From Don Juanism to nymphomania, sex addiction has long been recognized among the lay public, but recognition among professionals has been more controversial. Although highly stigmatized, excessive sexual behavior doesn’t qualify as a disorder until it causes real problems for patients, such as relationship issues, losing one’s job, and getting arrested.

Pornography addiction is more of a process or behavioral addiction where the effect on the brain is the same, but you’re not putting a foreign chemical into your body. Pornography is just one behavior that we would put under that umbrella of sexual addiction. And for some people who become sex addicts, it actually starts out with pornography—as a sort of gateway drug.

If you have not yet heard of kratom (usually pronounced kray-tom or krah-tom), consider this an introduction. Kratom preparations are gaining popularity among substance users because of the plant’s opioid-like and stimulant properties.

Cannabis users seem to be at higher than normal risk to develop psychotic symptoms (see CATR, March 2015, “High Potency Cannabis Increases Risk of First Episode Psychosis”), but so far researchers haven’t solved the chicken-and-egg problem.

After reading these articles, you should be able to…

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How do PDMPs work? To search for a patient in a PDMP, all you need to do is enter the person’s name and birthdate and click the search button. The PDMP will generate a patient activity report that will tell you what controlled substances the patient has picked up and where. The report gives you lots of detail, including the address of the patient; the drug names, doses, quantities, and refill information on any controlled substances that have been dispensed; and the applicable prescriber names, DEA numbers, pharmacy names, dispensing dates, and prescription numbers.

Dr. Raskin discusses strategies when dealing with prescription-seeking patients, including common scenarios for helping clinicians decide whether a patient requesting opioids is endorsing more pain than they actually have.