Adderall Addiction
September 5, 2012 9:27 PM Subscribe
I am abusing Adderall and need help. I have found a Narcotics Anonymous meeting in my area and am going to attend the next one, but I think I need more help.
I see a psychiatrist for ADHD/Depression and am prescribed Adderall XR and Adderall slow release. My prescriptions are for 30mg XR and 30mg slow release (in 10mg tablets) daily.
I have a new job that requires long hours and I started taking double doses of the XR a few months ago. I then run out of the XR before the next prescription is due so I take the slow release.
I am running out of the XR 12 days before the next one is due and the slow release 15 days before the next one is due.
Because of this deficit, I lied to my doctor about losing the pill bottle and was able to get him to give me an additional months supply. I was convinced I would use this extra amount to titrate down to my normal dose. Of course I did not. Then a relative gave me her two months supply because she had only recently started it and did not like it. Again I used all of it up.
This week I have been thinking of how I can buy it illegally without getting arrested. So, yeah, I know I have a problem. I have already found a Narcotics Anonymous meeting in my area and am going to attend the next one.
I am not going to tell my psychiatrist or therapist about this because I do not want to be labeled a prescription drug abuser and have that in my health insurance record for the rest of my life.
But I need more help. What else can I do?
I started looking for medical doctors who specialize in addiction treatment yesterday. I want to pay cash and work with one to get back to a normal dose schedule. Is that possible?
Is there any other help out there?
I see a psychiatrist for ADHD/Depression and am prescribed Adderall XR and Adderall slow release. My prescriptions are for 30mg XR and 30mg slow release (in 10mg tablets) daily.
I have a new job that requires long hours and I started taking double doses of the XR a few months ago. I then run out of the XR before the next prescription is due so I take the slow release.
I am running out of the XR 12 days before the next one is due and the slow release 15 days before the next one is due.
Because of this deficit, I lied to my doctor about losing the pill bottle and was able to get him to give me an additional months supply. I was convinced I would use this extra amount to titrate down to my normal dose. Of course I did not. Then a relative gave me her two months supply because she had only recently started it and did not like it. Again I used all of it up.
This week I have been thinking of how I can buy it illegally without getting arrested. So, yeah, I know I have a problem. I have already found a Narcotics Anonymous meeting in my area and am going to attend the next one.
I am not going to tell my psychiatrist or therapist about this because I do not want to be labeled a prescription drug abuser and have that in my health insurance record for the rest of my life.
But I need more help. What else can I do?
I started looking for medical doctors who specialize in addiction treatment yesterday. I want to pay cash and work with one to get back to a normal dose schedule. Is that possible?
Is there any other help out there?
Kudos to you for acknowledging your problem rather than denying it. Not everyone can do that, especially early in a situation before it gets totally out of control. I'm sure some MeFi'rs will help you find a good doctor to give you the help you need. Best wishes to you.
posted by Dansaman at 9:58 PM on September 5, 2012 [7 favorites]
posted by Dansaman at 9:58 PM on September 5, 2012 [7 favorites]
Hazelden publishes a ton of addiction/recovery material and for that they are well known around the country. They apparently offer rehab services at two locations in New York City, including an outpatient program.
posted by phaedon at 9:58 PM on September 5, 2012
posted by phaedon at 9:58 PM on September 5, 2012
First, I think you should anonymize this question.
Second, you have taken a great first step in admitting that you have a problem. Seriously.
posted by radioamy at 10:24 PM on September 5, 2012 [2 favorites]
Second, you have taken a great first step in admitting that you have a problem. Seriously.
posted by radioamy at 10:24 PM on September 5, 2012 [2 favorites]
IANAD but seconding the props for recognizing you have a problem and seeking help. That is truly the hardest part. I completely understand the reluctance to discuss this with your psych or therapist, especially since it is so ridiculously difficult to secure and fill prescriptions for controlled substances that you actually need (seriously, it's maddening), but eventually you will need to disclose your situation to whoever is treating you, whether it is your current psych or a new one. If you don't, it is too easy to continue the cycle of abuse. Also, your therapist, who does not need to answer to the DEA, can help you address your substance abuse and provide techniques for daily living to replace the extra doses. Keeping these things from those responsible for your mental health will eventually backfire and render that treatment at best useless and at most harmful. I say this knowing full well how difficult it can be to get a regular prescription, even if it is well documented it's what you need. Complicating that already difficult process isn't appealing on any level, but in this instance, it's medically necessary.
Initially, I was surprised you're being prescribed long and short term release tablets but the cumulative dose (when you aren't doubling down) seems reasonable. Turn to the healthcare professionals who are responsible for your care. It's not their first rodeo and they can help you navigate the blurred line between necessity and abuse. This may be new and disorienting to you, but this should be well within their professional experience. Personally, I think I would start with using a hypothetical with your therapist to see what they are required to report or code you as for insurance purposes. Also, an addiction counselor off the books should be able to steer you in the right direction. Allowing any mental health professional to treat you without full disclosure, however, can have unforeseen and traumatic consequences for both of you. Best of luck to you. It sounds like you are well on your way to addressing the issue at hand.
posted by katemcd at 10:28 PM on September 5, 2012 [2 favorites]
Initially, I was surprised you're being prescribed long and short term release tablets but the cumulative dose (when you aren't doubling down) seems reasonable. Turn to the healthcare professionals who are responsible for your care. It's not their first rodeo and they can help you navigate the blurred line between necessity and abuse. This may be new and disorienting to you, but this should be well within their professional experience. Personally, I think I would start with using a hypothetical with your therapist to see what they are required to report or code you as for insurance purposes. Also, an addiction counselor off the books should be able to steer you in the right direction. Allowing any mental health professional to treat you without full disclosure, however, can have unforeseen and traumatic consequences for both of you. Best of luck to you. It sounds like you are well on your way to addressing the issue at hand.
posted by katemcd at 10:28 PM on September 5, 2012 [2 favorites]
Relevant info: I worked in addiction treatment for a few years in the late '70s; one of my kids abused Ritalin and Adderall during high school (both prescribed and illegally obtained); I've taken Adderall for more than 10 years, but no abuse issues. IANAD, nor do I live in New York.
Some thoughts based on the above:
If you say you are "abusing Adderall", I doubt that the people in NA or most addiction professionals will support the notion that you should continue to take Adderall (or Ritalin, either). There are non-amphetamine options to treat ADD, but for most people they are not nearly as effective.
Have you been snorting your prescription? There is a relatively new drug, Vyvanse, that is similar to Adderall, but unlike Adderall and Ritalin, it can only be absorbed through the digestive system. Of course, you can still abuse it by taking more than the prescribed dose. BTW, my formerly substance abusing child has been taking Vyvanse for several months - not because of potential abuse issues - simply because it eliminated the end-of-the-day crash that came with Adderall.
How long have you been on your current dose schedule? Was it effective before the new job and added stress in your life? Are you sleeping, eating, and otherwise taking care of yourself? Perhaps your current prescription is simply not sufficient. For comparison, I take between 90 and 120 mg/day (not extended release).
Finally, keep in mind that there can be tremendous differences in the quality of advice you get at AA and NA meetings. It's really important to shop around.
Good luck.
posted by she's not there at 10:54 PM on September 5, 2012
Some thoughts based on the above:
If you say you are "abusing Adderall", I doubt that the people in NA or most addiction professionals will support the notion that you should continue to take Adderall (or Ritalin, either). There are non-amphetamine options to treat ADD, but for most people they are not nearly as effective.
Have you been snorting your prescription? There is a relatively new drug, Vyvanse, that is similar to Adderall, but unlike Adderall and Ritalin, it can only be absorbed through the digestive system. Of course, you can still abuse it by taking more than the prescribed dose. BTW, my formerly substance abusing child has been taking Vyvanse for several months - not because of potential abuse issues - simply because it eliminated the end-of-the-day crash that came with Adderall.
How long have you been on your current dose schedule? Was it effective before the new job and added stress in your life? Are you sleeping, eating, and otherwise taking care of yourself? Perhaps your current prescription is simply not sufficient. For comparison, I take between 90 and 120 mg/day (not extended release).
Finally, keep in mind that there can be tremendous differences in the quality of advice you get at AA and NA meetings. It's really important to shop around.
Good luck.
posted by she's not there at 10:54 PM on September 5, 2012
Response by poster: I have never snorted it. I have been taking Adderall for almost 12 years and this is the first time I have gotten myself into a deficit situation. It was effective before the current job.
posted by Francophone at 11:23 PM on September 5, 2012
posted by Francophone at 11:23 PM on September 5, 2012
That is truly the hardest part. I completely understand the reluctance to discuss this with your psych or therapist, especially since it is so ridiculously difficult to secure and fill prescriptions for controlled substances that you actually need (seriously, it's maddening), but eventually you will need to disclose your situation to whoever is treating you, whether it is your current psych or a new one.
Look, I don't mean to present myself as an authority on this subject, but the caution the OP has about providing abuse information to his doctor is warranted. It will in fact be written down and may affect his insurance. Anyway, I have no idea why this is legal, it's totally fucked up.
Now, I know even less about the legalities of talking to your therapist. However, in my case I received assurances, and I personally open up to my therapist to a far greater degree than my doctor. At the very least, if you work with a professional, you should ask about this before getting involved.
If you are in the awkward position of having to continue to take Adderall - even though you have abused it - I think that it is a great idea to work with an addiction professional that won't necessarily push you to abstain from your medication altogether. Even though I'm a fan of NA/AA, you may bump into some people that regale you with stories of how the solution was to abstain from everything - including your doctor-prescribed psych meds - and just "rough it out." To that I say - they are not medical professionals, and people there shouldn't tell you what to do, especially if you are clinically diagnosed. They are there to suggest and support.
Cognitive Behavior Therapy for example, might be something you want to check out. CBT is a form of of skills training that relies on a functional analysis of your thoughts and feelings. This could be done in the context of a therapist or a group class.
I also wanted to add anecdotally that a lot of people with drug problems do go to AA instead of NA. I'm not entirely sure why this is. Feel free to try both and see what works for you. By the way, there's a lot "more" you can do in the context of a 12-step program than just going to one meeting. You can make friends, you have opportunities to speak candidly, you can ask for guidance from a sponsor who will help you, and you can sign up for commitments to keep you busy and grounded. This is counter-intuitive behavior for alcoholics/addicts, so don't be all surprised if this ends up requiring some time and effort. But this stuff works for people. Good luck.
posted by phaedon at 11:25 PM on September 5, 2012 [1 favorite]
Look, I don't mean to present myself as an authority on this subject, but the caution the OP has about providing abuse information to his doctor is warranted. It will in fact be written down and may affect his insurance. Anyway, I have no idea why this is legal, it's totally fucked up.
Now, I know even less about the legalities of talking to your therapist. However, in my case I received assurances, and I personally open up to my therapist to a far greater degree than my doctor. At the very least, if you work with a professional, you should ask about this before getting involved.
If you are in the awkward position of having to continue to take Adderall - even though you have abused it - I think that it is a great idea to work with an addiction professional that won't necessarily push you to abstain from your medication altogether. Even though I'm a fan of NA/AA, you may bump into some people that regale you with stories of how the solution was to abstain from everything - including your doctor-prescribed psych meds - and just "rough it out." To that I say - they are not medical professionals, and people there shouldn't tell you what to do, especially if you are clinically diagnosed. They are there to suggest and support.
Cognitive Behavior Therapy for example, might be something you want to check out. CBT is a form of of skills training that relies on a functional analysis of your thoughts and feelings. This could be done in the context of a therapist or a group class.
I also wanted to add anecdotally that a lot of people with drug problems do go to AA instead of NA. I'm not entirely sure why this is. Feel free to try both and see what works for you. By the way, there's a lot "more" you can do in the context of a 12-step program than just going to one meeting. You can make friends, you have opportunities to speak candidly, you can ask for guidance from a sponsor who will help you, and you can sign up for commitments to keep you busy and grounded. This is counter-intuitive behavior for alcoholics/addicts, so don't be all surprised if this ends up requiring some time and effort. But this stuff works for people. Good luck.
posted by phaedon at 11:25 PM on September 5, 2012 [1 favorite]
Response by poster: Perhaps your current prescription is simply not sufficient. For comparison, I take between 90 and 120 mg/day (not extended release).
she's not there, that is a good point, if I wind up seeing an addiction doctor, I am going to ask for a review or evaluation or whatever, it might be that my prescription should be increased.
posted by Francophone at 11:33 PM on September 5, 2012
she's not there, that is a good point, if I wind up seeing an addiction doctor, I am going to ask for a review or evaluation or whatever, it might be that my prescription should be increased.
posted by Francophone at 11:33 PM on September 5, 2012
Francophone, as other's have already said, it's great that you are working so aggressively to get things under control. I'm wondering if you have too quickly labeled this a "drug addiction" problem that requires NA/AA type treatment/intervention.
You have been successfully treating ADD and depression with Adderall for 12 years and, naturally, you prefer to continue the treatment. That makes you significantly different from most NA/AA participants, who are focusing on doing everything it takes to completely eliminate whatever substances they are having issues with. (Just so you know, although I understand that for some people NA/AA can be a life saver, my limited experience with 12 step programs has not been particularly positive.)
It seems that the pressure/stress related to the new job is the primary issue. You attempted to cope by upping your meds - not wise, but not without reason/logic, either. From what little I've read, CBT (or other behavior-oriented therapy) might be more useful to you than NA/AA - both for developing strategies to deal with the changes at work and also getting back to your regular dose schedule.
Given your 12 year treatment history and how quickly your moved to deal with the issue, I suspect that you aren't as out of control as you may feel at the moment.
posted by she's not there at 12:34 AM on September 6, 2012 [1 favorite]
You have been successfully treating ADD and depression with Adderall for 12 years and, naturally, you prefer to continue the treatment. That makes you significantly different from most NA/AA participants, who are focusing on doing everything it takes to completely eliminate whatever substances they are having issues with. (Just so you know, although I understand that for some people NA/AA can be a life saver, my limited experience with 12 step programs has not been particularly positive.)
It seems that the pressure/stress related to the new job is the primary issue. You attempted to cope by upping your meds - not wise, but not without reason/logic, either. From what little I've read, CBT (or other behavior-oriented therapy) might be more useful to you than NA/AA - both for developing strategies to deal with the changes at work and also getting back to your regular dose schedule.
Given your 12 year treatment history and how quickly your moved to deal with the issue, I suspect that you aren't as out of control as you may feel at the moment.
posted by she's not there at 12:34 AM on September 6, 2012 [1 favorite]
I would tell your doctor the details that they need to help you: that you have been working longer hours and have sometimes been wanting to take another pill to work later at night. Would s/he consider increasing your dosage to cover late working weeknights? Your doctor wants to help you. As stated above, you may just need a higher daily dose.
posted by amaire at 5:09 AM on September 6, 2012 [1 favorite]
posted by amaire at 5:09 AM on September 6, 2012 [1 favorite]
IANAD.
However, I would suggest discussing this with your doctor without self-diagnosing yourself using loaded terms like abuse and addiction. Feeling the need to take more is not necessarily abuse.
You might also consider a switch to Ritalin. The extended release Ritalin (Concerta) is pretty hard to abuse unless you're willing to really carefully disassemble the capsule it comes in.
Also, Adderall is not itself an anti-depressant and really should not be prescribed for depression, though in practice that seems to happen pretty often. However, Adderall and Ritalin often have mutually beneficial and reinforcing effects when taken together with an anti-depressant. Wellbutrin is common, though it does have some side effects.
posted by RandlePatrickMcMurphy at 6:05 AM on September 6, 2012
However, I would suggest discussing this with your doctor without self-diagnosing yourself using loaded terms like abuse and addiction. Feeling the need to take more is not necessarily abuse.
You might also consider a switch to Ritalin. The extended release Ritalin (Concerta) is pretty hard to abuse unless you're willing to really carefully disassemble the capsule it comes in.
Also, Adderall is not itself an anti-depressant and really should not be prescribed for depression, though in practice that seems to happen pretty often. However, Adderall and Ritalin often have mutually beneficial and reinforcing effects when taken together with an anti-depressant. Wellbutrin is common, though it does have some side effects.
posted by RandlePatrickMcMurphy at 6:05 AM on September 6, 2012
Addiction isn't in the amount, it's in the behavior. And that's what is rightfully concerning the asker. Instead of asking the doctor for more, he has resorted to lying. But, he realized it right away and is taking steps to solve the problem, so I'm not sure a diagnosis of addiction is correct yet.
It seems that the pressure/stress related to the new job is the primary issue. You attempted to cope by upping your meds - not wise, but not without reason/logic, either. From what little I've read, CBT (or other behavior-oriented therapy) might be more useful to you than NA/AA - both for developing strategies to deal with the changes at work and also getting back to your regular dose schedule.
This seems right to me. I'm not sure you ARE addicted to Adderall, but you are nearing that threshold. So instead of forcing that label onto yourself, just talk to the doctor and explain the story from this perspective. Work got stressy, I used extra pills to cope and it all started to steamroll.
Amphetamine is sneaky. I take it for ADHD and I don't particularly *like* it. What I really don't like is the falloff. That period of time right after the blood level of the drug peaks and starts to drop off again. The higher the dose, the steeper that curve is, and the more unpleasant the effects are. So yeah, it is going to be super hard to white-knuckle through those moments when you have started the day with twice as much as you are supposed to be taking. So don't start the day with twice as much.
I started looking for medical doctors who specialize in addiction treatment yesterday. I want to pay cash and work with one to get back to a normal dose schedule. Is that possible?
It is possible, but it will be difficult to find a doctor willing to do it. Because the act of hiding your problem from your existing doctor is on the addiction spectrum and is not conducive to a good relationship. An addiction doctor is probably not going to be cool with that.
What you should consider is this:
1- you are freaked out, partially because you are behaving in a way you aren't comfortable with, but also because you are have a lot of amphetamine running through your system.
2- so maybe the addictive feelings you are feeling aren't addiction as much as they are manifestations of stress and lack of quality sleep and starting the day with twice as much as you are supposed to take.
3- so maybe you can wean yourself back down to normal. It is worth a try, and you won't have lost anything. It's not an either-or situation, if you can't do it yourself, you can just call the addiction specialist a week later if it doesn't work out.
What you might try is stopping cold turkey for a weekend, and then going back to your correct dosing schedule.
Amphetamine is addictive, but it isn't *that* addictive when you are taking normal therapeutic doses. Yes, you will feel shitty and empty and tired. So sleep or play video games or whatever to pass the time. Don't dwell on the "I feel bad and adderall will fix that" feelings, because that's wrong. You feel bad and adderall *caused* those feelings.
Look up the metabolism and half lifes of adderall and amphetamine. Learn how the stuff works. The more you take in the morning, the later the peak and the steeper the droppoff. You can take half as much in the AM, and then a very small amount a couple more times throughout the day to keep that curve at peak effectiveness, without getting peaky.
If that doesn't work, then yes, call those addiction doctors. It's not easy, but it is absolutely possible.
posted by gjc at 7:03 AM on September 6, 2012 [2 favorites]
It seems that the pressure/stress related to the new job is the primary issue. You attempted to cope by upping your meds - not wise, but not without reason/logic, either. From what little I've read, CBT (or other behavior-oriented therapy) might be more useful to you than NA/AA - both for developing strategies to deal with the changes at work and also getting back to your regular dose schedule.
This seems right to me. I'm not sure you ARE addicted to Adderall, but you are nearing that threshold. So instead of forcing that label onto yourself, just talk to the doctor and explain the story from this perspective. Work got stressy, I used extra pills to cope and it all started to steamroll.
Amphetamine is sneaky. I take it for ADHD and I don't particularly *like* it. What I really don't like is the falloff. That period of time right after the blood level of the drug peaks and starts to drop off again. The higher the dose, the steeper that curve is, and the more unpleasant the effects are. So yeah, it is going to be super hard to white-knuckle through those moments when you have started the day with twice as much as you are supposed to be taking. So don't start the day with twice as much.
I started looking for medical doctors who specialize in addiction treatment yesterday. I want to pay cash and work with one to get back to a normal dose schedule. Is that possible?
It is possible, but it will be difficult to find a doctor willing to do it. Because the act of hiding your problem from your existing doctor is on the addiction spectrum and is not conducive to a good relationship. An addiction doctor is probably not going to be cool with that.
What you should consider is this:
1- you are freaked out, partially because you are behaving in a way you aren't comfortable with, but also because you are have a lot of amphetamine running through your system.
2- so maybe the addictive feelings you are feeling aren't addiction as much as they are manifestations of stress and lack of quality sleep and starting the day with twice as much as you are supposed to take.
3- so maybe you can wean yourself back down to normal. It is worth a try, and you won't have lost anything. It's not an either-or situation, if you can't do it yourself, you can just call the addiction specialist a week later if it doesn't work out.
What you might try is stopping cold turkey for a weekend, and then going back to your correct dosing schedule.
Amphetamine is addictive, but it isn't *that* addictive when you are taking normal therapeutic doses. Yes, you will feel shitty and empty and tired. So sleep or play video games or whatever to pass the time. Don't dwell on the "I feel bad and adderall will fix that" feelings, because that's wrong. You feel bad and adderall *caused* those feelings.
Look up the metabolism and half lifes of adderall and amphetamine. Learn how the stuff works. The more you take in the morning, the later the peak and the steeper the droppoff. You can take half as much in the AM, and then a very small amount a couple more times throughout the day to keep that curve at peak effectiveness, without getting peaky.
If that doesn't work, then yes, call those addiction doctors. It's not easy, but it is absolutely possible.
posted by gjc at 7:03 AM on September 6, 2012 [2 favorites]
This thread is closed to new comments.
posted by phaedon at 9:31 PM on September 5, 2012