Misc Question: How Addicts Are Prescribed Meds

[ThePharmicist]

Hey all,

So I've been in outpatient for about four weeks. I'm one month, 15-days sober from heroin. Which is actually pretty crazy for me. I'm really happy that I was able to take the necessary steps to start to get myself clean. Of course I'm still on Suboxone, but that doesn't really relate to this post.

Here's a little background. In outpatient, my counselor has advised us to get all of our co-morbid psychological disorders taken care of. It's supposed to help us avoid relapsing, and I understand the logic in that. I'm taking an antidepressant which is supposed to cover my depression and anxiety, which most antidepressants never do for me and I'm still not sure how I'm feeling about this one (nefazadone). My psychiatrist won't prescribe me benzodiazepines for anxiety or panic attacks because of my addiction and treatment with Suboxone. I know this is bullshit but I have a small supply of benzos I always keep handy to take as needed.

Today, I spoke with my psychiatrist about getting tested for ADD. I felt that I fit the symptoms and my counselor advised me to speak with my psychiatrist about it. My psychiatrist said right off the bat "I don't need any test results to tell you that you have ADD, I've known you long enough to be able to determine you do." I still have to get the testing done, more as a formality than anything else. However, my problem lies with what he told me about what he would prescribe me. He said that I should start looking at Strattera (Atomoxetine) because that would be what he would prescribe me.

My problem lies not with whether Strattera will work, I haven't tried it so I can't comment. But I believe that he is unwilling to prescribe me a stimulant for one of two possible reasons. Reason one being that I'm a drug addict. Reason two is that he's afraid of repercussions from the DEA auditing his records. I know he's mindful of this because he was about to prescribe me Adderall earlier this year for my Fibromyalgia related fatigue. When I asked about the Adderall, he said that when the DEA audits his records they'd be suspicious of a doctor giving a Suboxone user Adderall. Bullshit.

My question is whether or not this is typical of doctors that are aware of a patient's substance abuse or the DEA auditing records. I don't know why I should have to be restricted to one medication because of either of those reasons. If I have a documented condition, shouldn't I be allowed to get a prescription for a medication that may be superior to another? Is there anyway to logically present this to my doctor, or should I have my ADD handled through another doctor?

Also, I know the only advantage Strattera has over traditional stimulants is that it has a lower abuse potential. Are there any other medications that have a lower abuse potential as well? Ones that might be more of a traditional stimulant?

Thanks for the help guys!

 

[halfoz]

why not follow his advice and give the strattera a try? i mean, adderall is pretty freaking strong and has a high incidence of dependency.

only reason i'm chiming in here is that me going dr shopping for an adderall script eventually led to a relapse on opiates.

especially since you're in a vulnerable state in your recovery, it seems like the healthier, non-fiendy approach would be to accept what you're dr recommends instead of trying to fill out his prescription pad for him.

if nothing else, if the strattera isn't working, then you've got a legimate case for trying an alternate medication. if it is working, then problem solved with a less abuse prone drug.

 

[CaPoNe.]

You could maybe try getting a script for Vyvanse which is Lisdexamfetamine and is supposed to be more or less the abuse proof version of Aderall from what I understand and your doctor may be more willing to prescribe that for you. But if not and you really think you should get a script for it then i would look for a new doctor cuz ive noticed when I switch doctors (which ive done quite a few times) some will just throw you a script for whatever you want and others are hesitant or make it a big deal to get a script and thats annoying as shit. But I have never taken Vyvanse and I dont know how well it works im sure someone on here can go into further detail about it. Hope that helps!

 

[ThePharmicist]

Thanks for the advice guys.

I'm not saying I won't give strattera a try, but strattera is not a first line medication for the treatment of ADD. I guess I'm hesitant of it because I have so much trouble on anti-depressant type medications that I'm very leery about taking that kind of stuff. I kind of feel like because I have a drug problem that I'm automatically going to abuse any kind of medication that's in a higher schedule than CIII. OR, I'm wondering if my doctor has prescriber's anxiety. Because he did state before that he'd prescribe me Adderall for my FMS related fatigue, but he stated that he couldn't because the DEA audits his records and he would catch some flack for prescribing a CII med to a Suboxone patient.

I'm just concerned that my doc has jumped to Strattera because he feels safer prescribing it. I'll suggest Vyanese, depending on how my tests turn out of course and also straight up ask him why he's chosen Strattera when I haven't even been formerly diagnosed - he doesn't know the specifics of my ADD.

One other thing, halfoz, I'm not trying to fill out his script pad for him - me and my doc have always had the kind of relationship where we both discuss what kind of meds I need. If I need to up my Suboxone, that's all I have to say. If I don't want to be put on a certain antidepressant and would like to try another, that's totally cool with him. He understands that I know my pharms and that I'm not going to take any doctor bullshit. This is the only time where he's taken a "This is all I'll prescribe you for this," route. That's why I'm wondering if the DEA audits may have something to do with it. He owns his own practice afterall...

 

[caseface99]

Depends on your doctor. My psychiatrist/bupe doctor was chill but sort of by the book and wouldn't prescribe me controlled drugs except for a few days worth once or twice when i really clearly needed it, and it was a weak ass benzo at that.
My buddies bupe doctor/psychiatrist though, shiieett.... he got mad bupe, 70mg vyvanse, 30mg IR generic amphetamine salts, 2mg klonopin 3x daily, diabetic syringes (not a diabetic - no legitimate access to clean needles is legal in new jersey without prescription), and some other shit i can't think of.

He however recently got arrested for like the seventh time, got out of jail only to overdose for like the billionth time; And i went almost 5 months totally sober and the last 2 months no hard drugs just pot and psychs. Clearly my treatment was more successful..

 

[etard7007]

it really depends on the severity of your issues and the psychiatrist specifically...

I had a serious, near-fatal, overdose from oxycontin and coke about 8 months ago... the coke made me feel so up that i kept doing more oxy... i went to sleep and as the coke wore off i drifted more and more into sleep... i was not found for 12 hours and by this time, my liver, kidneys and pancreas failed and i had shit and pissed myself. i was basically dead.

anyway, i also was lying motionless on my right arm for so long that i had extreme nerve compression damage leaving my arm mostly paralyzed. EVEN though this was so serious, the pain from the nerve damage became so excruciating 24/7 that i was prescribed fentanyl and dilaudid, later changed to opana ER and IR. with PT my arm/hand is getting much better but the pain is still damn bad. i was lucky all my organs healed to complete health within a week... really lucky. in spite of how shitty this was its great because it was a turnaround for me as i no longer drink, take benzos, or ecstasy, etc., except for my newly formed love for IV oxymorphone :/

i also have extremely serious anxiety/panic/insomnia that initially led me to become the addict and alcoholic that i am... with that said, my psychiatrist realized that i self medicated instead of seeking help, so now that i was getting help, as long as i wasnt drinking he gave me klonopin, which did wonders and stopped my extreme drinking habits. but i havent been on them for quite some time, not since the overdose.

basically if the doctor weighs the pros and cons and thinks it is necessary for you to stay sane and have a comfortable lifestyle he/she will prescribe an addict meds.

 

[Lady Codone]

Best thing for you to do would be to gladly accept whatever he prescribes and give it an honest try. If/when it doesn't work, be honest and tell him. Document any side effects and write down the symptoms you're still experiencing while on the medication so you can relate them clearly to him. It's not just an addict thing--sometimes we all have to do trial and error before getting a drug that works.

If you genuinely aren't getting the help you need from him after a year or so, go elsewhere. I can tell you from experience it takes a lot of "shopping around" (not doc shopping in the addict way, but just to get the help you need.)

Best of luck to you!

 

[Cane2theLeft]

(I typed most of this before I read etard's excellent post)

Think about it, man - the general view in the medical community is that addiction is a disease and doctors consider a patient's medical history when prescribing ANY treatment. If someone is diabetic, drugs that have the propensity to raise blood sugar have to carefully considered and the risk-benefit ratio analyzed.

Its the exact same with addicts. If someone has a history of addiction, you risk triggering or exacerbating their condition by prescribing recreational substances so this should be a consideration in the decision how to treat any condition. Obviously if someone has a fractured skull they aren't going to refuse to give narcotic analgesics and let someone suffer but overall it depends on the severity of what you require treatment for. In addicts, trying non-scheduled medications first ABSOLUTELY is first line unless the necessity is so high that it outweighs the risks to the individual.

On top of this, one of the most universal and basic manifestations of addiction is rationalization. The addict brain will convince you of absolutely anything to trick you into thinking you need that fix... I see this constantly around here in people who are convinced that no NSAIDs can touch any pain they have; their insomnia can ONLY be treated by benzos; there is no way SSRI's can work for their anxiety; atomoxetine will do fuck-all for their ADHD and so on and so on.

I won't pretend like I know if this is true for you or not but you are BRAND NEW to recovery and those rationalizations don't simply disappear when the use stops. In fact, this is when most people start to come up with more inventive ways to trick themselves into believing they need substances. This even presents when people trick themselves into thinking NOT taking a substance (generally prescriptions) is a threat to their sobriety.

 

[OpiYum]

I understand ur problem. I had the same thing happen. I was able to convince my doctor to trust me (or I would have gotten another doctor) with this rationale:

1)I am a downer person, I don't abuse stimulants, not interested.

2) I am depleted of dopamine and from years of heroin abuse suffer from the kind of depression that is a lack of motivation. Why give my and SSRI or SNRI that is addictive and has awful w/d when ADHD drugs like dextrostat, ritalin, and adderall work on dopamine and norepinephrine or acytelcholine (I forget which of the 2), the neurotransmitters that help motivation and focus and work immediately and this way, I wont have nasty w/d

3) In the past, I know that those ADHD drugs work on me and I dont abuse them and I dont get awful side effects, like I get from trying all these new drugs.

4) Let's work something out so I can prove to u that this is helpful and I'm not abusing it.

Seriously, I think heroin addiction is so fucking awful and it's usually common for ppl to need a cocktail of controlled substances to stay off heroin.

 

[ThePharmicist]

it really depends on the severity of your issues and the psychiatrist specifically...

I had a serious, near-fatal, overdose from oxycontin and coke about 8 months ago... the coke made me feel so up that i kept doing more oxy... i went to sleep and as the coke wore off i drifted more and more into sleep... i was not found for 12 hours and by this time, my liver, kidneys and pancreas failed and i had shit and pissed myself. i was basically dead.

anyway, i also was lying motionless on my right arm for so long that i had extreme nerve compression damage leaving my arm mostly paralyzed. EVEN though this was so serious, the pain from the nerve damage became so excruciating 24/7 that i was prescribed fentanyl and dilaudid, later changed to opana ER and IR. with PT my arm/hand is getting much better but the pain is still damn bad. i was lucky all my organs healed to complete health within a week... really lucky. in spite of how shitty this was its great because it was a turnaround for me as i no longer drink, take benzos, or ecstasy, etc., except for my newly formed love for IV oxymorphone :/

i also have extremely serious anxiety/panic/insomnia that initially led me to become the addict and alcoholic that i am... with that said, my psychiatrist realized that i self medicated instead of seeking help, so now that i was getting help, as long as i wasnt drinking he gave me klonopin, which did wonders and stopped my extreme drinking habits. but i havent been on them for quite some time, not since the overdose.

basically if the doctor weighs the pros and cons and thinks it is necessary for you to stay sane and have a comfortable lifestyle he/she will prescribe an addict meds.

That's a hell of a story man. I'm really sorry to hear that, I've passed out on the floor quite a few times using heroin, luckily never on my arm or other extremity. That's terrible that that has happened to you. I do understand what your getting at and I'll see what my doc says after I'm tested.

(I typed most of this before I read etard's excellent post)

Think about it, man - the general view in the medical community is that addiction is a disease and doctors consider a patient's medical history when prescribing ANY treatment. If someone is diabetic, drugs that have the propensity to raise blood sugar have to carefully considered and the risk-benefit ratio analyzed.

Its the exact same with addicts. If someone has a history of addiction, you risk triggering or exacerbating their condition by prescribing recreational substances so this should be a consideration in the decision how to treat any condition. Obviously if someone has a fractured skull they aren't going to refuse to give narcotic analgesics and let someone suffer but overall it depends on the severity of what you require treatment for. In addicts, trying non-scheduled medications first ABSOLUTELY is first line unless the necessity is so high that it outweighs the risks to the individual.

On top of this, one of the most universal and basic manifestations of addiction is rationalization. The addict brain will convince you of absolutely anything to trick you into thinking you need that fix... I see this constantly around here in people who are convinced that no NSAIDs can touch any pain they have; their insomnia can ONLY be treated by benzos; there is no way SSRI's can work for their anxiety; atomoxetine will do fuck-all for their ADHD and so on and so on.

I won't pretend like I know if this is true for you or not but you are BRAND NEW to recovery and those rationalizations don't simply disappear when the use stops. In fact, this is when most people start to come up with more inventive ways to trick themselves into believing they need substances. This even presents when people trick themselves into thinking NOT taking a substance (generally prescriptions) is a threat to their sobriety.

Oh I most certainly do a good job of rationalizing, you're right. And yeah, it doesn't stop when the use does, I find my "Addict Self" trying to confuse "Myself" into using all the time. Why it might be okay to use just once more. That's where I've tried to inject some meditation into the equation. Perhaps I didn't stop to think about that in this case.

During my short time in outpatient I've learned a lot about how the brain changes when one is an addict. I actually previously read about most of it in a book called In the Realm of Hungry Ghosts. It's incredibly interesting to learn about all the brain functions that are involved in addiction. Especially the frontal lobe, which (if I remember) is supposed to make the snap decisions to inhibit/allow behavior. Then there's the Amygdala, which reacts when addicts so much as think or see something that reminds them of using. Lots of different brain functions that get together to make addiction terribly hard to work around.

I get what you're saying overall though, that a non-scheduled medication would absolutely be the first line for an addict, even if it isn't for a normal person. One of my questions however was why my doctor was ready to prescribe me Adderall for FMS related fatigue (when he knew I was an addict, I've been seeing him for Suboxone for almost 2-years) but then back down because he was worried about the DEA auditing my records. Now when I have ADD, where he has a more legitimate reason to prescribe it to me, he has chosen something else. I'm just curious if his worries about the DEA might be his reasoning behind this too.

Either way, after I get tested I'll give Strattera a shot – that is if I can afford it with my insurance. My understanding is that it's a really new med and my insurance is "so-so" on brand name coverage.

 

[GratefulDeadhead]

alot, but sometimes people whoare not addicted get addicted after and accident or something..like me.

 

[Cane2theLeft]

^statistically speaking, iatrogenic addiction is very rare. If you eliminate people with a history of drug abuse/addiction prior to the treatment, the number of people who become clinically addicted (NOT just physically dependent) is no higher than the rates in the general population and possibly even lower.

You always hear people say shit like "meth hooked me the first time" or blame the pills they were prescribed but that's just more rationalization. If exposure alone was sufficient to produce addiction then every pain patient would be a junkie but its not the case at all. Exposure produces physical dependence - it takes a lot more than exposure to produce the psychological and social dependence requisite in addiction.

 

[stray cat]

i was just going to add that it seems like strattera is becoming more and more the first thing doctors want to use to tread add/adhd (regardlesss of whther pt has a history of addiction). i've been prescribed ritalin or adderall since a fairly young age, but when i was in grad school, a lot of my friends thought they might have add/wanted to get adderall to help deal w/ the work/ or whatever, and even the ones who ended up on stimulants or amphetamines after a legitimate add diagnosis usually were given strattera for a while first. i guess it makes sense that doctors these days would first try to treat w/ the non-addictive, non-sched ii drug now that it's available

 

[SpunkySkunk347]

why not follow his advice and give the strattera a try? i mean, adderall is pretty freaking strong and has a high incidence of dependency.

Adderall has a high incidence of abuse; not dependency.

especially since you're in a vulnerable state in your recovery, it seems like the healthier, non-fiendy approach would be to accept what you're dr recommends instead of trying to fill out his prescription pad for him.

if nothing else, if the strattera isn't working, then you've got a legimate case for trying an alternate medication. if it is working, then problem solved with a less abuse prone drug.

Strattera is garbage.

As for getting an adderall script, it all depends on the doctor really. It doesn't matter what you say, what your symptoms are, or how well you choose your words - if the doctor doesn't believe in prescribing meds that have the potential to be abused, he won't give you any.

 

[ThePharmicist]

You always hear people say shit like "meth hooked me the first time" or blame the pills they were prescribed but that's just more rationalization. If exposure alone was sufficient to produce addiction then every pain patient would be a junkie but its not the case at all. Exposure produces physical dependence - it takes a lot more than exposure to produce the psychological and social dependence requisite in addiction.

Drugs are not addictive, that is that. You wouldn't blame a deck of cards for a gambling addict's addiction, so why blame drugs for drug addiction.

C2TL is right on all those points. I'm not sure where he stands on where the prerequisite comes from though.

I myself tend to believe that addiction isn't genetic. I haven't really seen any evidence that would lead me to believe that it's a genetic trait. The only evidence I can say I've seen is that addiction runs in families, but that can easily be explained. If you think about it, there are a lot fewer genes that humans posses than we once thought. There simply isn't enough room in our genetic material to predefine something as utterly complex as addiction. I think the "it's genetic" response is how we as a society like to view it because it's neatly wrapped up and easily explained. It also allows we as a society to continue to look at drug addiction the same way as we always have, and allows the War on Drugs and things like imprisonment for drug offenses to continue. If it remains the way it is, then we don't have to take a look at ourselves and question our ways.

What's of the utmost importance in addiction is the environment we were raised in. Children are very attuned to their caretaker's emotions, and children lack the coping mechanisms to deal with things like depression, anxiety and stress. Therefore, the child develops his/her own coping mechanisms which at a later age divert to drug and alcohol abuse.

 

[splenda]

Drugs are not addictive, that is that. You wouldn't blame a deck of cards for a gambling addict's addiction, so why blame drugs for drug addiction.

Certain drugs ARE addictive actually, especially those that activate regions in the brain that play roles in reward, pleasure, addiction, et cetra (nucleus accumbens for example.) Drugs such as amphetamine activate these regions/pathways in the brain, thereby inducing reward and pleasure, amongst other things. It does not mean that every person who takes amphetamine will become addicted to it but it does mean that the drug certainly is addictive in its nature because of its effects on the central nervous system.

 

[TheAzo]

Regarding strattera, it's always the first line treatment for ADD. Yes, it's garbage. Yes, it doesn't help most people, but it does help some of them. All the friends of mine who are getting meds for ADD got the same thing - first the doc gave them Strattera, it sucked and they told the doctor as much, and then they got adderall or ritalin.

Play innocent regarding it - take the doctors advice, and try it, and see if it helps. If it doesn't (which is likely, but keep an open mind, maybe it will work for you), tell the doctor that it doesn't work, or makes you feel like crap, or whatever - be honest - and ask about other options.

 

[Captain.Heroin]

Hey all,

So I've been in outpatient for about four weeks. I'm one month, 15-days sober from heroin. Which is actually pretty crazy for me. I'm really happy that I was able to take the necessary steps to start to get myself clean. Of course I'm still on Suboxone, but that doesn't really relate to this post.

Here's a little background. In outpatient, my counselor has advised us to get all of our co-morbid psychological disorders taken care of. It's supposed to help us avoid relapsing, and I understand the logic in that. I'm taking an antidepressant which is supposed to cover my depression and anxiety, which most antidepressants never do for me and I'm still not sure how I'm feeling about this one (nefazadone). My psychiatrist won't prescribe me benzodiazepines for anxiety or panic attacks because of my addiction and treatment with Suboxone. I know this is bullshit but I have a small supply of benzos I always keep handy to take as needed.

I think it's bullshit only if you aren't the type to abuse benzos. Even in the worst of circumstances, I only take one benzo each week at the most frequent. At the least often, I can go months without them.

Even as a non-drug abusing patient with doctors, some doctors and psychiatrists almost expect you to get dependent on benzodiazepines. I have been told because I have panic and anxiety I will find benzos addictive - nope! I have a bottle of benzos for anxiety. When I get anxious, I typically don't go running for the benzos. They don't even appeal to me unless I am having overwhelming anxiety - and if I am, I'll typically not be around my benzos and unable to take anything for it anyways.

Also, methadone and benzos is a very dangerous combination, Suboxone and benzos is *much* safer.

Today, I spoke with my psychiatrist about getting tested for ADD. I felt that I fit the symptoms and my counselor advised me to speak with my psychiatrist about it. My psychiatrist said right off the bat "I don't need any test results to tell you that you have ADD, I've known you long enough to be able to determine you do." I still have to get the testing done, more as a formality than anything else. However, my problem lies with what he told me about what he would prescribe me. He said that I should start looking at Strattera (Atomoxetine) because that would be what he would prescribe me.

My problem lies not with whether Strattera will work, I haven't tried it so I can't comment. But I believe that he is unwilling to prescribe me a stimulant for one of two possible reasons. Reason one being that I'm a drug addict. Reason two is that he's afraid of repercussions from the DEA auditing his records. I know he's mindful of this because he was about to prescribe me Adderall earlier this year for my Fibromyalgia related fatigue. When I asked about the Adderall, he said that when the DEA audits his records they'd be suspicious of a doctor giving a Suboxone user Adderall. Bullshit.

That is 100% bullshit. Many ex-heroin addicts have ADHD. Heroin is actually very therapeutic for ADHD symptoms in the short run, although an addiction to heroin will exacerbate symptoms for most people. ADHD meds have helped me stay away from heroin because I feel like with a minimal amount of bupe + d-amp, I really don't ever have heroin cravings.

My question is whether or not this is typical of doctors that are aware of a patient's substance abuse or the DEA auditing records. I don't know why I should have to be restricted to one medication because of either of those reasons. If I have a documented condition, shouldn't I be allowed to get a prescription for a medication that may be superior to another? Is there anyway to logically present this to my doctor, or should I have my ADD handled through another doctor?

Also, I know the only advantage Strattera has over traditional stimulants is that it has a lower abuse potential. Are there any other medications that have a lower abuse potential as well? Ones that might be more of a traditional stimulant?

Thanks for the help guys!

I would have your ADD/ADHD handled through another doctor - ONLY because I do NOT like when doctors say "I haven't known you a long time, but for this 1 disorder you get 1 and only 1 drug. If you don't like it, tough shit, take some more SSRI's" - this is an irresponsible way to practice medicine.

He can say "Oh I like to start people off on ______" or "I don't like to write Adderall prescriptions if I don't have to....", and he may not want to side with any one ADHD medication for any given reason. However, a doctor cannot limit themselves to one treatment option for all of his patients. These sorts of doctors give me the shudders.

If you ask me, a moderate amount of amphetamine isn't abuse-proof but it isn't likely to be abused. Why, you ask me?

If you get one XR capsule, or one IR tablet (which is to be split in half), you could abuse this, and end up only getting high for 2 or 3 days out of the month, or you could use it wisely and get a full month worth of relief.

What drugs have a tendency to be abused can vary. Even some anti-depressants can be addictive to the right people; look at a small group of people who claimed to be addicted to Prozac.

http://en.wikipedia.org/wiki/Fluoxetine#cite_ref-69

Some people may abuse clonazepam - I might like some benzos, but clonazepam is a benzo I would willingly flush down the toilet before I'd ever put it in my body again. I only get negative effects from it, because I get a paradoxical reaction from it. However, some doctors are perfectly content with only pushing clonazepam on their patients, some will even go so far as to say it's "not addictive" 8) - far from it to be honest.

why not follow his advice and give the strattera a try? i mean, adderall is pretty freaking strong and has a high incidence of dependency.

I've done my research, and strattera has a black box warning. But look about what it's warning about specifically here....

http://newideas.net/adhd/medication/FDA-warnings#section3

I personally think Adderall is a safer medication - at the right dose, and only if taken correctly.

If you don't have a history of abusing this medication, you should get a chance to use it responsibly IMO. If you DO have a history of abusing the medication, but you have a legitimate reason to have it, I would (if I was a doctor) prescribe it, but give the paper prescription to the patient's family member who is trusted to hold onto it, so that they could divvy out the medication to the patient.

only reason i'm chiming in here is that me going dr shopping for an adderall script eventually led to a relapse on opiates.

This is a real possibility - but don't you think other people may relapse in the event their ADHD goes untreated?

And are you sure the two events in your life are actually correlated?

Clearly my treatment was more successful..

I disagree. YOU were more successful. The treatment, in this scenario, was compared for one person, to another person with a different plan. I could compare one person who quit using bupe and one person who quit using methadone, and say they have the exact same efficacy. You could also look at two different people, one who tried bupe, the other methadone, both of whom relapsed (75% of people relapse in 9 months for alcohol, tobacco, or heroin) - and then claim neither of the treatments work.

But all of these assumptions would be wrong.

You can't make inferences about the treatment, but what you can make inferences about is yourself.

(I typed most of this before I read etard's excellent post)

Think about it, man - the general view in the medical community is that addiction is a disease and doctors consider a patient's medical history when prescribing ANY treatment. If someone is diabetic, drugs that have the propensity to raise blood sugar have to carefully considered and the risk-benefit ratio analyzed.

Its the exact same with addicts. If someone has a history of addiction, you risk triggering or exacerbating their condition by prescribing recreational substances so this should be a consideration in the decision how to treat any condition. Obviously if someone has a fractured skull they aren't going to refuse to give narcotic analgesics and let someone suffer but overall it depends on the severity of what you require treatment for. In addicts, trying non-scheduled medications first ABSOLUTELY is first line unless the necessity is so high that it outweighs the risks to the individual.

On top of this, one of the most universal and basic manifestations of addiction is rationalization. The addict brain will convince you of absolutely anything to trick you into thinking you need that fix... I see this constantly around here in people who are convinced that no NSAIDs can touch any pain they have; their insomnia can ONLY be treated by benzos; there is no way SSRI's can work for their anxiety; atomoxetine will do fuck-all for their ADHD and so on and so on.

I won't pretend like I know if this is true for you or not but you are BRAND NEW to recovery and those rationalizations don't simply disappear when the use stops. In fact, this is when most people start to come up with more inventive ways to trick themselves into believing they need substances. This even presents when people trick themselves into thinking NOT taking a substance (generally prescriptions) is a threat to their sobriety.

You are right, some people really do this to get addictive drugs.

However, NSAID's cause perforation of the stomach lining (they voluntarily took selective cox-2 inhibitors off the market ), and kidney failure. I also don't like how two separate NSAID's made me more sedated than benzos. Only the long lasting benzos will make me sleep in that long. 8( - I use benzos for insomnia only rarely, and actual d-amp works better as a sleep med because I can sleep on it and it is relaxing to me. And finally, I have tried one SSRI many years ago and never again, it made my anxiety and most of my mental problems much worse.

I have never used atomoxetine but because of its black box warnings I am skeptical, and certainly because of my propensity for negative thoughts due to PTSD I wouldn't use it at all and would avoid it like the plague.

However, Cane has made great points and I do believe there are good alternatives to benzos and amphetamine drugs for many different reasons. There are good alternatives, and poor alternatives. I just have issues with the poor alternatives.

 

[BHannon24]

Well here is my two cents,
I was diagnosed with adhd before i was addicted to opiates and was prescribed adderall for about a year and a half until vyvanse came out then i was prescribed 70mg vyvanse for three months until the doctor wanted me to have blood work done for me to get my next script, well i hate needles very much so i just never went because by that time the negative side effects of the add's and vyvanse outweighed the positive side effects and i wasnt even taking them anymore just occasionally. It wasnt until a couple months after that i picked up my oxy and started self medicating my adhd with that.......hell i even got a better GPA in college taking Mechanical Engineering while i was on oxy's until my rents found out so i went to rehab and while in rehab they gave me stratera for my adhd which wasnt good and i didnt like how it made me feel after rehab i got back to my town and it wasnt long until i started using again which went on for about another 7 or 8 months until i told my parents about a month ago went to detox, after getting out i started using again until i got into a suboxone clinic about a week and half ago....Sorry for rambling but to answer your question yes it is very common once you are labeled an addict and you tell your doctor you are on suboxone for an addiction problem you are not going to get prescribed a controlled substance or stimulant. I also have not been able to sleep since i got put on the suboxone unless i threw a benzo in but with my sub doctor any benzo that comes up in my urine is instant termination so i couldnt do that except right after my urine screen and i have been having some bad leg and back pain so i just got prescribed something for it and what do you think it was? an NSAID diclofenac which i just picked up and havent tried yet....non narcotic non addictive blah blah blah anyhow thats my two cents i know what it is like to be in your boat and it sucks but i am gonna do what the doctor says now cause i really dont wanna go back to using at least not everyday ever again

 

[BHannon24]

wish i would have seen your post before i posted Captain haha