I Want My Pills!
March 14, 2013 8:32 AM   Subscribe

I've been taking ADD meds for years with the same psychiatrist, but lost my insurance last summer and had to stop taking them. Now I have insurance again and scheduled an appointment with my doctor today, but I'm worried he'll say that I'm doing just fine without the pills. However, I'm also afraid of looking too desperate if I tell him how much I want them! Can I tell him everything without sounding like I'm a junkie? Details follow.

In some ways, the structure I built while taking the pills did serve me well when I tapered off. I've been consistently on time to work (something I had a huge problem with for a while), I've been regularly using a calendar to schedule events/meetings with friends, I haven't left my wallet at home in months...stuff like that. I've even started exercising regularly!

But I work in the design industry, and the only way I got through my holiday rush of projects was by stockpiling some pills. Until I dipped back into my stockpile, it was like my brain adamantly refused to seriously work on stuff, and that was worrisome. I've also had a hard time processing my conversations with people; haven't remembered names very well, forgotten things that people have said to me, that sort of thing.

Luckily my main job doesn't have a lot of in-depth projects, but I've still been really distracted at work (click over to personal email, click over to project, click over to other project, click over to metafilter, check my work email, repeat) and the only thing that's kept me from freaking out is the knowledge that this state of mind is only temporary. Especially because I have some high profile projects coming up, and I don't know how I'll get through them if my brain stays like this.

How much of this should I tell my doctor? And will he consider my pill stockpiling problematic behavior, even though I never took more than my normal dose?
posted by brisquette to Health & Fitness (14 answers total) 1 user marked this as a favorite
Best answer: Maybe don't tell your doctor about the pill stockpiling, but definitely tell him that while you're managing, you feel that you performed at a much higher level with the medication and be prepared to give examples as you did here.
posted by mchorn at 8:39 AM on March 14, 2013 [7 favorites]

Best answer: ...but I'm worried he'll say that I'm doing just fine without the pills.

Don't be worried about this. Doctors have to deal with insurance companies a lot more than you do, and they know what a giant pain in the ass it is, and what people end up doing because they don't have insurance (i.e. not taking medication they need to take or seeking medical attention they require.) Don't mention anything about the stockpiling, and just say that you were on the medication, you couldn't afford it, and now you'd like to get back on because it makes a profound difference. That's it. No more, no less.
posted by griphus at 8:41 AM on March 14, 2013 [8 favorites]

Best answer: Spell this out for your doctor. Go over the bullet points of what you are doing well. Then list the areas that you still need help with. I don't think you will have any problem getting your meds back. I would not mention the stockpiling of pills.
posted by raisingsand at 8:45 AM on March 14, 2013

Best answer: n-thing no communicado on the stockpiling. And I definitely feel you because I'm in the same boat except no insurance and there are days when my ADHD drives me insane. I feel fortunate to have been born with a wild pack of feral cheetahs in my brain, just not so much so when the healthcare industry breaks my leash and doesn't give out warrantees.
posted by Lipstick Thespian at 9:15 AM on March 14, 2013 [1 favorite]

My MD charges me less when I've not been on insurance for ADD tune-ups and I pay not a huge amount at Costco for the generic. See if your Dr. write Rx for a double amount, so you don't have to see him as often (or post dated Rxs.)
posted by Ideefixe at 9:58 AM on March 14, 2013

Something I learned the very hard way is:

Don't obfuscate the truth or lie to your Dr. out of fear you might not get what you want or what he/she may personally think of you.

That's the surest way to sound and act like a junkie. Good doctors base treatment on what we need, not what we want.

Be honest, he is the professional whose diagnosis you are trusting your life and mental health with. If you honestly need the medication it will be prescribed to you. If you disagree with his opinion, there are other doctors who can re-approach the situation with a fresh perspective.
posted by Debaser626 at 10:58 AM on March 14, 2013 [1 favorite]

Best answer: Just tell your doc how much benefit you got from the pills, with specifc examples, and how being off of them really highlighed how much better you were with them.

That's it.

In the future, when you lose your insurance, talk to your doc, you'll be amazed at how much they'll go out of their way to help (office samples, offering lower cost alternatives/generics, etc.)

Also, now that you have insurance, bring your formulary with you. What you used to take may not be on it, but something very similary may. This happend with one of my meds. On my old formulary I had to pay $125 per month, but now I only pay $7. It's worth exploring.
posted by Ruthless Bunny at 10:59 AM on March 14, 2013

I really don't see any reason to even consider lying if the "stockpiling" was just a matter of rationing out your last refill over a few months. How could that possibly be a red flag at all? Dexedrine is not the sort of medication that you have to take at the same time every day for it to be effective, so it shouldn't be an issue.
posted by steinwald at 12:32 PM on March 14, 2013

...but I'm worried he'll say that I'm doing just fine without the pills.

This probably won't happen, but if it does, this is a perfect time to go shopping for a new doctor, because the doctor isn't listening to you. It's one thing if there's a clear abuse of a med going on, but doctors aren't typically going to monkey around with something that is working very well for you.

My wife and I have been through this with gaps of insurance and certain meds before, and we don't really go in and ask the doctor "Can you write me a perscription for these meds?" We more tell them "I've been on these meds for x years, and need to renew the prescription." This has never once caused a stir.
posted by furnace.heart at 1:09 PM on March 14, 2013

Response by poster: Thanks, guys. I think I've been selling myself short when it comes to how important my work is, and worrying that as long as other stuff is going well, work somehow isn't important enough to warrant meds.

After looking over your responses and my summary here, I think it'll be a little easier to communicate to my doctor what's working and what's not working, and I think it's clear that some things definitely aren't working.
posted by brisquette at 1:56 PM on March 14, 2013

On the "don't obfuscate the truth or lie" point, I have to say that I am nowhere near as impressed with the professionalism of the average doctor as is Debaser626. Just taking a look at your state's web site listing complaints, licensing suspensions, and other actions or the frequent discussions of how effective pharmaceutical marketing that leverages the influence of a doctor over their patients is, is enough to demonstrate that the profession as a whole is nowhere near beyond reproach or deserving of implicit trust.

If it's a medication you've been taking for years and you're acquainted with all the warnings and the literature about it, I see no reason to treat your doctor as anything other than what she or he is - a highly-paid professional who is being well-compensated to advise you, not someone you have to bare your soul to. You don't have to leave your own judgment behind at the door when you go into a consultation, especially with someone who probably isn't going to tell you about disciplinary or other actions the medical board or other regulators have taken against them unless mandated to by law, much less that they let the pharmaceutical company rep take them out to lunch at the Ritz the other day.
posted by Sockpuppet Liberation Front at 3:19 PM on March 14, 2013 [2 favorites]

Best answer: Yeah, I've been through the insurance, switching providers, and maintaining access to Schedule II stimulants more times than I can count. If you were on the same meds for years from the same doc, you're likely freaking out about nothing.

Something like this should do fine. You don't need to mention the stockpiling - though most prescribers know full well people do it.

I was on x medication for x amount of time under the care of Dr. Whatever. I have her contact info if you need me to sign a release. While I was on that medication I did well. I could meet expectations at work and take care of my life outside of work. My insurance lapsed. Since I have been off the medication I have been doing okay. I can get to work on time, meet my deadlines etc. I can even get myself to exercise. I've noticed that it is far more difficult to do these things without the medication. My work is slipping. I can't remember names, I jump from task to task more frequently. I have a hard time processing conversations. I built a really solid structure while I was on X but that structure is getting harder and harder to maintain.
posted by space_cookie at 5:41 PM on March 14, 2013 [1 favorite]

I am not sure why you are concerned - psychiatrists love to prescribe meds. That's basically what they do. I had to basically beg my psychiatrist to take me off SRRIs.
posted by radioamy at 10:57 PM on March 14, 2013

Response by poster: Guys, it went totally fine, and thanks so much for the help and reassurances.

We spent the bulk of the visit talking about my work and relationship, and yeah, at the end we started talking meds, and I pulled out a post-it note with my "working" and "not working" points on, and he wrote out another prescription like no big deal.
posted by brisquette at 9:20 AM on March 15, 2013 [2 favorites]

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