View Full Version : Choosing addictionologist pdoc over regular pdoc? I'm 101% sure I have combined add.

03-09-14, 02:28 AM
Hi, mid 20s male. I'm no medical pro, so anything I say here is my opinion and I understand that my opinion is not legit. But really been realizing lately I probably have it. I am also considering an addictionologist psychiatrist for add, and very occasional but unfortunate and persistent substance abuse for years off-and-on. The thing is, I think I was a self-medicater. And now that I have stopped, these symptoms are really coming to light ever since about a week ago when I came across some adult add/adhd article on a site called helpguide (I always hyperfocus on the net late into the night researching and looking at stuff, (not on FB though:D)). Also, never used add meds but once. When friends got seriously addicted to the pills and into worse ****, I got scared and backed out. I was always extremely careful and they would make fun of me for only taking a little bit. When they got bad, I thought "I never wanted it to be like this, I wouldn't have been involved". I think I was just into it for the self-medication. They were more habitual. If I felt I was any more than just dabbling, I would take a good break usually 3 or 5 days. I was scared of it becoming a habit. Anyway, all those friends moved away and I can't even get stuff anymore. And it was NOT add meds, it was more on the other side of the spectrum (I am against drugs and smoking, and the whole thing, and even though I was against it, i did it. I wouldn't recommend it to anybody) I moved twice with friends but had to come back home (I think because of my potential undiagnosis). Drove my friends crazy living with me. Anyway, so they say drug abuse is more like a way out. For me, I believe it was more of a way-in. I would always plan out doing all the things that I want to do so bad but never do because of my potential add/adhd. I have very gradually and I think completely stopped trying to medicate myself illegally, though I still smoke. In the past year, I don't even drink but a few beers on weekends occasionally with my dad. I have no friends cause a year ago I realized all my "friends" wanted to do was get drunk and really didn't "have my back" and weren't loyal. I was just drawn to those people because I wanted to self medicate. They didn't use drugs, just drank and smoked like mad. I have no problem not using drugs now. None of my friends do it. And when I did, I didn't even tell them. I did use add meds once, very small an sparingly for a day and the next day. The other people who took it said they couldn't sleep and I slept like a baby. It quite awhile ago, but my main memory of the experience was driving, (which is kind of a big deal with my symptoms, I've been in two accidents rear-ending people because I forget I'm driving). I didn't feel high, though I was taking small doses. The only way I could describe it is that everything just seemed to "fit". When I try to meditate, I can feel my mind trailing off, losing attention. Like I can't just think about not thinking cause I forget or something. Like I can almost see it happening. Think of a line that's moving along, getting longer you know, and it has this little curved line coming off of it, downward, that keeps bouncing off of it like a sawtooth but vertical when it comes back to the main focus line. Like my attention is literally trying to come up for air all the time or something. You know how everyone prefers to interlace their fingers and put both hands together prefers left or right, or vice-versa? Well it's like everybody told you how good and perfect and right it feels when you interlace your fingers together the right way, but you never actually did it right and when I took Adderall, it was like interlacing my fingers together for the first time. I wasn't quick or high, I actually was literally more relaxed, and able to think more. It's like I feel nervous to just ask for it but I want to be honest. I Just wanted to run it by and see any of your thoughts or experiences with addictionologist pdoc compared to regular pdoc or my symptoms. His office is actually a place for suboxone, but I'm told by my parent I should go there. My parent is in medical field and going with me as I recently came clean about my drug usage and my need to get evaluated and I already said what med I did and that it worked for me and I think I need it. I will tell doc I am open to whatever he thinks is right as I am no professional. My parent is going with me. Perhaps they test me to make sure I'm not doing anything while my parent locks up the add meds... And I go to the counseling services, just like the people that get bupe/sub ox there? He has been in practice for like 34 years or something like that so he hasn't been treating just sub and opiate addicts forever, that's for sure. Is he more prone to blacklist me or not get the medication I'm interested in, or more willing to understand the self-medication since he's in addictionology? When I say understand the self-medicating, I'm talking about many cases I have read on these forums where people have substance abuse problems, and then they get on adderall and they quit everything, including smoking cigarettes, and have no urges to ever go back? I've never had any physical dependence to anything, or any real cravings. Just like, "Oh I wish" once in a while. I still smoke smoke smoke, though. My susbstance abuse was never to "take away" it was to "add to" which my old therapist asked me and said that was a decently good sign that it's not an addiction or at least not as bad of one. Oh yea and I talked to him about OCD. I can trace my first potential ADD symptoms affecting me back to first grade, same time OCD started. I got rid of all my fears and we couldn't figure out why I still had the anxiety that needed to get pushed out by the OCD, but I think the ocd is a causal effect resulting from me having Add. The OCD is very mild, and doesn't affect my quality of life. I have reduced it so that it's only in my eyes, not doing any physical things any more like touching things. I transferred it to my eyes and all I do now is count things and spaces between things up to one of the first ten-or-so fibbonacci numbers. Maybe it's because I'm really smart and people always think I'm stupid until they learn I'm really not and it hurt my self esteem, and I feel smart again by being "in tune" with the fibonacci numbers, like it's some secret knowledge or something. Anyway the ocd is under control, and the whole add thing really affects my life. I've been hyperfocused on add stuff on the internet for the past week, ever since I realized it. And I even haven't been able to sleep cause I'm so focused on it and excited that I think I finally figured out what's going on with me, and how to fix it. So any experiences with addictionologists treating your add with adderall or just in general. Or any other advice you might have. And next paragraph is just some of my symptoms. And I mean SOME. Any Advice Appreciated, thank you! Best of luck to everyone with add, or not, or whatever troubles!

03-09-14, 08:22 AM
Ok, just a side note but it was kinda hard for me to read your post because it was a huge wall. It helps if you break up your paragraphs with spaces and such because alot of us cant read a huge block of text. Any how...

What is an addictionologist? I have never ever heard of this. I have heard of a psychologist with and addictions counseling specialty or a psychiatrist with some sort of training to deal with prescribing suboxone for opiate addicts but I have never heard of the kind of doctor you mention.

If you want to stop using drugs (you havent said which ones or how much so I am not sure) you should see a therapist that specializes in addictions. Someone that can help you figure out why you use and what kinds of behavior changes you need to make so you dont relapse. These behavior changes will be the key in preventing a relapse. Yes, untreated adhd can make people self medicate to make the symptoms lesson and yes stimulants can help but you havent said what kind of adhd symptoms you have or long have had them so I am not sure of what it is you would be treating. I suspect though if you are going to see a doctor that deals with addiction, especially opiate addiction, he is not going to be so keen on treating you for something other than opiate addiction. I mean if you do have a problem with opiates then go for it, I am just not sure if he would be the right doctor for you if you have other addictions. Its going to be very hard for a very long time to get a doctor to treat you with stimulants. Doctors freak out with addicts and without a commitment to real treatment with real behavior changes I am not sure they would be willing to write you a script anytime soon even if you have a parent willing to handle meds for you. I urge you to consider inpatient or outpatient addiction treatment first. Its more important to figure out why you use and what you can do not to than it is to get adderall.

03-09-14, 10:50 AM
Only read the first couple sentences but if you feel you need to go so the doctor GO!

The best course of action I would recommend.

Go see your PDOC

Get a Referral to get a ADHD evaluation by a psych(behavior therapist,psychologist,psychatrist) Your PDOC will recommend someone.

Go see said psych and be accepting of whatever diagnosis comes your way if any at all.

Then begin treatment if required.

03-09-14, 03:50 PM
Yeah, I also think therapy is the place to start. And if you're dealing with an active addiction then inpatient would be optimal since it gets you away from life and everything else that makes it possible to use. It's near impossible to diagnose ADHD, anxiety, depression or anything else that might cause someone to self-medicate unless the self imposed "medication" is withdrawn for a period of time. Once that baggage is stripped away, you can start working on what got you there in the first place.

Also, the first pdoc I went to for ADHD specialized in both addiction and ADHD. It seemed like a wise choice after I'd been clean and sober for 2 years, and he did indeed diagnose me with ADHD after an extensive evaluation that included everything but a cavity check.

Unfortunately, he immediately declared that he would NOT prescribe any stimulants at anytime for my treatment. I wasn't after stimulants and had hoped for successful results by other means in the first place, but to remove anything from the table before we got started was a huge warning sign.

I left, but ultimately I ended up with a PNP who doesn't specialize in ADHD or addiction, but has ADHD and understands addiction who has treated me successfully with stimulants ever since.

A good psychologist is a place to start, but even the best may not be able to do much good if you continue to use. Just know that freedom is there if you really want to go for it.

03-09-14, 05:20 PM
I guess I didn't specify hard enough, so everyone knows: I smoke cigarettes and pot daily. If I don't smoke pot before class, I get ornery and irritable and keep losing focus like every few seconds. I do that with pot but not as bad. I used to use opiates, in very small amounts. I never built a tolerance, and never consecutive days or never been dependent in any way. Always scared of overdoing it or getting addicted. So the only thig I think I'm addicted to is cigarettes and maybe weed but I don't mind if I don't have it for a day at all. And I want to stop cigarettes bad. My cigarette habit literally lives cigarette to cigarette, I'm always "about to" quit. Just like everything else I "want to do". It's like I have motivation to do great things and function at home and take care of myself, but that motivation never materializes outside of my head, and I'm sick of people thinking I'm lazy or stupid. My opiate use is very minimal, I'm talking like once every two or three weeks if not less. And in very small amounts. I just know that adderall would help me a lot.

03-10-14, 04:42 AM
The general rule for many pdoc's for using stimulant medication in treating ADHD is minimum 6 months clean for people with substance abuse. Many, but not all. The reason being that no matter what the current symptoms may be, the one diagnosing has no idea if these are residual from abuse and withdrawal or the actual underlying cause.

For instance, if I go to a pdoc for severe anxiety and tell him that's why I drank, he really has no way of knowing if it's true or if it's withdrawal. Especially if it's only been days or weeks of my last binge. It really does take the brain a while to shake off the after effects. And it's possible that they may refer me to a psychologist before any thought of prescribing meds is considered.

These things can apply to pot use just as much as X, oxy, coke, speed, heroin, etc. "Occasionally" is normally held in the same regard as "always". Also, if one walks in with a self-diagnosis of ADHD and recommends stimulant treatment, and especially by naming which one, it's pretty well guaranteed a pdoc will see you as a drug seeker. These days there's too much liability for any docs to prescribe schedule 2 meds haphazardly.