Hello doctor,
I have a 23 year old son. He admits to current marijuana use once or twice a week. He admits to a variety of drugs including cocaine, meth, heroin, LSD in the past year. His ex-mother in law says he currently uses cocaine and meth. He denies current drug use beyond pot. He says he has not done cocaine for a few months. He swears he is only currently using pot occasionally now and no other drugs. I realize he may be lying. In the last month, he has had several extended blackouts where he was fully functioning, walking around town, having conversations with people, damaging property, etc. Sometimes friends cannot wake him, and they think he is having a seizure. He does not remember drinking any alcohol on that day. In fact, he has no memory of that day, until waking up at home. Everyone told him about the events the next day. He has no memory of these events. Some are as short as an hour. Some are as long as 48 hours or more. I live 6,000 miles away from him and flew in this week to see him. I only have a few days with him to try to convince him to see a doctor, and I am trying to see if this is just drug use, him lying, being in denial or if there is a severe neurological condition that is not being treated because everyone is assuming he is on drugs. He has a history of serious sleepwalking when he was a child. He would rush out of his room, frantically searching for something but unable to describe it. He would carry on whole conversations, very agitated, would go outside, walk around the house and come to the back door crying and try to get in but be unable to turn the knob. It was like a walking nightmare or dream. We would get him back to bed and back to sleep. The next day he would have no memory of it. This current behavior sounds similar to me but on a much more extreme level. His sister had night terrors similar to this when she was a child. I, as their biological father, have a history of talking in my sleep, and some sleepwalking when I was a child but never this extreme. So, there seems to be some family history as a possible explanation outside of drug use being the probable cause. He sleeps very little. His current girlfriend says he is extremely sleep deprived. He lived with me until a few months ago and was extremely sleep deprived then. I realize you cannot give a definitive answer without personal examination and tests and such. What I am looking for right now is the answer to these three questions. Cancocaine and meth use actually result in these kinds of fully functional blackouts? Can just marijuana, (without any other drugs) or just alcohol or just marijuana and alcohol, combined with sleep deprivation and extreme stress cause these kinds of blackouts? Are there any other possible explanations for this kind of blackouts that are not drug related, for example, sleep deprivation and stress, a tumor, or other neurological or medical conditions? What might some of those possibilities be? Thank you for your help. I am distraught and confused.