Brief Answer:
There are many other treatment options

Detailed Answer:
Hi XXXX,

Thanks for writing to us,

Addiction to substances like marijuana or others in some cases can begin because of problems like mood instability, lack of confidence, feeling rejected often etc. What happens in addiction or dependence is, on taking marijuana regularly, the body gets habituated with the drug and causes physiological changes that makes the drug a necessity in the body. So stopping the drug suddenly causes withdrawal symptoms like, insomnia, restlessness, irritability or restlessness etc. So what is done in rehabilitation centers (or on an out patient basis) is prescribing medications that ease these symptoms to reduce the intake of substances. Now after this is over, and after the patient has stopped taking these drugs, the patient has to make up his mind and have a strong will power in order to have good self-control to not take the drugs. If he has underlying problems like mood instability etc., it acts as a cause of relapse or taking drugs again and again. So the primary target in management has to be these underlying causes that leads to and perpetuates the habit of taking substances. This can be done by either therapy or by medicines, depending on the severity and nature of the problem. This can be found out after a detailed psychiatric evaluation. It can also be made more accurate with the help of psychological tests, like personality assessment using tests like Rorschach ink blot test, Thematic Apperception test, MMPI, etc.

A diagnosis like Borderline personality disorder can only be made by a professional like a psychiatrist and/or with the aid of psychological tests. It cannot be made based on personal opinions or views. If it has been diagnosed by an experienced psychiatrist then in that case, there are quite a few medications that can be tried to control few of the symptoms that may have a role to play in his substance seeking behavior. Few of the medicines that are used are mood-stabilizers, antidepressants etc.

The incident you say, where he said, "I feel I am not from here I am not from there neither" sounds like a part of his negative thinking. He needs to be examined further to rule out a depressive episode. For the time being, till you re-visit your psychiatrist, do keep a watch on him at all times just to be sure he does not harm himself in anyway because this sort of negative thinking can also give rise to suicidal thoughts. Be very careful.

Kindly visit his psychiatrist again and discuss about all these options with him/her. Also discuss regarding an out-patient basis treatment since your son is apprehensive about getting admitted in a hospital.

Hope this helps,

Dr A Rao

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