What do I tell my psychiatrist about trying drugs given by friends?

February 4, 2013 3:16 PM

Is it safe to admit to a new psychiatrist that I have tried some anti-anxiety drugs given to me by friends who were trying to help me out?

I wish to see a psychiatrist about some depression and anxiety issues. I've taken prescription anti-depressants, but my regular doctor has not prescribed specific anti-anxiety drugs. I have struggled with anxiety for quite some time, and I have had friends occasionally give me some of their prescription meds to help me out. I do not abuse these drugs, I have taken them only when I felt that I really needed them. However, it is illegal, and if I admit that would it be construed as 'drug seeking behavior'? OTOH, I feel like I should talk about it, because it represents valid data about what seems to work for me.

posted by anonymous to health & fitness (19 answers total)

Yes, you need to be completely open to your psychiatrist. It doesn't work otherwise.
posted by Thorzdad at 3:21 PM on February 4 [7 favorites]

Psychiatrists encounter so many drug seekers, they're pretty good at recognizing them. Drug seeking is a little bit about what you say, but a lot about your affect and attitude/how you say things.

If you are insistent about wanting certain medications even if your psychiatrist thinks they are not the best choice for you, that can come off poorly. Tell your psychiatrist you are willing to try whatever they think is most likely to work for you (and mean it), and it is doubtful you will appear to be drug seeking. Be honest with your psychiatrist. You will definitely not be telling them anything unusual or shocking to them.

Keep in mind that certain anti-anxiety medications are not meant to be taken on an as needed basis, and as such, borrowing one here and there from a friend would not be effective.
posted by treehorn+bunny at 3:22 PM on February 4 [3 favorites]

On a scale of 1 to whatever upper limit psychiatrists experience once in a professional lifetime, this is a 1.

From their side, of course - I know it's a big deal for you. But you have to be totally open with them - drug interactions, symptom masking, and a fundamentally dishonest doctor- patient relationship are all real risks here. Someone can probably explain the legal position more authoritatively than me, so I won't do that bit.
posted by cromagnon at 3:26 PM on February 4 [2 favorites]

Drug interactions is the big thing here. Well, that and if you know that a certain one made you go all suicidal and you should never let it in your body again. But they're not going to get you thrown in jail or anything.
posted by theichibun at 3:34 PM on February 4

There are probably some psychiatrists whose ears will prick up if you admit to using meds you weren't prescribed--different people make different judgments in the same situation--but this is extremely common. It's well worth the risk of having to possibly go to another psychiatrist to give them the additional data on what works for your anxiety. It's my understanding that doctor-patient confidentiality would protect you from any legal consequences here, but I'm not any kind of expert on this.

That said, I've known a few people who have gotten labeled as drug seekers from admitting to using prescription anti-anxiety meds without a prescription. However, most of those people were the sort not to see the difference between:

"I tried some Xanax at a party and it made me feel really awesome. Can I get some Xanax?"

and

"My friend gave me some of her Xanax when she saw me having a particularly bad panic attack. It really helped with my symptoms, and I think that benzodiazepines might be a good option for controlling my anxiety. What do you think?"

That's an important distinction.
posted by lemonadeheretic at 3:44 PM on February 4 [3 favorites]

I would absolutely tell them. "My friend gave me some xanax once and it seemed to help, but I felt like I should speak with a professional and not just self-medicate" is a thing you could say.

When I started talking to my doctor about anti-anxiety medicine I said that I drank to take the edge off and that seemed like a bad plan and I was hoping to find a better way of coping (in addition to diet/exercise stuff which I was already doing). Usually drug seekers are more like "I need this medicine because I have these symptoms!" and not "I am concerned about my psychological well-being because my anxiety is impacting my life in these ways and I'd like some help figuring out how to not be so stressed all the time" so I think you are okay. One of the problems with anxiety, of course, is that it manifests itself in these sort of "My doctor is going to give me a hard time!" metaworries which is enough of an unliklihood that I'd lump it in with "Things my anxiety is doing to me" and just go in and tell the doc the truth.
posted by jessamyn at 3:46 PM on February 4 [18 favorites]

This is purely anecdotal, but my doctor really doesn't mind and uses it as data points for what works.
posted by Raichle at 4:19 PM on February 4 [1 favorite]

Confidentiality = they can't rat you out, with very few exceptions, without violating their own professional ethics.
posted by Elagabalus at 5:36 PM on February 4

Everybody with anxiety likes taking Xanax or Klonopin, but you need to trust your doctor's judgment. On the other hand, it's your job to tell them that your current anxiety medication (SSRI is in fact indicated for anxiety) isn't cutting the mustard.

But taking benzos for anxiety is almost the same as drinking to calm your nerves. Sure it works great for short term relief but for most people it's going to cause more problems than it fixes. Over the last year I've received several separate, lengthy emails from professional societies talking about the pressing need to entirely stop long term benzodiazepine use for anxiety and how someone really needs to get around to sanctioning doctors that prescribe benzos for more than a couple of months.

In my experience some psychiatrists are going to judge the hell out of you and put their private frowny passive-aggressive drug seeker labels in the chart, and others are going to hand you whatever drugs you ask for without a single question. Still others are going to take that into account for whatever future plans they had for medicating your brain.

Giving you what you want is not their job. They are actually following the guidelines for the highest level of evidence by not giving you benzos. But the primary goal is treating your anxiety, so you need to properly articulate that you're not feeling the chemical love.
posted by hobo gitano de queretaro at 5:38 PM on February 4 [4 favorites]

I think it's best to be honest, but I agree with the above comment that some psychiatrists aren't going to care at all, and some are going to make judgements. I think good psychiatrists recognize that occasional use of a non-prescribed medication is common and not a warning sign of drug-seeking behavior, especially when someone is honest enough to admit it.

Anecdata: When my psychiatrist was considering prescribing me Ritalin, he was thinking about what dose to start me on. I volunteered that I had tried my friend's Adderall once or twice, and his reaction was basically, "Oh, that helps us figure out what dose you need, and now we know that you don't react badly to it. Great!"
posted by puppetshow at 6:00 PM on February 4

So I've been there, done that... I even had drug abuse in my history. I had a diagnosis from years before, but hadn't been treated in many years. During a particularly rough patch, a friend with the same diagnosis gave me a sliver of a pill, which helped immensely.... for a day or two...

After checking myself into a psychiatric hospital a few weeks later, I told the psychiatrist about the friend's assistance. I was also afraid of being accused of "drug-seeking behavior", but the doctor considered it as closer to self-medicating.

Of course, mine was not anti-anxiety meds, and definitely not benzos (I've had bad experiences with benzos), but I agree with the above comments that it's all in the way you approach the topic.

Also, you don't need to worry about them calling the cops or something. Your situation is probably something they see all the time.
posted by MuChao at 6:01 PM on February 4

It's actually very common for folks to seek a doctor after trying a friend's medication. In my case, I just assumed that I was always going to be the way I was (super ADD), but a friend gave me an Addreall one day. I had no idea life could be so different with medication. It was mind-blowing! And it made me realise there might be other options for me out there. I never would have gone to a psychiatrist if I hadn't tried the Adderall from a friend. My doctor said it's an extremely common situation.
posted by barnone at 6:12 PM on February 4

Before you decide that it's such a fabulous idea to be completely open with your psychiatrist it might be worthwhile to investigate whether he or she has been very open with you. Googling a state web site I stumbled across the fact that a psychiatrist I was a client of had his medical license temporarily revoked a couple of years previously (at which point I'd already been working with him for a while), a fact I certainly never heard about from him or his office.

And that guy, honestly, actually seemed more professional, knowledgeable, and "with it" than the other psychiatrists I'd seen previously.

I'm not saying that you shouldn't tell your psychiatrist about the prescription meds you've tried, I just don't think there's any reason to subjugate your own judgment to his or hers or be especially trusting. You should use your doctors' expertise as you would that of a construction contractor who's working on your house or an attorney you're consulting on a legal matter.

I wouldn't think there's any likelihood that your psychiatrist is going to call the cops on you either but if you get the sort of reaction hgdq mentions and he or she starts to "judge the hell out of you and put their private frowny passive-aggressive drug seeker labels in the chart" I wouldn't take it too seriously and maybe start looking for another psychiatrist.
posted by XMLicious at 7:36 PM on February 4

What patients say to their doctors is protected by doctor-patient confidentiality (with a few legal strings attached that aren't relevant to you speaking to your psychiatrist about past Rx drug use, e.g. if you tell him at a cocktail party or if you tell him you're planning to kill someone).
posted by Capri at 8:07 PM on February 4

I would not even sweat it. Tell the doctor. You're only hurting yourself if you have information that could help your treatment and you don't contribute it. On the scale of ill-advised things that doctors see patients do to themselves, this is barely a blip.
posted by the jam at 9:03 PM on February 4

Your psychiatrist works for you. If your psychiatrist isn't giving you what you need, you should feel free to fire that psychiatrist and try someone else. If you know something works for you, I see no reason not to mention it.

When my husband was diagnosed with restless leg syndrome, his doctor gave him a few different 30 day prescriptions and said, I don't know what will work for you but these are things that have worked for other people, if one of these works for you, let me know and I will write you a prescription for more.

Meanwhile, my psychiatrist has thus far refused to give me klonopin, even though I take it largely to fall asleep or settle down on planes and the other drugs she's prescribed for my anxiety have not worked.

I started seeing the doctor who treats my husband's restless leg and I'm firing my psychiatrist. I don't feel badly about it - the drugs she has prescribed for me have not worked and the thing I know that does work is a thing that she hasn't prescribed for me. If she had prescribed something for me that had worked, this would be a non-issue.

Side note - my sister is a resident and once when she was talking about work, she brought up a patient who was exhibiting drug seeking behavior. I asked her to explain the difference, or how she could tell the difference, between someone trolling for pain meds and someone who knows what they want and won't abuse drugs. The thing that tipped her off was that this person specifically refused other pain killers and only wanted dilaudid. So as long as you're open to other drugs, you shouldn't be worried about being labeled as exhibiting drug seeking behavior. And you should probably be open to trying other drugs anyway.
posted by kat518 at 9:21 PM on February 4

Yes. But stop with the help from your friends. 1. you are reducing their supply for when they need it 2. a psych doc knows the interaction, type of drug you need and dosage. Some of them you need to taper down and one here, one there isn't going to do much unless it's a Seroquel or Benzo (which essentially makes you sleep).

This practice you have doesn't seem to be drug seeking behavior.
posted by stormpooper at 10:12 AM on February 5

No. The ramifications of being a "drug seeker" on your insurance is not worth the risk. Bea t way to go about is discussing options wrt medications for anxiety.
posted by handbanana at 11:31 AM on February 5

i've been where you are, except with ADD instead of anxiety. i'm not a "you must tell EVERYTHING" to your doctor person, but i think you should bring it up like "i'm here because i have this problem, i tried my friends drug and it helped, and i'm interested in using in more regularly." the key things is to have a story about your life that shows you have the problem.
posted by cupcake1337 at 8:37 PM on February 5