Help Me With Doctor Anxiety Concerning Prescriptions
September 2, 2014 7:51 AM   Subscribe

Can anyone give me some advice on how to approach my doctor about wanting a prescription? I feel like a "drug seeker".

The sitch: I was on Vyvanse for several years for adult ADD and stopped in 2010 due to a lifestyle change. Back then I was able to get things done through coaching and the short-burst productivity nature of my job at the time, so I felt that medication was no longer necessary. Things have changed back after a switchup in careers (money too good to pass up) and I am feeling that I need to ask my doctor if medication is a good idea again.

Thing is, I have moved recently and I've only been to my new doctor once so far. I feel like if I come in the door asking about what basically amounts to speed I am going to sour our doctor/patient relationship irrevocably. The dreaded "drug seeking" on the clipboard.

Is this rational? If so, what is my course of action here?
posted by Willie0248 to Health & Fitness (12 answers total) 4 users marked this as a favorite
Vyvanse isn't like antibiotics; you don't take a course of it and your ADHD goes away. It's a medication that is prescribed to be taken regularly, and compliance with it means you actually take it regularly. If a legitimate doctor prescribed it to you and you decided to stop taking it because your ADHD wasn't making life as hard as it usually was because of the context of your job, you stopped complying with doctor's orders (or came to an agreement that your ADHD wasn't effecting your life so much you felt a need to be medicated.) But the fact remains that the ADHD is still around.

Now you want to do the correct thing and start taking again the medication a doctor originally told you you should take. You're not drug seeking; you're simply doing what a doctor previusly advised you to do. If you can substantiate your previous prescription, it shouldn't be an issue unless you just walk in there saying "gimme some Vyvanse, doc." Just sit down, relate your history just as you did here, and it should be pretty clear you're no longer in a situation where your quality of life can be kept up while your ADHD remains untreated.
posted by griphus at 8:03 AM on September 2, 2014

Vyvanse, though a stimulant, is hardly the sort of drug that drug seekers are going to be asking for. It's completely reasonable for you to tell your doctor that you used it in the past and feel like it could be helpful again. However, be prepared for the possibility that he might tell you that psycho-active drugs are not inside his sphere of competence, and that he would prefer you to see a psychiatrist.
posted by ubiquity at 8:04 AM on September 2, 2014 [1 favorite]

Oh, that's a very good point. I had been under the assumption you'd be asking this from a psychiatrist. Don't ask a GP for this; on a general basis they're not equipped to monitor you for any issues that long-term stimulant use might present. Get a referral for a psychiatrist.
posted by griphus at 8:05 AM on September 2, 2014

Is your anxiety really because you'll be acknowledging you didn't comply with the last doctor's instruction? Just rehearse the script. "Hey doc, I have ADD, I was diagnosed back in 2008 and was prescribed Vyvanse, which worked pretty well for it. In 2010 I had a job that I figured the ADD wouldn't really hurt, so I stopped taking the medication, but I regret it now and I really need to go back on. Can you re prescribe it for me?" and if he says you need a psychiatrist to do it, "can you refer me to the right person?"
posted by fingersandtoes at 8:06 AM on September 2, 2014 [1 favorite]

This "I don't want to be a drug-seeker" thing is anxiety talking. You're not in the ER with a sprained ankle screaming for vicodin. You have previously taken this medication, went off it, and have decided that on it is where you want to be again. You ARE seeking this medication - to take for a permanent condition you have, which is the appropriate use for the drug.

Don't go in there saying "hey doc, I heard this Vyvanse shit sells for $25 a piece, hook me up with some of that" and you will be fine.

Even if you were getting it to sell, the doctor doesn't give a shit unless you are trying to wheedle more than he's legally allowed to prescribe at one time.
posted by Lyn Never at 8:07 AM on September 2, 2014

Don't ask a GP for this; on a general basis they're not equipped to monitor you for any issues that long-term stimulant use might present.

GP's are significantly more equipped than most psychiatrists to monitor long-term stimulant use, insofar as any issues will present as general medical issues.. They may not be as able to monitor the appropriate control of you ADHD symptoms, however.
posted by OmieWise at 8:10 AM on September 2, 2014 [2 favorites]

You can usually pay a fee to have your file from your old doctor transferred to your new one.

It's pretty common for people with ADHD to start and stop medication often. I mean, you DO have ADHD. ;)

Also, Vyvanse isn't usually the first choice for "drug seekers". It's a pro-drug that only activates in the gut, so it takes 1-2 hours to kick in, you can't snort it and there's very little up/down on it. It's generally regarded as low abuse potential in terms of ADHD meds. Someone seeking prescription speed will most likely be asking for Aderall or Dexedrine.
posted by tenaciousmoon at 8:33 AM on September 2, 2014 [1 favorite]

Just bring your medical records from when you were on Vyvanse. You're much more likely to get a prescription for something you've been prescribed before and can therefore say you know it works for you.
posted by Jacqueline at 8:52 AM on September 2, 2014 [1 favorite]

I don't think you have to worry about looking like you're seeking drugs; it's a medication you've used before for a condition you still have. Bring your past records or have them transferred.

Now, who to go to. You don't say if your new doc is a GP or a psychiatrist, but I think it makes sense to go to the latter in your situation. If the dose you were on wasn't having a noticeably helpful effect before, consider that you may need to test new doses and maybe new medications (which of course you must do with a specialist by your side). You could start the conversation there.

Ongoing—Vyvanse (like all ADHD meds) is Schedule II and ongoing prescriptions can't be written without a new assessment/appointment every 90 days, so it's not unusual to go to an in-network GP for the quarterly check-ins and new prescriptions rather than an expensive specialist. In fact, my psychiatrist actually offers to do this after the first check-in for this specific reason.
posted by peachfuzz at 9:53 AM on September 2, 2014

Psychiatrist is going to be good for this. You have significant anxiety and balancing that with your need for ADHD medication is important.

Also, many to most GPs literally refuse to prescribe this class of controlled substance. I think that's too bad but it is what it is.
posted by the young rope-rider at 10:09 AM on September 2, 2014

Just talk to your GP about your history with the drug and tell him/her that you want to get back on it.

No doc it going to think you're some kind of addict or anything.
posted by Ruthless Bunny at 6:23 PM on September 2, 2014

Nthing that if you're coming in stating that you have a history of AD/HD that was successfully treated with Vyvanse, you've been off Vyvanse for a while, and you'd like to try it again, a doctor is extremely unlikely to see that as drug-seeking. However, if you're concerned, you're concerned. One concrete thing you could do is list a few ways you think your AD/HD is affecting your performance at your new job, and why that wasn't a factor at your last job. That might help calm your anxiety and will help give your doctor a good sense of the degree to which your AD/HD is affecting your life right now.
posted by epj at 6:08 PM on September 3, 2014

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