Adderal addict wants to go straight

October 6, 2008 7:12 AM

How willing would a doctor be to overlooking my illegal use of prescription medication in prescribing it for me?

I've been taking study-aid drugs since freshmen year of college. Living in a dorm being surrounded by people prescribed Adderal and Concerta made it hard to resist. At the worst I took it around once a week for about a month. I never got any 'high' from my use.

Now in my Sophomore year, I'd like very much to be properly prescribed for some medicine, as I feel that the extreme procrastination I had experienced for the past many years is an indication of myself having ADD.

I liken my use of Adderal to when I first wore glasses and I felt amazed that 'everyone else saw like this'.

However, I fear of addiction and already feel as though I am building a tolerance, and in more recent usages I noticed an uncomfortable lack of circulation in my extremities, requiring me to shake my fingers, arms, and legs every so often.

posted by anonymous to human relations (11 comments total)

I wouldn't mention it to your doctor, no--and I'm not sure that, if you plan to be seen at your school health service, you'll be seen by a doctor at all. If you want an ADD diagnosis, you probably need to see your school psychiatrist first. (My guess is they know that students abuse it and they are probably fairly strict about prescribing.) Try getting a diagnosis first--certainly don't go in asking for a particular medication.

Constricting blood vessels and poor circulation is indeed a side effect. Maybe lay off it.
posted by liketitanic at 7:24 AM on October 6, 2008

Now in my Sophomore year, I'd like very much to be properly prescribed for some medicine, as I feel that the extreme procrastination I had experienced for the past many years is an indication of myself having ADD.

You're not qualified to diagnose this. That said, if you are legimately diagnosed with a disorder, and are prescribed a drug in the same class as Adderal, you (ethically) need not inform your doctor of past experimentation with it except if you're aware of any negative effects that might contraindicate usage in your particular case.
posted by Inspector.Gadget at 7:26 AM on October 6, 2008

Do you really think you have ADD? If so, you should absolutely talk to your doctor and get a referral to a psychiatrist.

Note: possible scenarios include 1) no, you don't have ADD, 2) yes, you may, but a behavioral approach to treatment plus counseling would be a wiser course, 3) yes, you may have ADD, and are prescribed a non-stimulant drug.

I never got any 'high' from my use.

But you were able to think incredibly clearly and get many things done at once, efficiently and felt all in touch with your potential? That's not having ADD, that's what speed does in lower doses, for pretty much everyone.
posted by desuetude at 8:10 AM on October 6, 2008 [7 favorites]

Emphatically seconding Inspector.Gadget. Not only is self-diagnosis of "conditions" like ADD extremely unreliable, it sounds offhand to me like you're offering up a very week one, at that. Procrastination? Welcome to college, that's not ADD. You don't give much information, but that plus your admission that you're building up a tolerance says to me that you're currently abusing Adderal and are looking for an excuse to keep abusing it.

Start with the problem- you're having trouble, IMO, keeping your academics in focus- it's totally common in college. If your school offers any kind of free counseling, start there, with the problem, not with the solution.
posted by mkultra at 8:13 AM on October 6, 2008 [1 favorite]

First of all, ADD is an outdated diagnosis. Any current diagnosis would be ADHD even if the attention deficit is the focus of the disorder.

Second of all, the DSM-IV-TR lists it under the category of "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence," and it is very rare that someone over the age of 15 would be diagnosed with it.

The symptoms tend to be pretty strong, and unless you have had attention problems in the past that directly contributed to low or failing grades, problems with peers related to your attention or hyperactivity all the time as a kid, regular problems following instructions even when instructions are clearly laid out, losing things regularly, and a whole host of other behavioral symptoms, you probably don't have ADHD.

For what it's worth, I'm almost done with my graduate degree in counseling and have studied childhood disorders with some depth.

As for your question about reporting your illegal use of prescribed drugs....*if* your doctor/nurse practitioner *should* prescribe you something, you ought to tell them because they will know how what they prescribed will interact with any other drugs that may be in your system. And mixing drugs is not something to mess with on your own. If you think you are developing an addiction to these drugs (and it entirely possible), you may wish to consider mentioning your use to assess whether it is the beginnings of an addiction you have....I mention this because you stated some concern over the possibility of addiction.
posted by zizzle at 8:40 AM on October 6, 2008

However, I fear of addiction and already feel as though I am building a tolerance, and in more recent usages I noticed an uncomfortable lack of circulation in my extremities, requiring me to shake my fingers, arms, and legs every so often.

Hi, addiction, nice to meet you.

You need help, not more medicine that you've decided you now "need" even though you initially couldn't "resist" it.

Seek a psychiatrist. Sounds like you have a substance abuse or dependence disorder, not an attention deficit hyperactivity one.
posted by gramcracker at 9:02 AM on October 6, 2008 [3 favorites]

ADHD Medication is not a study aid. I do not take medicine for my ADD simply so I can study. I take it so I can function period. I take it so I can do my laundry, care for my pets, shop for groceries, work, and enjoy a television show.

If you only took it once a week and didn't seek out a doctor at that time, the benefits can't have been that great. If they were that noticeable, you'd have gone to a doctor right away - you don't wear your glasses just once a week, do you?

People who are truly dependent on a medication very rarely enjoy that dependence, and rarely seek a diagnosis that requires medication. People with a disorder that requires medication want to be normal, not medicated. I hope for your sake you do not have ADD, but the only person who can tell you that is a psychiatrist, and you should see one soon - and not the schools doctor. Be honest with them, they've heard everything you could say before.
posted by jesirose at 9:21 AM on October 6, 2008

I heartily disagree with liketitanic - you should absolutely tell your doctor that you've been taking prescription medication! I'm sure he will advise you that to do that without a doctor's advice can be very dangerous - these medications are not prescription medications because they can be very dangerous with incorrect dosage or in interactions with other things or without an understandings of their long-term effects and side-effects.

You are welcome to ask your doctor for a particular medication, but your doctor will certainly examine you first to make his/her own determination of your condition and medical issues. Remember that any physician worth his/her salt will have your physical and mental health foremost in mind. You should approach the doctor with the attitude that he/she wants to help you function more successfully and healthily in the world.

I strongly recommend going to a doctor and talking to him/her about this ASAP. If you are worried about the legal ramifications of illegally taking prescription drugs, you shouldn't. Your doctor (at least in the USA) is bound by strict patient-doctor confidentiality laws, put in place for the exact purpose of allowing you to consult a physician in situations like this without fear of being caught.
posted by Salvor Hardin at 9:23 AM on October 6, 2008

It's extremely unlikely that a doctor would prescribe you stimulants if you told him that story. You might get Ritalin with an understanding (or lazy) doctor who doesn't mind living close to the edge.

You're far more likely to be prescribed Strattera or referred to a therapist. If you really believe you have ADD then it wouldn't hurt to try Strattera, but the effects are not the same as Ritalin or Adderal.

If your goal is stimulants, don't mention it. If your goal is to treat a medical condition, it's best to be completely honest.
posted by polyhedron at 10:40 AM on October 6, 2008

As everybody else is saying, you're going about this backwards.

Go to a psychiatrist.

Ask for an evaluation.

If you have ADD, then discuss treatment, and ask if you should be prescribed.

If you don't, you still have a problem with procrastination. Ask the psychiatrist what to do. Discuss options and solutions.

You should never have taken Concerta or Adderall - I don't think you know what those drugs do. They're not prescriptions for procrastinators. They're prescriptions to treat the chemical deficiencies that stem from ADD. If you don't have ADD - which is a distinct possibility - then you were only benefiting from side-effects, and you probably could have gotten the same effect from drinking more coffee. Do that instead.

I'm sorry, but as a person who has and struggles with ADD, it really and truly aggravates me that everybody seems to think that I just have "a problem with procrastination" and that I take little magic pills to make it go away. Be assured: if I took Adderall, Ritalin, or Concerta without treatment, it wouldn't help me much. I have to make an effort toward organizing my life, and I have to submit to treatment to make it work. You have some serious misconceptions about how psychiatric prescriptions work.

Get evaluated. If the doctor thinks you should, get medicated. But if you have ADD, don't expect it to magically go away when you take a drug; and conversely, if your procrastination magically went away when you took Adderall or Concerta, you probably don't have ADD. You probably have a placebo effect.
posted by koeselitz at 11:23 AM on October 6, 2008 [6 favorites]

I have had pervasive and serious problems with time, organisation, and procrastination, going through to at least early childhood, with notes indicating such in my school records, one-on-one help during high school before an official school recommendation that I see a psychologist, due to 'academic underachievement' (really - and only on the basis that I was getting C's, and my teachers felt me capable of getting A's). I have had friends and house mates suggest ADHD. I have filled out American self-questionnaires for ADHD and had friends and boyfriends fill them out - all scored me in the 'high' range.
The first time I had Ritalin, I just felt. Calm, on top of things, enjoyed quietly sitting and talking with people, then went home and went straight to sleep within two hours.
The next time, I even felt a little sleepy, until 5-6 hours later, where I got kinda manic (it should have worn off by this point, apparently this is called the 'rebound' affect in children).

Guess what? Yes, you can probably get a diagnosis for ADHD.
Guess what? I don't have one.

There's a stark difference between the two of us you see, (assumed from your choices of wording), and it is - you live in America.
I don't. And America uses over 4/5th of the total world supply of Ritalin.

If you go around enough Doctors & GP's, and say you are having trouble focusing, keeping up with your work etc, and that you used to have more structure in your life and could kind of keep up with it but you're having problems now, you *will* get a diagnosis of ADHD.
Even better, you've got pretty decent chances of a Dr 'trialling' you on ADHD medication, and then diagnosing you on the basis you're getting an 'improvement'.

It may well be bullshit, but you'll still get your stimulant or non-stimulant-but-sure-as-hell-acts-a-lot-like-a-stimulant 'medication'.

There's still plenty of ADHD books that parrot the 'paradoxical effect' line, and suggest that evidence that the medication is working, is evidence you have ADHD.
Neither of these are true, as I was sadly disillusioned to find out.
Stimulant medications give the same increase in concentration etcetera to 'control' populations of children & adults, as they do to 'ADHD' populations (http://www.hhs.gov/ohrp/panels/jreview01/proref.pdf). Evidence of long-term benefits is scanty. It's use usually doesn't translate to better academic results, and in children, gains in 'behaviour' are not kept once off it, in contrast to purely behavioural interventions (how many of the kids on 'Supernanny' would be diagnosed with ADHD?).

Some medications only work for those who need them, some have negative effects on people who don't need them - eg antibiotics, insulin.
And some... well, some are like steroids, which just work on everyone. Sometimes they're medically required, for say, building up lung strength.

The difference is, if you're in the US, if you're a 90 pound weakling in the area variously known as 'concentration', 'willpower', and 'sitzfleisch' (that wonderful German word which refers to you 'sitting flesh', your ability to sit down, and stay on task, or endure boredom), you *can* get prescribed the equivalent of steroids for your 'sitting muscles'.
But even there, the analogy breaks down, because at least with steroids, you get to keep the gains in muscle you have made when you come off them, but with amphetamines, the effect is gone as soon as it wears off.

So, it's really up to you.
But sure.
If you want it, it's there, but don't reveal that prescription abuse, unless they're really friendly. There are actually a bunch of Drs who will take the information that you 'borrowed' a friends ADHD and then found everything a lot better in a positive light (as seen in the above diagnosis by meds example).

You're only gotten a negative reaction because you've brought up the spectre of abuse and addiction. Go back a few tag-threads, and see the almost unanimous positive reaction to anyone who 'thinks' they might have ADHD even in the face of prior negative diagnoses.

Whatever you decide, good luck.

(And really, tweakers suck)
posted by Elysum at 5:15 PM on October 6, 2008 [1 favorite]