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PsyChris said:
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JustForToday said:
I have a hunch that pdoc doesn't want to rx a stimulant because of the eating disorder. Stimulants and laxatives are usually not prescribed for anyone with and ED, just as
controlled substances are not usually prescribed for addicts. Strattera is, as far as I know, the only non-stimulant med for ADHD.
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If only that bit about addicts were true... Some addicts spend a majority of their time trying to get those medications from doctors. If they get inventive enough, it usually works.
I know a lady who used to use fake names, fake complaints all in an effort to get anti-anxiety medication. It worked for many years. She is now in her late 60's and goes into a psychotic state when she does not have Ativan or similar benzo. This happens all too often. Physicians do not want to promote this kind of behavior. Anyone that tells the physician what to give them is going to come under the looking glass.
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It is extremely difficult to get a prescription for stimulants, considering that they are confined to two FDA approved disorders for treatment: ADHD, and Narcolepsy. They are sometimes used "off-label" but I haven't heard of too many doctors prescribing them for other disorders, although I have read of their use in treatment resistant depressive disorders. ADHD assessments are usually very expensive too... most of them involve neuropsychiatric testing alongside traditional psychiatric/psychological workups. Any doctor who gets a new patient who says they have ADHD and doesn't have a report from the last treating doctor, is likely to be very resistant to prescribing a stimulant, making doctor shopping unlikely.
It's also unlikely to get much of a high from prescribed stimulants, as the 30 day supply will be of the lowest dose possible in any patient, especially a new one. The low dose is unlikely to get you high for very long, as you would have to take a copious amount, depleting your 30 day supply rather quickly. The same goes for any dose; addiction always requires taking higher doses in order to obtain the same high. When stimulants are abused, the tolerance builds up very quickly, and the abuser needs more and more to achieve the same high they once did. This said, the likelihood of an addicted person to continue getting refills for stimulants is very low. The physician is very likely to be highly suspicious of patients who "lose" their stimulant medication less than halfway through, especially new ones. You have to request a new prescription from your doctor every month, which means you will either have to make an appointment if he demands it. A new patient will be reassessed after the first trial prescription to determine efficacy. Some doctors demand an appointment every time.
The extremely high cost of stimulants will also confine most purchases of stimulants to insurance holders; which means that any pharmacy that the patient goes to will have a detailed record of the stimulants prescribed, and how far apart they were prescribed. Every prescription filled will be evaluated against the insurance record by the pharmacy. They are likely to give the doctor a call if they notice something fishy, insurance or no insurance, as the law requires it. They don't want to be taken advantage of, or lose their license. The insurance might not even allow additional early prescriptions to go through, and they will flag your policy anyway if they think a controlled drug is being abused. They will talk with your doctor if they have doubt. It would be very expensive for an addict to pay out of pocket, even if they could somehow keep getting new prescriptions.
The ADHD assessment itself is usually very detailed, and they do look for any signs of addiction and addiction history. I've no doubt some get through, but I don't think we should compare apples and oranges here to your lady you once knew with the benzodiazapene addiction. Anecdotal evidence isn't very good to rely on anyway. Additionally, most stimulants prescribed are of the long-acting variety. These are very difficult to abuse, as they are made of special time-release beads. They cannot be crushed and injected, nor snorted. Multiple longetudinal research studies have even indicated that of people with ADHD, those who are properly treated with stimulant medication are LESS LIKELY to become drug or alcohol abusers than those who have no treatment.
I'm a big fan of telling my doctor if I want to try a different medication, or up the dose. Good physicians are appreciative of the interaction as it helps to determine what works and what doesn't. Unfortunately, drugs like this are all trial and error.
