Pathological gambling is defined as persistent and repetitive gambling behaviors, characterized by the inability to control the gambling behavior of the individual, family or professional functionality. It is stated that the possibility of occurrence of alcohol and substance use disorders is increased after obesity operations, which have been frequently applied in recent years. Until now, gambling disorder, which is considered as impulse control disorder, is evaluated under the category of addiction behaviors with DSM-5. In this case report, the case of gambling disorder following bariatric surgery will be discussed.

Buprenorphine is a semi-synthetic opioid derived from thebaine. It is used for analgesic effect and opioid substitution therapy. In Turkey, buprenorphine and naloxone combination (Suboxone®) has been used in opioid substitution therapy since 2010. In this paper respiratory depression arising after buprenorphine use together with benzodiazepine will be told and possible mechanisms of this interaction will be discussed.

Psychoactive substance use disorder can be defined as a chronic illness with an uncontrollable impulsivity to drug use by affecting reward, motivation, memory and decision making mechanisms in individuals brains. These substances can cause dangerous consequences in the lives of individuals by causing addiction and, on the other hand, by stimulating or depressing the central nervous system, causing mood, mental state, behavioral and motor function disorders. Caffeine, hallucinogens, lysergic acid diethylamide (LSD), inhalants, nicotine, phencyclidine, sedatives, hypnotics, anxiolytics, anabolic steroids, nitrous oxide are among the addictive substances (1 ,2). The incidence of psychiatric disorders in patients with substance use disorders is 2.7 times higher. It has been reported that 70-75% of individuals with substance use disorders are accompanied by at least one psychiatric disorder (2,3). It is also known that substance abuse is more common in psychiatric disorders. In a study conducted in Turkey psychoactive substance use in schizophrenia 3.2%, while bipolar disorder is reported to be 3.5%. In the same study, 39% of the patients who received substance abuse and inpatient treatment received psychotic disorder and 23% received bipolar disorder (4).

Very common psychotic disorder or comorbid condition among substance use related disorders is clinically important. One of the biggest challenges faced by clinicians in this case is the primary-secondary distinction (5). In this study, psychoactive substance use and psychosis association and primary-secondary distinction are discussed through two case studies.