist.com, “Social Media Anxiety Disorder is a mental illness that is related to generalized social anxiety, which is acquired when social media interferes with the mental and physical health of a human being.” This can mean that the idea of not being able to check your social media can cause you extreme anxiety. Your anxiety may rise because of the number of likes you’re receiving on a picture, the number of repost on your tweet, or just not getting as many views on your story. Since this new form of anxiety is now increasing, ever climbing with more technology, most people have never heard of the disorder. In this article we will delve more deeply into the topic.

According to The Anxiety and Depression Association of America (ADAA), below are some symptoms of Social Media Anxiety Disorder:

  • Lying to others about how much time you spend on social media
  • Unsuccessfully trying to stop or reduce your use of social media
  • Loss of interest in other activities
  • Neglecting work or school to comment on Facebook or Twitter
  • Experiencing withdrawal symptoms when you are unable to access social media
  • Overwhelming need to share things with others on social media sites
  • Having your phone with you 24 hours a day to check your social media sites
  • Severe nervousness or anxiety when you are not able to check your notifications
  • Negative impacts in your personal or professional life due to social media usage

At first glance, the symptoms probably seem like they would have no physical or mental effects on a person. That’s a false assumption. For starters, being on a phone constantly will affect your eyes by drying them out which then leads to headaches and vision issues. Furthermore, sitting on your phone all day, instead of being active, can cause issues with weight, lower back problems, and neck strain. Using social media constantly can also feed into OCD, depression, and feelings of loneliness, according to ADAA. We think social media is all about being able to connect and share happy things with others but many people subconsciously begin to compare their lives or physical selves to others.

 

If you or a loved one appears to be suffering from SMAD, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

References:

ePainAssist, Team. “Social Media Anxiety Disorder: Causes: Symptoms: Treatment: Recovery Tips.” EPainAssist, 15 Apr. 2019, http://www.epainassist.com/mental-health/social-media-anxiety-disorder.

Fadar, Sarah. “Social Media Obsession and Anxiety.” Anxiety and Depression Association of America, ADAA, Nov. 2018, adaa.org/social-media-obsession.

n/a, n/a. “Social Media Anxiety Disorder All Occasion.” Zazzle.com, 2009, rlv.zcache.co.uk/social_media_anxiety_disorder_all_occasion-re4d11e0809ba45fbbbf7a966b6e2f527_xvuak_

Self-Harm

Self-Harm

Self-Harm

By: Julia Keys

        Self-harm is the act of intentionally injuring oneself without intending suicide. Self-harming behaviors may include, but are not limited to: cutting, scratching, burning, banging/bruising or interference with an injury so that it cannot heal. Self-harm has become a huge concern within the adolescent demographic. Research shows that girls are more likely than boys to self-harm. A recent study shows that up to 17% of teenagers self-harm. To many others who do not self-harm, the act of intentionally hurting oneself may be perplexing, however there are many reasons why people self-harm.

The root of self-harming behavior stems from a lack of healthy coping mechanisms. Oftentimes people turn to self-harm when they have overwhelming feelings of anger, anxiety, depression, or guilt that they do not know how to express. Some self-harm as an act of release, similar to crying or screaming. Once they self-harm, the body releases endorphins which are the body’s natural painkillers, giving the individual feelings of relaxation or happiness. Sometimes people self-harm because they “feel numb”, and harming themselves makes them feel alive.

Here are some signs someone you love may be self-harming:

  • Unexplained cuts, bruises or marks
  • Patterns of parallel cuts or scars
  • Sudden change in mood
  • Wearing clothing inappropriate to the weather in an attempt to cover certain parts of the body
  • Secretive behavior
  • Self-isolating behavior

While self-harm is usually not an attempt at suicide, it is a very serious sign of emotional distress. If you are struggling with self-harm or know someone struggling with self-harm, here are some resources you may find helpful.

Self-Harm Hotline: 1-800-DON’T-CUT (1-800-366-8288)

Self-Harm Text Hotline: Text CONNECT to 741741 in the United States.

If you or a loved one is struggling with self-harm, do not hesitate to seek help by contacting Arista Counseling & Psychotherapy, located in New York and New Jersey to speak to licensed professional psychologists, psychiatrists, psychiatric nurse practitioners or psychotherapists. To contact the office in Paramus NJ, call (201) 368-3700. To contact the office in Manhattan, call (212) 722-1920. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Sources:

https://www.psychologytoday.com/us/blog/evidence-based-living/201805/why-do-youth-self-injure

https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Self-harm

https://www.webmd.com/mental-health/features/cutting-self-harm-signs-treatment#3

Source for Picture:

https://www.bing.com/images/search?view=detailV2&id=70C2902B0BC552C00A01D3254CDAA5F74916A647&thid=OIP.kRmbbAZz8C3wXx0wFCH7bAHaHb&exph=602&expw=600&q=semi+colon+tattoo&selectedindex=25&ajaxhist=0&vt=0&eim=1,2,6

 

Gambling

Gambling

By Lauren Hernandez

              Gambling can be a fun occasional activity to do with friends or family. However, some individuals can develop a serious addiction known as Gambling Disorder. Through frequent compulsive, habitual impulses, a person who is unable to resist gambling can have extreme negative consequences throughout their life which may affect relationships, finances, and even be a stepping stone towards engaging in criminal behavior. Typically a person addicted to gambling will develop this pattern of behavior during adolescence or young adulthood.  Gambling Disorder may begin with occasional gambling and develop into habitual, problematic gambling episodes. An increase in gambling is associated with stress, depression, and substance use or abstinence. Patterns of problematic gambling may also include periods of long term remission.

According to the DSM-5 the symptoms of Gambling Disorder include:

  • Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the fol­lowing in a 12-month period:
  • Needs to gamble with increasing amounts of money to achieve the desired excitement.
  • Is restless or irritable when attempting to cut down or stop gambling.
  • Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
  • Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
  • Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
  • After losing money gambling, often returns another day to get even (“chasing” one’s losses).
  • Lies to conceal the extent of involvement with gambling.
  • Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
  • Relies on others to provide money to relieve desperate financial situations caused by gambling.
  • The gambling behavior is not better explained by a manic episode.

The treatment for Gambling Disorder is an eclectic approach. It is important to seek treatment early, before the individual poses any extreme risks to themselves or friends and family. Prevention may not always be possible; however limiting exposure to casinos, scratch off tickets, or other triggers is helpful. Compulsive gambling is best treated through psychotherapy in the form of therapy or support groups. In addition to psychotherapy, medications such as antidepressants or mood stabilizers are extremely helpful. If you or someone you know is struggling with Gambling Disorder or has problematic gambling habits, it is important to reach out to a mental health practitioner such as a psychologist or psychiatric nurse practitioner.

If you or someone you know who may have Gambling Disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

 

 

 

 

 

 

 

Source: https://www.psychologytoday.com/us/conditions/gambling-disorder-compulsive-gambling-pathological-gambling

Image Source: https://www.google.com/search?q=gambling&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjb9amb7PDiAhUC0FkKHejVDsEQ_AUIESgC&biw=990&bih=595#imgrc=traFs2aEWBYMlM:

Relapse Prevention: Substance Use Disorders

Relapse Prevention: Substance Use Disorders Relapse Prevention: Substance Use Disorders

By: Julia Keys

The road to recovery from substance abuse can be long and difficult. There may be many times when those recovering are tempted to just give up. However, there are many different strategies for when individuals are in a place where they feel ready to quit all the progress they made. Relapse is part of recovery, but it should be avoided and treated carefully.

Most people think that relapse starts when the addict starts using again, however relapse can start much earlier than that. There are three stages of relapse: emotional relapse, mental relapse and physical relapse.  Emotional relapse starts when one is thinking about using. Although they have made no real attempts at obtaining any substances, the thought of using is very tempting. During mental relapse one has decided to use again. Physical relapse is when you contact your dealer, obtain substances, or use substances.

When preventing relapse it is important to seek many different types of support. Studies show that those recovering who see therapists alongside any inpatient or outpatient detox programs have faster recovery rates than those who do not seek additional treatment. Therapists can help those in recovery come up with personalized strategies to prevent them from relapsing.

If you or a loved one is struggling with substance use or recovery from substance abuse, do not hesitate to seek help by contacting Arista Counseling & Psychotherapy, located in New York and New Jersey to speak to licensed professional psychologists, psychiatrists, psychiatric nurse practitioners or psychotherapists. To contact the office in Paramus NJ, call (201) 368-3700. To contact the office in Manhattan, call (212) 722-1920. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Sources:

https://www.psychologytoday.com/us/blog/where-science-meets-the-steps/201312/preventing-relapse-among-addicted-youth

https://www.addictionsandrecovery.org/relapse-prevention.htm

Source for Picture:

https://www.bing.com/images/search?view=detailV2&id=F86C5ECD05E0D6595A3D9A0588384D10CCA60F4B&thid=OIP.idNVRUm7p8tdl-M-0iQdzgHaE8&mediaurl=https%3A%2F%2Fwww.thenationalcouncil.org%2FBH365%2Ffiles%2F2017%2F09%2Froad-to-recovery.jpg&exph=334&expw=500&q=the+road+to+recovery&selectedindex=4&ajaxhist=0&vt=0&eim=1,2,6

 

Lies, Lies, Lies

Lies, Lies, Lies

By Crystal Tsui

Lying is something that we are predisposed to do from the time we are born. Infants cry sometimes for no reason at all except for attention. Caregivers would see if the infant wants to eat or have its diaper changed, but in most cases, infants only want to get the caregiver’s attention. That is the earliest form of a lie and we don’t even recognize it.

As adults, we lie all the time and it’s usually conscious. If we want to get out of doing something, we lie to get ourselves out of the situation. For example, if we want to get out of going to work, we would make something up like we’re sick or our stomachs hurt. We also lie with friends and colleagues too. If we were asked “does this outfit make me look fat,” we would likely to say “no” in order for the other person to feel better and to keep the peace.

In the Merriam Webster Dictionary, lying is defined as “to make an untrue statement with intent to deceive.” However, when we speak, we can omit certain information that leaves the recipient an impression of something other than what we intended.

So, what constitutes a lie?

  • A statement must be made
  • The statement must be untrue or an inaccurate description of reality
  • Speaker has the intention to deceive
  • The recipient believes the false statement to be true

Types of people who lie the most are:

  • Psychopaths
  • Sociopaths
  • Young adults
  • Narcissists
  • Extroverts
  • Salesman

Although you may spot these people in your life, consider why they may be lying before making assumptions about the person.

If you or someone you know is a compulsive liar, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Citations:

https://www.psychologytoday.com/us/blog/the-nature-deception/201905/what-is-lie

https://www.psychologicalscience.org/observer/the-truth-about-lying

https://plato.stanford.edu/entries/lying-definition/

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=2ahUKEwiNh_WBuariAhXhRt8KHV97CZIQjRx6BAgBEAU&url=http%3A%2F%2Fwww.porticomagazine.ca%2F2015%2F10%2Flying-to-get-the-job%2F&psig=AOvVaw3au372DVa_mkb1rB9lTS66&ust=1558453235267372

The Opioid Epidemic: How to Spot the Difference Between an Addiction and Physical Dependency

The Opioid Epidemic: How to Spot the Difference Between an Addiction and Physical Dependency

By Crystal Tsui

In a paper written by Turner et. Al (2017), Opioid Use Disorder: Challenges During Acute Hospitalization, discussed the difference between drug addiction and physical dependency. Addiction is described as a disease. It occurs when a drug produces chemical changes in the brain that enforces the medication to be more desirable. When a person is addicted to a certain drug, they start to build a higher tolerance meaning that they would not feel the effects of the drug with the same dosage. This would make them want to increase the dosage each time just to experience the same effect, which can be dangerous and lead to an overdose. The 4 C’s are the beginning signs of addiction. They are:

  • Craving
  • (loss of) Control
  • Compulsion
  • (using despite) Consequences

A few physical signs of substance abuse includes:

  • Track marks
  • Abscesses
  • Pinpoint pupils
  • Blood in their vomit
  • Chronic cough

There are 3 types of opioid consumers we should be aware of; these include patients with chronic pain, patients who are on medication-assisted treatment and stable, and those who are self-medicating. If you or anyone you know has an opioid addiction, they should be met with warmth and compassion. A caring individual, like you, can help an addict seek the help they need, such as medication–assisted treatment or detoxification.

Individuals who are physically dependent on opioids are a different story. They are usually patients with chronic pain and have become dependent on opioids to relieve pain. However, they don’t feel the desire to take the medication for any purpose other than to relieve their pain. They wouldn’t feel the need to have their dosages increased constantly because the dosage of opioids does not change the effects of relieving pain.

This article is to help define the difference between an addiction and being physically dependent on opioids. This is not an exhaustive list.

If you or someone you know has a drug addiction, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Citations:

https://www.rivermendhealth.com/wp-content/uploads/2017/09/opioid-epidemic.png

Opioid Use Disorder: Challenges During Acute Hospitalization, Turner et al. (2017).

The Opioid Epidemic and Drug-Seeking Behavior

The Opioid Epidemic and Drug-Seeking Behavior

By Crystal Tsui

AMA Journal of Ethics states there has been a 300% increase in opiates in the US. What does this mean for the people? Well, drug availability increases when the demands for opiates increase. Long story short, patients with complaints of pain are getting addicted to opiates and are relying on opiates as pain medication when it’s not entirely necessary. Doctors and nurses in the Emergency department are in the frontlines of this epidemic. They see patients with all sorts of complaints, but over 500,000 ED visits are patients with drug-seeking behavior, specifically for opiates. Different types of opiates include:

  • Heroin
  • Oxycodone
  • Percocet
  • Morphine
  • Tramadol

How did the epidemic begin? Doctors and nurses would prescribe their patients opiates just to improve the flow of the ED. However, recently the epidemic has gotten worse. Patients have learned different catch phrases and to over exaggerate their pain to get these opiates. Such as “headaches”, “back pains”, “neck pain”, and even “dental pain”, or rate their pain higher on the scale of 10.

So, how do doctors and nurses know when to give opiates for patients complaining of pain? The answer to the tough question is quite simple, they don’t. Opiates are always a last resort and there are other pain medications out there that treat everyday pain. The most common are:

  • ibuprofen (motrin)
  • acetaminophen (Tylenol)
  • aspirin (advil)
  • steroids

If you or someone you know is addicted to opiates do not be afraid to reach out for help with pain management or drug addiction.

If you or someone you know a drug addiction, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/ .

Citation:

https://humantraffickingsearch.org/wp-content/uploads/2018/05/1140-pill-usa-opioids-aarp.imgcache.rev5b2d008604b6e9d3635709395bae1267.jpg

https://www.asahq.org/whensecondscount/pain-management/non-opioid-treatment/

https://journalofethics.ama-assn.org/article/drug-seeking-or-pain-crisis-responsible-prescribing-opioids-emergency-department/2013-05

https://americanaddictioncenters.org/the-big-list-of-narcotic-drugs