Psychiatrist requets Drug Screening

I just had my first appointment with my psychiatrist which he identified my symptoms as possible ADD and talked about starting me on a trial of a prescription to see if that corrects my symptoms. During the appointment he asked if I had ever used drugs or any prescription medications that were not my own before, to which I replied honestly that I have smoked marijuana before and do on occasion. He then schedules another appointment to prescribe the medication but wants to perform various tests CBC, CMP, TSH, but also a urine drug test.

Is ordering a drug test standard procedure for a psychiatrist appt.?
Since I told the psychiatrist that I have used marijuana im assuming it is not going to somehow become an issue once he gets the results since I had already told him.

No, it is definitely not standard procedure, and personally I would never do it.

Thanks for the response 'bipolarmedstudent'. I really don't understand either. I'm going to continue to give updates in this thread simply because I couldn't really find anything similar in situation through "google" so hopefully my experiences with this will help others as well.

Just had all of the tests done yesterday. I honestly felt like a criminal/addict or something during it. All of the tests were normal until the "urine drug screen". Where I was forced to empty everything out of my pockets and remove my clothing and change into a hospital gown where I was led into the bathroom while the nurse stood outside the door. This just all seemed way too much to even have the option of being treated for something that a prior MD and now a psychiatrist have confirmed as likely having ADHD.

Is there anyone else out there that could share their thoughts on this matter or any past experiences they may have had that are similar. I understand that the medication they provide typically are all controlled substances so i understand some precautions but the experience I just had with the drug screen were not pleasant in the least.

Has anyone else had anything like this happen to them or been in a similar situation as myself in terms of being honest and admitting that I have used marijuana and do so on random occasions?
From what I was told and read on my own is that it is best to be honest with someone like a psychiatrist or doctor because they are there to help you. I feel as though he ordered these tests in lite of my comments on cannabis and In my opinion is total BS. If I would have said No i never have but I drink scotch ever-night after work I believe the situation my have gone differently.

I think he ordered a urine test with your blood tests, that's very standard; http://www.webmd.com/a-to-z-guides/urine-test not a urine "drug" test; I think you unconsciously added in that thought. While it will be able to tell if there are other medicine or drugs in your system, that will not be its primary objective.

Yeah, both my past and current pdoc know I use drugs on occasion. Hell, I told my current p-doc that I've used cocaine in the past. Neither have ever drug-tested me.

Seems you guys get off easy.

Here you cannot get a stimulant without a proper 3 day testing for ADHD or ADD. This test includes WAIS, an interview and a computerized test and some more stuff. You cannot get a stimulant as a test run.

Also, here you have a proper drug screening, they test for things connected to alcohol, stimulants, THC, benzodiazepines and so on. They also test your organ function so they know you are healthy enough to take the drug. You also go on controls for your blood pressure.

They wanted me to pee with the door open, which of course I refused since I don't want to be treated as a drug addict. They converted all my test to blood tests which I found kept my dignity intact.

They have never retested me for illegal drugs, but they sometimes test other things, like liver and blood count.

Personally I would never admit drug use, I would have stalled the testing until I tested clean. Because here there are NO second chances, once admitting to drug use, stimulants are out, and possibly sedatives as well.

That's insane. Where do you live???

All I had to do was tell my old psychatrist that I think I have ADHD. We talked about the symptoms for a few minutes, then she prescribed me stimulants. And I've been on stimulants for 8 years now. She knew I occasionally smoked pot and got drunk at the time.

My new pdoc, I told him I have adhd, and that I was on 25mg of dexedrine. He asked me if I had done illegal drugs. I told him I had done practically everything, including cocaine. Then he said my dose of stimulants was too low, and prescribed me 35 mg of dexedrine instead of 25mg.

...I went to an ADHD specialist 14 years ago to get formally diagnosed. I already knew I had it from my own research and just plain common sense...as well as the fact I had been self medicating with amphetamines for 8 years...and not the "lets party" type use, it was regular and addictive and damaging use.

But it was also expensive and I'm lucky to be alive considering what I would get sometimes. Interestingly I didn't know about the medications or didn't pay attention...though when I found out there was an alternative...I hurried off to the specialist.

So off I went to get my diagnosis...no blood or urine tests were done...I was forthright in passing about my drug use but only to the point where I explained amphetamines would slow me down and help me function better.

...This seemed to just confirm my diagnosis to the doctor. Immediately I was given dexamphetamines, 100 pills every 21 days.

I could not control myself....having such focus and concentration was like the holy grail and it was only 5 bucks and all legal...awesome!....

...or not so awesome?? I would go through my script in 3 days and then use what was on the street in the meantime.

....so you might think...."you're just a speed freak!...not ADHD"

...I agree I am a "freak"...of some variety....but I do suffer from it and just cannot be trusted with any feel good substance because I have an addictive nature.

...anyway 8 months later my brain was completely fried and I ended up in rehab for quite a while. I told the doc what I was doing and they banned my scripts.

....I guess thats why they test sometimes?
if they tested me they might have discovered I was already loaded....I can't remember

In my world, THAT is insane. I wish all people would have a proper diagnosis before being treated. They do that with some other meds here, prescribe without a real DX, and in some cases it ended really bad.

holy crap, how is that even possible?! I think my brain and heart would explode on that much dex. I find that above my therapeutic, prescribed dose of dex, I'm not able to concentrate any better. I just get more side effects. So I don't go above my prescribed dose. There just isn't any point. Plus, dex never gets me 'high'. It just makes me functional.

I did have a proper diagnosis. I met all the symptoms in the DSM-IV, and it was seriously impairing my function. She determined I met the criteria, so she diagnosed me. Psychiatric diagnoses are based entirely on history taking, and that's what she did.

thats a good attitude to have

Neuropsychiatric diagnoses are tested with tests here.

Sorry to come onto this discussion late, but here's my two cents...

My family member (20 years old) was recently diagnosed bipolar. The first psychiatrist ran lab work (blood and urine) and I saw the report, they tested for many illicit drugs. He hadn't confessed to prior use.

We got a second opinion from another psychiatrist, and she also wanted labs.

My feeling was that these doctors were being thorough, not nosey.

The second psychiatrist said that weed complicates the treatment of bipolar disorder, as it is psychoactive.

Thanks to everyone for the great comments and personal experiences in regards to my current situation. I will be returning to my psychiatrist in a few days to go over my test results and to receive the proper prescription. I'll provide an update this week after my appt. to hopefully provide a good outcome.

I think he ordered a urine test with your blood tests, that's very standard;not a urine "drug" test; I think you unconsciously added in that thought. While it will be able to tell if there are other medicine or drugs in your system, that will not be its primary objective.[/quote]

Thanks for the reply. I was given the documents that I had to take to the testing facility for the tests. There were numerous tests listed like you mentioned the blood tests and also a urinalysis. There was also a urine "drug-screen" listed as well. Also when I was at the testing facility I was made aware I would need to provide two separate urine samples. 1 for urinalysis and the other was for a drug-screen.

I am more worried that I have yet again wasted my time with another doctor, with the thinking that since I will almost definitely test positive for cannabis, He would then tell me I got not be prescribed any medication. Which would make no sense considering he was well aware that I had used it recently but still requested the drug-screen.

Side-note: The past failed attempts with doctors were not because of any drug-screen, Just had a hard time over the past year finding a doc that would take me seriously and not just account the issues Ive had/been having to stress or not taking enough vitamins :/

Well here is the update i promised: Pdoc prescribed me Strattera and said he would be unable to prescribe me any type of stimulant medication until there is no trace of THC found in my system. I was given the prescription and an order to have another urine drug screen performed a few days before my next appt. in a month... Unfortunately my insurance does not cover the Strattera so I was switched to Wellbutrin. Strange that a few days ago my Pdoc talked for about 10 minutes on how Strattera was the only non stimulant medication available but, now that my insurance wont cover it, He assures that Wellbutrin will work fine and prescribed that now.

Has anyone else had any experiences with taking Wellbutrin for ADD?

Apparently it's an antidepressant that acts like a stimulant:

http://www.add-adhd-help-center.com/...utrin_adhd.htm

My first pdoc orderd a CBC, CMP, and TSH once a year to monitor my health since my meds can cause problems in things those tests could catch. He never ordered a drug urine test though. My new pdoc hasn't ordered any blood tests yet.

Since being on the Bupropion (Welbutrin) I have noticed no increase in focus / attention in the past week. If anything it seems worse because of the extreme increase in sex drive that I have had since starting it. Normally I am not like that at all, I typically focus on all my own goals with my degree and work but since starting it about a week ago I have been completely different. I never considered myself a depressed person and my pdoc has never said that as being a possibility. I was prescribed the Bupropion for ADD. Major issues with focus and attention span on even subjects that I am really interested in. Since there has been such a large increase in my sex drive this has been terrible in helping my ADD symptoms. I am unsure if I should call my pdoc ahead of my next appt which is in about a month or just wait it out being that this type of medication can take a long time to build up and start fully working?

Since starting the Bupropion about a week ago numerous people have told me that I seem more happy and smile a lot more than usual. I never felt unhappy prior just usually keep my emotions to myself I guess before starting the medication.

Is this normal to experience worsening ADD symptoms upon starting this and then become better as the medication builds up or is this a clear sign Bupropion is not going to help. Being that finals are less than a month away and I had a hard time with focus and attention before starting the medication I am slightly worried it is only going to get worse which will not make my university finals much fun at all.

Im going to start a new thread being that this seems as though it has gone past the scope of my original thread posting.

I think you should call your pdoc and let him know that the bupropion has increased your sex drive to an unmanageable level, and as a result you are having even more difficulty concentrating. Increased sex drive is a common side effect of bupropion, so I don't think your pdoc will be surprised. I think calling him ahead of time and explaining what you are experiencing is a good idea because it will make you look responsible. Also, it gives him an opportunity to prescribe you something different.

Every single time I am an inpatient my urine is screened for drugs.
Others are also breath tested if they have alcohol issues.
I know of others who are struggling with illicit drugs while trying to deal with mental health issues.

Personally I think that drugs testing is being thorough.

I agree it is being thorough, but it can't/shouldn't be done without patient consent. The only exception is if the patient is involuntarily commited, because in that case patient consent doesn't apply.

But otherwise, the patient needs to consent to the test.

My Dr prescribed me adderall. topomax and wellbutrin and he knew I had an eating disorder. Sweet cocktail I thought and never drug tested me. My pain Dr did through.

Yes, it has been very helpful to me. At first I took it on its own, and it helped somewhat. Then Vyvanse was added and I did even better. My PNP did say I might be able to get by just on the Vyvanse, so I tried that once for a few months, but I found my ADHD symptoms are much better controlled with low level Wellbutrin plus the Vyvanse stimulant. I only take 100 mg Wellbutrin, which is hardly anything, but that little bit adds something that really helps with the ADHD. The Vyvanse helps too. Good combo for me.

When I first started taking the Wellbutrin a few years ago, it was extremely activating for me. Made me very jittery for the first few days and then again each time I had a dose increase. Once we had settled on the right dose and I had been on it a while, I settled down and wasn't all jittery. I hope you are doing better on the Wellbutrin now.