[AniManiac]

I don't really consider myself an addict (my T confirms this), but I could use a little support breaking some long-standing bad habits with substance use. But I have a lot to say about it at the moment, so apologies for a long post...

My pdoc is forcing me to quit smoking weed in exchange for ADHD meds, which I need pretty badly in order to work. They will be doing urine tests - probably the first one at my next appointment in a couple weeks. This is really pissing me off. I feel like I'm a teenager being grounded, and it's the first time I'm being treated as though I can't be trusted to manage my own health. If I were ready to quit, I could walk away; forcing me to quit just makes me angry and resentful. It doesn't help that I'm having a particularly irritable mood swing!

Part of the irony is that I have very few observable side effects from weed, and it's substantially more effective than the anti-anxiety meds that they gave me (hydroxyzine hcl, PRN, but I won't touch it unless desperate because of side effects). My main reason for using is admittedly self-medication; I'm pretty much always subject to low-level anxiety, with the occasional mini panic attack, but they won't give me benzos either. I'm not stable on meds yet, so my only real crutch is being knocked out from under me when I'm feeling particularly wobbly.

And then the other part is alcohol. I vastly prefer weed to alcohol, but the only thing they've told me about alcohol is to "keep it to a minimum." Alcohol, however, is contraindicated for all my meds and there's a whole slew of problems that go with it. If I were weighing evils, weed would come out a saint compared to alcohol.

There's no acknowledgment of the fact that if they're making me give up weed, I'll most likely drink instead - which I told them from the start. When I'm hypomanic, I'm a binge drinker, and it wouldn't be unusual for me to have a dozen drinks in an evening. For quite awhile I was drinking every day - occasionally just a glass of wine with dinner, usually two, but sometimes the whole bottle. Moderation is not my strong suit...

I really, really worked to cut my drinking down to almost nothing. By my count, in July I had about 150 drinks, and in November (when I was dx'd bipolar) I had 7. I'm worried that giving up weed is going to push me back over into semi-alcoholic behavior. My T wants me to put together a "moderation management" contract but I'm so bad at moderation, I don't know if I can do that.

At the moment, I'm so irritable and anxious that I've actually been thinking about smoking cigarettes again. This is the most unbelievable thing to me; I quit smoking in 2003 and have not missed it at all, until every other vice except my daily shot of espresso was taken away. And now I can't stop thinking about it.

This feels like a train wreck waiting to happen.

I'll get through it somehow, but I could use a little support. I apologize for the long post, and feel like it somehow doesn't belong here because I'm not "technically" addicted, but I hope it's OK since I'm struggling with getting substance use under control.

I have mostly questions, not answers. Wrestling with addiction myself, I know that it's not at all a good feeling to be addicted to anything, even something like pot. Have you ever been at all concerned about the long-term effects of pot? I guess it can have radically different effects on people but a friend of mine who has smoked since high school has now a very fuzzy memory of things-not good; but you are obviously high-performing and your work apparently unaffected by the habit.

You have detailed your good relationship with your husband; does he have anything negative to say about your pot habit?

I had thought you were still on the ADHD meds but that's not the case, eh? It's not entirely clear why quitting pot is a prerequisite for those meds; is the effect blunted by pot or what is the rationale behind it? Does your doc simply believe that continued pot use is affecting your concentration? Have you felt that to be the case ever, or the reverse? Sounds like it's not helping you at the moment. In which case, is it not wise to take the doc's suggestion-and possibly also get some anti-craving meds for what you suspect will be an increased desire to resort to alcohol? Sorry I'm not much help but I"m hoping a pragmatic solution will suggest itself.

[AniManiac]

Originally Posted by gulas

I have mostly questions, not answers. Wrestling with addiction myself, I know that it's not at all a good feeling to be addicted to anything, even something like pot. Have you ever been at all concerned about the long-term effects of pot? I guess it can have radically different effects on people but a friend of mine who has smoked since high school has now a very fuzzy memory of things-not good; but you are obviously high-performing and your work apparently unaffected by the habit.

I honestly haven't given much thought to consequences of long-term use. Hey, it's only been 13 years or so... I have friends who have been using longer than I've been alive - mostly sharp as ever, easily comparable to the average non-user of the same age, moderately successful and fairly smart people. So I haven't really seen any negative examples, but also haven't gone looking to see what scientific research has to say on the topic.

Work is indeed largely unaffected, and sometimes benefits substantially. When I'm too anxious to write or work, it's one of the things that helps. I cannot use the anti-anxiety meds the same way because they make me nonfunctional, and the next-day meds hangover is worse (by a long shot) than any brain fuzz from pot.

Originally Posted by gulas

You have detailed your good relationship with your husband; does he have anything negative to say about your pot habit?

Nope. He feels sorry for me, but he's not quitting himself. That's OK with me - he doesn't rub it in. He's typically much more concerned about the way I drink.

Originally Posted by gulas

I had thought you were still on the ADHD meds but that's not the case, eh? It's not entirely clear why quitting pot is a prerequisite for those meds; is the effect blunted by pot or what is the rationale behind it? Does your doc simply believe that continued pot use is affecting your concentration? Have you felt that to be the case ever, or the reverse? Sounds like it's not helping you at the moment. In which case, is it not wise to take the doc's suggestion-and possibly also get some anti-craving meds for what you suspect will be an increased desire to resort to alcohol? Sorry I'm not much help but I"m hoping a pragmatic solution will suggest itself.

I am on the ADHD meds - I didn't even consider quitting pot until I had the right prescription in hand. But they will be testing to make sure that I do clean up my act. They already gave me a little extra time, but I know I won't pee clean on the first shot because of the length of the habit and fairly high body fat percentage.

They didn't give me a reason why I should quit pot, which is the worst way to get me to comply. I will doubtless agitate on this point next time I go in. My suspicion is that it's just the pdoc's policy (I actually only see his PA) but I don't really know.

My T tells me that street drugs are better at using up your brain's receptors that would otherwise slurp up the meds, so it probably dampens the effectiveness of everything to some degree. Much of the time, a little pot actually seems to go a long way toward supporting concentration; my unfounded hypothesis is that it somehow lets me ignore some of the stimuli that otherwise overwhelm my poor silly cranium.

Mostly I just want to shut my brain off long enough to get some respite. Alcohol's pretty good for that but I have a lot less control under that influence. I'll probably be having a drink every evening until I get past the irritability, but hopefully can leave it at that.

The last time I followed a pdoc's instructions for teetotalling, most of my mood-related symptoms got a lot worse. But things have changed since then and maybe it will be different this time.

I'm sure a lot of this stupid angst is just feeling rebellious at being told what to do. The rest is just plain irritability from withdrawal or mood swings or PMS or who knows what.

[Lauru]

Ok, so I have issues with substances as well. But it seems to me, (and I say this gently) that if you can't just stop the pot with no effects or if you're not willing to, perhaps you are addicted to it. Perhaps smoking weed is not the answer to keep you from drinking. Both weed and alcohol are depressants, and if you have a mood disorder, this can wreak havoc on you. Also, drinking that much alcohol is a problem, especially for someone on meds of any kind. If you can't stay away from pot or alcohol when they are both contraindicated and the pot is against the law too, then maybe it is time to look into seeing if you have an addiction problem.

Just my 2 cents which you probably don't want, but I wanted to share with you a different perspective. I wish you all the best in whatever you decide to do.

[bluemountains]

Hi AniManiac,

Good luck with your upcoming changes! If you have a good med/drug plan, you should be able to save lots of money. Obviously, I am not in a good place to offer advice about how to quit, but I can completely relate and sympathize with your panic over giving up something you enjoy and that is calming to you.

Be strong and believe that you can do this!
Bluemountains

[roads]

** hugs galore **
AniManiac
** hugs galore **

I am so sorry that they are throwing all of this at you, and without so much as the curtesy of an explanation. I understand that this would make a difference. It would for me too.

Obviously the doc is either a sadist or totally ignorant of addiction medication. Of course you are now going to be either back using alcohol & tobacco, those receptors are open & waiting--or back in a fight for your life again to not use. What a drain on your already over-taxed resources.

I think somebody in the mob hates you. Nothing else explains why anyone would do this to you. You're a nice woman! You don't deserve this!

I am so sorry.

Roadrunner

[AniManiac]

Originally Posted by Lauru

Ok, so I have issues with substances as well. But it seems to me, (and I say this gently) that if you can't just stop the pot with no effects or if you're not willing to, perhaps you are addicted to it. Perhaps smoking weed is not the answer to keep you from drinking. Both weed and alcohol are depressants, and if you have a mood disorder, this can wreak havoc on you. Also, drinking that much alcohol is a problem, especially for someone on meds of any kind. If you can't stay away from pot or alcohol when they are both contraindicated and the pot is against the law too, then maybe it is time to look into seeing if you have an addiction problem.

Just my 2 cents which you probably don't want, but I wanted to share with you a different perspective. I wish you all the best in whatever you decide to do.

Yeah, I know. Maybe addicted, but not dependent (those are different, right?) I don't come anywhere near the criteria for dependency or substance abuse. My T and I have reviewed it more than once.

I can manage not using at all. I've done it before. I actually do want to clean up my act. Just not like this - abrupt, unprepared, and unstable. It's a pretty major lifestyle change, and I've already had a lot of changes thrown at me in the last couple of months. Big changes. And I've learned I can really only work on one at a time; the second I try to make three or four lifestyle changes at once, it all falls apart.

I think the underlying problem is the symptoms I've been trying to medicate away. But who knows, maybe it's not that bad. I guess we'll see.

[AniManiac]

Originally Posted by roadrunnerbeepbeep

I am so sorry that they are throwing all of this at you, and without so much as the curtesy of an explanation. I understand that this would make a difference. It would for me too.

Obviously the doc is either a sadist or totally ignorant of addiction medication. Of course you are now going to be either back using alcohol & tobacco, those receptors are open & waiting--or back in a fight for your life again to not use. What a drain on your already over-taxed resources.

Most people at this pill mill only get 15-minute appointments, so I'm lucky to still be getting 1/2-hour appointments. It doesn't allow much time for explanations, but last time I did ask why Concerta and not Adderall when I know Adderall works better. I didn't get a reason - I got an Adderall prescription, which tells me that they prescribe by routine.

I don't think it's bad enough to require any kind of meds for addiction. But it is not easy on top of everything else. I think I could handle this just fine if everything else were stable, but it's not.

[Lauru]

Originally Posted by AniManiac

Yeah, I know. Maybe addicted, but not dependent (those are different, right?) I don't come anywhere near the criteria for dependency or substance abuse. My T and I have reviewed it more than once.

I can manage not using at all. I've done it before. I actually do want to clean up my act. Just not like this - abrupt, unprepared, and unstable. It's a pretty major lifestyle change, and I've already had a lot of changes thrown at me in the last couple of months. Big changes. And I've learned I can really only work on one at a time; the second I try to make three or four lifestyle changes at once, it all falls apart.

I think the underlying problem is the symptoms I've been trying to medicate away. But who knows, maybe it's not that bad. I guess we'll see.

Of course addiction and dependency are two totally different things. Addiction is using substances even when there are negative consequences. Dependency is physiological and psychological dependence and physical withdrawal if you don't have it. Only you know which one or if you even have one of these. I agree changing everything at once is a really bad idea. It has never worked for me either. I really don't think your doctors/professionals should require you to make several big changes at once. It is just setting you up for failure. I wish you all the best and hope everything works out ok for you.

[Caretaker Leo]

May I ask a question?

If you were diagnosed bipolar this past November - why are they prescribing meds for ADHD? That doesn't make sense to me. My son was diagnosed ADHD when he was very young. The meds helped some - but the alcohol and drug addictions that came later should have been a signal to his doctors that something wasn't right.

He now has the correct diagnoses of bipolar - and the meds he takes are completely different than those for ADHD. He no longer self-medicates with alcohol or drugs because he is on the right meds for his diagnoses.

[AniManiac]

Originally Posted by Caretaker Leo

May I ask a question?

If you were diagnosed bipolar this past November - why are they prescribing meds for ADHD? That doesn't make sense to me. My son was diagnosed ADHD when he was very young. The meds helped some - but the alcohol and drug addictions that came later should have been a signal to his doctors that something wasn't right.

He now has the correct diagnoses of bipolar - and the meds he takes are completely different than those for ADHD. He no longer self-medicates with alcohol or drugs because he is on the right meds for his diagnoses.

Because I'm lucky enough to have both bipolar disorder and ADHD.

I was dx'd with ADHD as an adult, over 10 years ago. They confirmed the ADHD dx after I started treatment for bipolar with a computer-based test that backed up multiple independent clinical interviews.

I stopped taking the ADHD meds in February on the advice of a pdoc who wanted to rule them out as a cause of mania. But without the ADHD meds (which do not make me manic), the self-medicating got a lot worse, I wasn't able to work for a couple months because I couldn't function well enough, etc, etc, etc.

The stimulants make all the difference in the world for me, and I don't use as much when I'm on them. Most important to me, I don't use when I'm working because I don't feel like I need to.