View Full Version : What could we do to help reduce methylphenidate abuse?


mildadhd
11-03-16, 10:06 PM
I have been thinking about the book "ADHD Nation", by Alan Schwarz.

And I have been wondering what we could do to help to reduce methyphenidate abuse?


G

mildadhd
11-03-16, 10:45 PM
Obviously the fact that methyphenidate abuse exists, means that taking methylphenidate is not always as safe as taking Tylenol.

Maybe we should stop telling new members that methyphenidate is as safe as Tylenol?


G

namazu
11-03-16, 11:30 PM
Maybe we should stop telling new members that methyphenidate is as safe as Tylenol?
Absolutely. ...Acetaminophen is hard on the liver and it is associated with far more injuries and deaths from overdose (http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/UCM164897.pdf) than methylphenidate.


Any prescription medication (or even food or supplement or psychotherapy) that has effects on the body/brain also has the potential to cause adverse effects. It's important to be aware of the potential risks of any form of treatment -- and also of failure to treat.


People with ADHD can avoid methylphenidate abuse by:
- Seeking out a careful diagnosis from a qualified professional;
- Educating themselves and weighing the risks and benefits of medication carefully;
- Disclosing any personal or family history of substance abuse (especially of stimulants) to the doctor and having a frank discussion about minimizing risks;
- Taking medications as prescribed and staying in close contact with the prescribing doctor;
- Seeking out other forms of treatment and support;
- Asking for help immediately if they find themselves taking more than prescribed.

ADDF members can help reduce methylphenidate abuse in general by:
- Storing medications in a safe place;
- Not advertising to others that they take methylphenidate;
- Not sharing medication with anyone else (even if they have ADHD or a prescription), and not selling methylphenidate;
- Disposing of unused medication through safe prescription "take-back" events;
- Advocating for better awareness, diagnosis, and treatment of ADHD; and
- Probably in other ways?

[EDIT: Also...
- Recognize that methylphenidate is not a panacea;
- For parents of kids taking methylphenidate: Talk with your kids (in general, about medication use and any side effects, and about using it responsibly and not sharing/selling it).]

What are your thoughts on how we could reduce methylphenidate abuse?

mildadhd
11-04-16, 12:22 AM
Absolutely. ...Acetaminophen is hard on the liver and it is associated with far more injuries and deaths from overdose (http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/UCM164897.pdf) than methylphenidate.


Any prescription medication (or even food or supplement or psychotherapy) that has effects on the body/brain also has the potential to cause adverse effects. It's important to be aware of the potential risks of any form of treatment -- and also of failure to treat.


People with ADHD can avoid methylphenidate abuse by:
- Seeking out a careful diagnosis from a qualified professional;
- Educating themselves and weighing the risks and benefits of medication carefully;
- Disclosing any personal or family history of substance abuse (especially of stimulants) to the doctor and having a frank discussion about minimizing risks;
- Taking medications as prescribed and staying in close contact with the prescribing doctor;
- Seeking out other forms of treatment and support;
- Asking for help immediately if they find themselves taking more than prescribed.

ADDF members can help reduce methylphenidate abuse in general by:
- Storing medications in a safe place;
- Not advertising to others that they take methylphenidate;
- Not sharing medication with anyone else (even if they have ADHD or a prescription), and not selling methylphenidate;
- Disposing of unused medication through safe prescription "take-back" events;
- Advocating for better awareness, diagnosis, and treatment of ADHD; and
- Probably in other ways?


What are your thoughts on how we could reduce methylphenidate abuse?

Thanks.

-Along with the list you have posted.

-I would never label methylphenidate as the first line of treatment, because other forms of treatment must be first explored. (Medication should be the last line of treatment, in any diagnostic process.)

-prescriptions should only occur after lengthy diagnoses process so that any possible misdiagnosis or intention of abuse have been ruled out.

-doctors diagnosing and prescribing medication should be monitored.

-the awareness of the dangerous gateway effects of performance enhancing methyphenidate on a brain of someone who does not have deficits of self-regulation.

-awareness of other forms of treatment for promoting brain development before age of medication is even an option.

All members thoughts would be appreciated..


G

Jeftheginger
11-04-16, 12:45 AM
Nah you guys covered it. You know much more than me I just try to understand what I am reading.

sarahsweets
11-04-16, 04:54 AM
Thanks.

-Along with the list you have posted.

-I would never label methylphenidate as the first line of treatment, because other forms of treatment must be first explored. (Medication should be the last line of treatment, in any diagnostic process.)
What makes you say this? In depression for example, a patient must often get stable on meds before they can even attempt other measures of intervention.

-doctors diagnosing and prescribing medication should be monitored.

IME they are monitored- sometimes too much to the point of not prescribing any controlled medications.

Simargl
11-04-16, 11:30 AM
I'm grateful that I'm able to take methylphenidate. I was refused medication and a proper diagnosis 5 years ago.

I come from a family with an addictive background. I think I might have an addictive personality. I know I've been a thrill seeker in my past. I've been able to turn off most of that though. I don't know why or how but I don't want to drink to excess and I don't want to take recreational drugs. I don't have any desire or need to be inebriated. It wasn't a struggle for me to stop those behaviors. I know that's not how it works for most people. I know I'm lucky in that regard.

I don't abuse my ADHD meds. I don't have any desire to abuse my meds. I have the amount I need for the day on me and that's it. I keep the rest at home in a safe place. I don't think anyone I know would steal my medicine.

I think the list that Namazu posted is sufficient.

I think that if someone wants to get high-- they're going to get high. If someone wants to get a hold of a substance badly enough-- they'll get it. This is with any drug that offers a desired high.

I think pushing for ADHD awareness could help. Everyone has their preconceived notions of ADHD and most of the time those notions are incorrect.

Greyhound1
11-04-16, 11:50 AM
Absolutely. ...Acetaminophen is hard on the liver and it is associated with far more injuries and deaths from overdose (http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/UCM164897.pdf) than methylphenidate.


Excellent point Nam! Acetaminophen is one of the most abused drugs around. It is the leading cause of liver failure in the US and poison control centers receive more calls about it than any pharmaceutical medication.

Lunacie
11-04-16, 01:12 PM
Thanks.

-Along with the list you have posted.

-I would never label methylphenidate as the first line of treatment, because other forms of treatment must be first explored. (Medication should be the last line of treatment, in any diagnostic process.)

-prescriptions should only occur after lengthy diagnoses process so that any possible misdiagnosis or intention of abuse have been ruled out.

-doctors diagnosing and prescribing medication should be monitored.

-the awareness of the dangerous gateway effects of performance enhancing methyphenidate on a brain of someone who does not have deficits of self-regulation.

-awareness of other forms of treatment for promoting brain development before age of medication is even an option.

All members thoughts would be appreciated..


G

In response to the bolded paragraph . . . your opinion seems to be at odds with the medical profession.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616598/

"Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder of childhood that can result in significant functional impairment, and if not adequately treated can lead to impaired quality of life. Pharmacotherapy is considered the first-line treatment for ADHD in children and adolescents."

When properly administered, stimulants have a minimal risk of unwanted side effects and/or abuse.

"Psychostimulant treatment was reported to normalize the rate of cortical thinning seen in children and adolescents with ADHD compared to a more rapid cortical thinning in unmedicated ADHD patients."

Those with untreated ADHD are MORE likely to have substance abuse disorders.

". . . stimulant therapy in childhood was found to be associated with a reduced risk of subsequent cigarette smoking and alcohol and substance use disorders compared to untreated patients."

The link above also discusses some of the unwanted side effects of non-stimulant medications which are generally less effective.


In summary . . . more information about the benefits of stimulant treatment to counteract the fear-mongering about "drugs" would be helpful IMO.

Little Missy
11-04-16, 01:21 PM
Honestly, I had no idea that Ritalin was such a problem.

A lot of hungry and a headache if you asked me.

aeon
11-04-16, 02:11 PM
I would never label methylphenidate as the first line of treatment, because other forms of treatment must be first explored.

Yet, medication is consensus first-line treatment for ADHD because the clinical data demonstrates its efficacy.

As to whether other forms of treatment must be explored first, thatís down to the patientís needs, and license/legal parameters. I can appreciate if that is your perspective, but it isnít an objective truth.

(Medication should be the last line of treatment, in any diagnostic process.)

To my mind, there should be no treatment of any kind whatsoever in any diagnostic process. Only when a diagnosis is made at the end of the process can a proper course of treatment (of whatever kind) begin.


Cheers,
Ian

Greyhound1
11-04-16, 03:09 PM
Yet, medication is consensus first-line treatment for ADHD because the clinical data demonstrates its efficacy.

As to whether other forms of treatment must be explored first, thatís down to the patientís needs, and license/legal parameters. I can appreciate if that is your perspective, but it isnít an objective truth.



To my mind, there should be no treatment of any kind whatsoever in any diagnostic process. Only when a diagnosis is made at the end of the process can a proper course of treatment (of whatever kind) begin.


Cheers,
Ian
I don't want to get too off topic but I respectfully disagree with you about no treatment without diagnosis. I wasn't officially diagnosed until after I began treatment for a month. My Dr. felt certain I had ADHD after several types of evaluations. The final evaluation was how I responded to treatment and then she made the diagnosis.

I guess she could have made the diagnosis before treatment began but this was the last confirmation she needed. I am glad she did it that way because I needed time to accept a possible ADHD diagnosis.

I felt and saw all the improvement in my life from treatment which made accepting it as a valid diagnosis much easier. I was very doubtful at first and treatment convinced me just how right she was.

Sorry for the side track

Cheers

mctavish23
11-04-16, 03:45 PM
I've posted this before, but it never hurts to remind us :

The (12+ yr. evidence based/research derived & supported) data on the use

of ANY stimulant (by an informed physician (as to whether or not someone

with ADHD also has a history of substance abuse) for the treatment of ADHD,

DECREASES the likelihood of a Substance Use Disorder (SUD); by decreasing

impulsivity.

Furthermore, those data also reinforced the fact that children diagnosed with

ADHD, and treated with stimulants, were NOT at risk for future substance

abuse.

Therefore, in light of the above, my personal opinion as to the OP's question,

is for "us (as an ADHD community)," to continue promoting the evidence

based diagnosis and treatment of ADHD.

Valid and timely question to raise. Thanks.


tc

mctavish23

(Robert)

aeon
11-04-16, 04:09 PM
I don't want to get too off topic but I respectfully disagree with you about no treatment without diagnosis. I wasn't officially diagnosed until after I began treatment for a month. My Dr. felt certain I had ADHD after several types of evaluations. The final evaluation was how I responded to treatment and then she made the diagnosis.

I guess she could have made the diagnosis before treatment began but this was the last confirmation she needed. I am glad she did it that way because I needed time to accept a possible ADHD diagnosis.

I felt and saw all the improvement in my life from treatment which made accepting it as a valid diagnosis much easier. I was very doubtful at first and treatment convinced me just how right she was.

Fair call, and I should have been more explicit about the formal diagnosis (what the medical record says, what the bill says), and the internal process of discernment by the medical professional where they consider the data, come to an informal diagnosis, and then engage in an initial treatment regimen to test their arrived-upon conclusions.

I know I consider the meaning of the word ďdiagnosisĒ in terms of its Greek language roots. Whether that has any relevance to modern procedure or theory of medicine, I do not know, as I didnít go to medical school. ;)

I just get on thar interwebs sometimes and try to sound like I know a little sumptiní. :D


Thanks,
Ian

Greyhound1
11-04-16, 05:51 PM
Fair call, and I should have been more explicit about the formal diagnosis (what the medical record says, what the bill says), and the internal process of discernment by the medical professional where they consider the data, come to an informal diagnosis, and then engage in an initial treatment regimen to test their arrived-upon conclusions.

I know I consider the meaning of the word “diagnosis” in terms of its Greek language roots. Whether that has any relevance to modern procedure or theory of medicine, I do not know, as I didn’t go to medical school. ;)

I just get on thar interwebs sometimes and try to sound like I know a little sumptin’. :D


Thanks,
Ian
I totally get your point and agree with it for most situations.

You know lots of sumptin's Ian, including Greek definitions!
I had to go look it up.:)

mildadhd
11-04-16, 07:04 PM
I am presently taking methylphenidate, to help treat my deficits of self regulation.

This thread is about reducing methyphenidate abuse.

I can go down to the rough areas of town and buy methyphenidate.

I can go to the university and buy methyphenidate.

Where are the people getting the methyphenidate?

The people that are selling the methyphenidate must be getting the methyphenidate through intentional and unintentional misdiagnosis?

Thoughts?


G

mildadhd
11-04-16, 07:11 PM
Sarahsweets.

Here is an example.

Reducing sugar intake for a couple of weeks and other forms of treatment are first and second and third and... lines of assessment /treatment for the children possibly being diagnosed by these doctors in this video, before methyphenidate.

Everyone should be receiving a similar "complete assessment" during diagnosis, to help reduce misdiagnosis and methyphenidate abuse.


http://m.youtube.com/watch?v=KqpmIgg15_Y


G

namazu
11-04-16, 08:44 PM
Where are the people getting the methyphenidate?

The people that are selling the methyphenidate must be getting the methyphenidate through intentional and unintentional misdiagnosis?

Thoughts?
It is probably a combination of people who were misdiagnosed and people with valid ADHD diagnoses who are not taking their medication as prescribed.

For example, I have a cousin with ADHD who was prescribed Adderall, which helped her a lot. She couldn't afford the medication on her own, and had "friends" who offered to pay for it if she'd give them some. :(

karenparker
11-04-16, 09:01 PM
I am presently taking methylphenidate, to help treat my deficits of self regulation.

This thread is about reducing methyphenidate abuse.

I can go down to the rough areas of town and buy methyphenidate.

I can go to the university and buy methyphenidate.

Where are the people getting the methyphenidate?

The people that are selling the methyphenidate must be getting the methyphenidate through intentional and unintentional misdiagnosis?

Thoughts?


G
To be honest, I'm not sure I understand what you mean.

Are you talking about people who take ADHD medication to get high, or about people being over-diagnosed, or...?

Well, if it's the former, then my take on it is, certain amount of people will always get high for whatever reason, on whatever they want - be it cocaine, amphetamine, heroin, LSD, hash, methylphenidate, alcohol or anything else.
Some people see the solution to that in even stronger substance control.
I personally think it only makes the issue worse. In my opinion education, harm reduction and different approach to regulation are better ideas. There are also many strategies, that are supposed to prevent people from finding themselves in the situation, when they're most vulnerable to substance abuse, in the first place. One of those could be, for example, diagnosing and medicating ADHD appropriately, since untreated ADHD can lead to substance abuse. Ta dah!

But in general I don't think people will ever stop using drugs completely, be it illegal or legal substances.
And in all honesty, I don't think this should worry us, at least provided we're already having a sensible, realistic approach (which I don't think we do, but that's for another discussion).
I personally don't care about people abusing ADHD drugs. I don't support it, I don't fancy the idea and I would probably not be close friends with those people, but I think it's obvious that every substance that has a potential to be used in a recreational way will be used this way by some.

My issue is, that many people fail to recognise, that the fact that something can be used this way, doesn't mean it will be, by a person that actually needs the med X to function. People, including doctors, seem blind to the fact, that even thought ADHD meds can be abused, it doesn't mean they're not effective or that they're harmful when used correctly by people who are diagnosed with the disorder. And in terms of addiction, as I mentioned before (and as others mentioned before me), the studies generally suggest that it's less likely for a medicated person with ADHD to actually have substance abuse tendencies. So there we go.

And yes, abuse of ADHD meds can lead to multiple issues for people with the diagnosis who want to take them to relieve the symptoms. Nevertheless, in my opinion, its not the abusers that's the issue here, but rather the complete ignorance of the medical community combined with the terrible stigma, as well as the lack of any reasonable drug policy.

____

Now, as for over-diagnosis, I'm not sure.

I don't know what the prevalence of over-diagnosis is among children or adults. I can imagine there are some issues with that, because, sure, you'll have lazy parents, and you will also have bad doctors that don't care and will prescribe anything.

Actually, does anyone know in what ways the (early?) childhood experiences affect brain development? I have been wondering, because people scream that "it's not ADHD, it's lazy parenting!", but I keep thinking that sure, it's true in some cases, but then can it not affect the brain in a way that would lead to rather permanent impairment? If so, what's the difference? How is a child with bad parents more deserving of a ****** and frustrating life, than one that was born this way?

Anyway, now, you're saying "reduce misdiagnosis and methyphenidate abuse". Are you just referring to every person that might potentially be wrongly diagnosed and be prescribed ADHD meds?
I might be wrong, so please someone correct me if that's the case, but I think if someone genuinely has some issues that seem to mimic ADHD, I don't think this situation would lead to abuse. I think the bigger issue here is those people not receiving treatment they should, but if they stick to prescribed doses of stimulants I fail to see how that could lead to more abuse

And then if someone is simply manipulating the doctor to get the meds for recreational purposes, we're essentially back to square one. People will always want to get high, and some people will always be able to lie in a convincing way to a pdoc. That should probably just be addressed altogether with the rest of the drug issues in the ways I mentioned before. IMO it's the causes of that situation that we should try to resolve, instead of trying to add even more regulations and restrictions.

_____

I wrote so much and I'm still not sure I actually understood what we're talking about here. :confused:

Edit:
As for the sugar intake, I am pretty damn sure it has been well proven by many studies, that it has absolutely nothing to do with hyperactivity and ADHD symptoms.

Joker_Girl
11-04-16, 10:59 PM
I don't care if people want to abuse any kind of drugs because it's not my business, people have been abusing any and every psychoactive substance as long as there have been people, and it is not for me to say it's right or wrong.

It's only been considered morally wrong in the last hundred years if even that. Before as long as you could handle your drugs, it wasn't seen any different than drinking.

As long as I can get what I need, it's whatever. As long as people can keep themselves in check and their drugs and drinking or whatever they're into isn't hurting anyone, more power to them. I don't have any right to be the buzz police.

I can't imagine the high is that fabulous, but it's whatever I guess.

Tightening the screws down won't help. People who need meds will suffer, and the pill snorters will just switch to crack. And then, they will suffer.

If I don't take my pills, my brain just runs wild and I will get in trouble my own self.

FogNoggin
11-05-16, 03:30 AM
Self control, no Dr, can prescribe that.
She seemed more concerned with my marijuana and beer drinking habit saying that she was concerned how it would interfere with assessment, BS, she wanted to see if I had a drug habit or if I am drug seeker.
I am a drug seeker alright, i seeked my own meds, and am aware when I need to trim it, like today, two days no stims to avoid tolerance and total dependence.

They really help,

I just seeked me some Modafinil (provigil) and Armodafinil, they are supposed to be the cats bottom for ADD/ADHD people.
Super motivational, used by airforce pilots to maintain alertness and focus.
My ADD I can handle, my main problem is motivation.

If I can't get help due to some Doc's preconceived ideas and prejudices, I'll find my own way.
Wow, it's 4:16am and I've got a busy day of drinking and debauchery and teasing my cats ahead of me tomorrow, a sac and a case of beer tomorrow I'll shall seek.

Ta!Ta!

FogNoggin
11-05-16, 04:03 AM
I understand the flak I am going to get.
(looks at watch)

But me being me I am going to do what I am going to do.
I am not stupid, I do research, I am careful.

I don't condone what I do.

It's the way she goes....
http://thumbs.newschoolers.com/index.php?src=https%3A%2F%2Fi.imgflip.com%2Ffw3fb. jpg&size=400x1000


And it's 5:05 am

mildadhd
11-05-16, 09:49 AM
We are all suppose to have a complete assessment, before being diagnosed (or not).

The idea is not something new.

A complete assessment is suppose to be done every time, by the doctor(s), when deficits of self regulation are suspected.

Complete assessments are extremely important in helping to reduce possible misdiagnosis.

Everyone of us should care about people being misdiagnosed.




G

Little Missy
11-05-16, 09:59 AM
We are all suppose to have a complete assessment, before being diagnosed (or not)

The idea is not something new.

A complete assessment is suppose to be done every time, by the doctor(s), when deficits of self regulation are suspected.

A complete assessment is extremely important to help reduce possible misdiagnosis.




G

Maybe you could be on The Proper Assessment Committee. I don't know of any in the U.S.

karenparker
11-05-16, 10:36 AM
We are all suppose to have a complete assessment, before being diagnosed (or not).

The idea is not something new.

A complete assessment is suppose to be done every time, by the doctor(s), when deficits of self regulation are suspected.

Complete assessments are extremely important in helping to reduce possible misdiagnosis.

Everyone of us should care about people being misdiagnosed.

I am really curious, where exactly you see the issue. So far you've only made some statements and haven't supported it with much arguments.

Not to mention, it all really is not black and white, and there are no simple solutions to complicated problems, which seems to be what you're looking for.

@Joker_girl, you're awesome, you managed to put exactly what I wanted to say, but in a much more coherent way and 1/4 of words.

FogNoggin
11-05-16, 11:29 AM
I think a lot of Dr.'s are highly motivated people who are good at memorising things in med school, not necessarily highly intelligent or brimming with wisdom.

Has any Dr. helped you any better than you could help yourself with your ADD?

Ever left the Dr. thinking, 'Thanks for nothing'.

Well, I have.

I know myself better than ANYBODY else, why do you need a Dr. for ADD? You know you have it, you've been diagnosed, They are just that wall between you, and the medication you want. That's why you went to the Dr.

A drug abuser is going to abuse, the careful person will be careful.

Face it, it's true.

But don't take my advice,...I ain't no Dr.. ;)

Greyhound1
11-05-16, 11:56 AM
I think a lot of Dr.'s are highly motivated people who are good at memorising things in med school, not necessarily highly intelligent or brimming with wisdom.

Has any Dr. helped you any better than you could help yourself with your ADD?


Yes. I never considered ADHD to be the root cause of my issues. Neither did the many Dr's and specialists I sought out for over a decade.

I spent 45 years with serious struggles, multiple comorbid issues and being undiagnosed. I hug my smart Dr. every time I see her. She changed my life for the better. I could have never helped myself more than she has.

karenparker
11-05-16, 12:14 PM
I... kind of agree. The sad truth is, in every profession there is probably just a few % of people that actually know what they're doing and doctors are no different.

I hate it. I truly hate being the patient and seeing my doctor has no clue what they're talking about or straight on noticing that they're simply not even being logical. I hate it because I always assume I don't know any better as it's not me who spent a decade learning this stuff. And I'm anything BUT a person that reads something once in a questionable source and thinks they know everything now.

BUT, as greyhound says, a good doctor is an amazing doctor and helps way beyond we can help ourselves. It's worth looking for one and trusting then when we find them.

But then again, not much that can be done here. There's only so many intelligent and open minded people on earth, and they can't all become medical professionals, and even then it would be too litle.

mctavish23
11-05-16, 12:34 PM
The research I previously referred to readily acknowledges stimulant abuse. At the same time though, those data

also point out that "Most cases of stimulant abuse are among adolescents and adults who are not treated for

ADHD." However, that's not to say it doesn't happen; just not to an evidence based degree of significance.

As to the source of said stimulants, I have no clue.

As I stated earlier, the most we (as an ADHD community) can realistically do, is, in my opinion, to continue to

promote the use of education on the science behind the disorder, in order to dispel myths, and reinforce the use

of evidence based diagnosis and treatment.

Thanks.


mctavish23

(Robert)

FogNoggin
11-05-16, 12:53 PM
Myself, I go to my Nurse Practitioner (Not a full fledged Dr.btw)

She is more concerned with my self medication habits like my 1 or 2 case (12 packs) of beer a week and my daily pot use, than actually helping me with the reason why I go for those things to begin with.
I knew she didn't want to refer me to a Dr. who could actually prescribe me meds that I actually needed.
She was (in my mind) a barrier between me and ADD drugs that would actually address the problem as she had me pegged as a drug seeker, and not as someone who was desperately self medicating.

Haven't seen her in well over a year now, don't really want to either.
Took matters into my own hands, and better off for it.

karenparker
11-05-16, 01:26 PM
Myself, I go to my Nurse Practitioner (Not a full fledged Dr.btw)

She is more concerned with my self medication habits like my 1 or 2 case (12 packs) of beer a week and my daily pot use, than actually helping me with the reason why I go for those things to begin with.
I knew she didn't want to refer me to a Dr. who could actually prescribe me meds that I actually needed.
She was (in my mind) a barrier between me and ADD drugs that would actually address the problem as she had me pegged as a drug seeker, and not as someone who was desperately self medicating.

Haven't seen her in well over a year now, don't really want to either.
Took matters into my own hands, and better off for it.
But what were you expecting from a nurse? And why did you need nurse's referral to go and see a doctor in the first place?

FogNoggin
11-05-16, 02:01 PM
That's what was provided for me, you see, in Canada we have Government funded health care, and there is a huge waiting list to see a Dr. because of the aging population and shortage of Doc's.

This NP could not prescribe me anything stronger than wellbutrin and Strattera (yuck).
So a referral would be needed to acquire controlled Rx drugs.

But she didn't refer me after I asked, she was stuck on (IMO) the thought of me being a drug seeker abuser risk case, therefore I felt it a colossal waste of my time.

I wasn't progressing, I felt she was set in her mind and too much 'by the book'
spinning my tires, wasting rubber, better traction elsewhere.

namazu
11-05-16, 02:46 PM
Maybe you could be on The Proper Assessment Committee. I don't know of any in the U.S.
This exists, kind of.

The major medical organizations for each of the relevant medical specialties in the U.S. have practice guidelines for diagnosis and treatment of ADHD.

Most of them have adopted the basic model of the American Academy of Pediatrics (the organization that board-certifies pediatricians) for diagnosis of kids and adolescents through age 18. You can see a summary of these guidelines (http://www.cdc.gov/ncbddd/adhd/guidelines.html) here.

There are similar guidelines for diagnosis and treatment of adults.

In Canada, CADDRA publishes guidelines, and in the UK, "NICE".

Of course, not all doctors are aware of these guidelines, not all doctors follow them closely, and sometimes people who are determined to get drugs can pull one over on an unsuspecting doctor. (And unlike with medications such as lithium, there's no easy blood test to determine if a person who has been prescribed methylphenidate is taking an appropriate therapeutic/non-toxic amount.)

karenparker
11-05-16, 03:14 PM
That's what was provided for me, you see, in Canada we have Government funded health care, and there is a huge waiting list to see a Dr. because of the aging population and shortage of Doc's.

This NP could not prescribe me anything stronger than wellbutrin and Strattera (yuck).
So a referral would be needed to acquire controlled Rx drugs.

But she didn't refer me after I asked, she was stuck on (IMO) the thought of me being a drug seeker abuser risk case, therefore I felt it a colossal waste of my time.

I wasn't progressing, I felt she was set in her mind and too much 'by the book'
spinning my tires, wasting rubber, better traction elsewhere.
Very interesting.
Literally a few days ago I read an article about Canada that listed state funded healthcare as one of the good things about the country. Is it generally not working well, or does it depend on the region...?
Do you have private healthcare?

karenparker
11-05-16, 03:17 PM
(And unlike with medications such as lithium, there's no easy blood test to determine if a person who has been prescribed methylphenidate is taking an appropriate therapeutic/non-toxic amount.)
That got me thinking. I'm pretty sure that through testing you can find out the amount of components in blood/urine. Is it just very unreliable, for example, because it's strongly individual? Or is it just too much of a hassle?

FogNoggin
11-05-16, 03:28 PM
Very interesting.
Literally a few days ago I read an article about Canada that listed state funded healthcare as one of the good things about the country. Is it generally not working well, or does it depend on the region...?
Do you have private healthcare?
No private health care, all that does is offset prescription drug costs (?) and gets you a nicer hospital room.
Dental (except emergencies) and eyecare is not covered by gov. health care which is why people here buy private health care insurance primarily.

Since it's state funded, people go get medical help when they need it, because it won't cost anything out of their pocket and won't saddle them with life crushing debt.

But at the same time it creates waiting times and the need for more Dr's, and sometimes it feels rushed, like get em in and get em out.

Sure beats bankruptcy though.

karenparker
11-05-16, 03:41 PM
No private health care, all that does is offset prescription drug costs (?) and gets you a nicer hospital room.
Dental (except emergencies) and eyecare is not covered by gov. health care which is why people here buy private health care insurance primarily.

Since it's state funded, people go get medical help when they need it, because it won't cost anything out of their pocket and won't saddle them with life crushing debt.

But at the same time it creates waiting times and the need for more Dr's, and sometimes it feels rushed, like get em in and get em out.

Sure beats bankruptcy though.
So you can't just get an appointment with a private doc?
I've lived in two countries with state funded healthcare and, granted, I have no good experiences with it. It certainly works in some ways, though I personally find it unreliable and I'm glad I'm smart/confident enough to be able to judge when someone is not giving me enough attention. After all, I can push for further treatment, change docs or just go privately (which I usually end up doing).
But that brings me to my point - in both those countries, the access to private health services is wide and easy, as long as you can pay, of course.
So how does it work in Canada? Is it more equal, as in being "bad for everyone equally"?

That's interesting, I think I have some reading to do.

FogNoggin
11-05-16, 03:46 PM
The reason why some Canadians go to the US is to get treatment NOW!

Yes, here, everyone is equal.

But, certain medical problems if serious enough will push you to the head of the line.

But sometimes waiting times can make a medical problem worse, hence going to the US.

Little Missy
11-05-16, 04:02 PM
Honestly, I'm just not quite grasping that Ritalin is something anyone would want to abuse or that it would even be fun to take.

FogNoggin
11-05-16, 04:05 PM
Yeah, it's in the 'good enough' category, but not the best, but probably less problematic than the 'best'.

Some will abuse the most accessable thing to abuse, if it's ritalin, ritalin it be.

Joker_Girl
11-05-16, 04:11 PM
It must be different in Canada.
Controlled substances can be prescribed by not only a psychiatrist, but a physician of any specialty, a primary care physician, a nurse practitioner, a PA, and some other advanced practice nurses (clinical nurse specialist, registered nurse anesthetist, etc).

So basically, you just must find someone who has some sense about it, and doesn't carry prejudices regarding prescription stimulants.

The lady I go to now happens to be a PA, it is a family practice group of 2 general practice MDs, 2 nurse practitioners, and 3 PAs. I go to her really only because she and I are friendly, but I would be fine with any of these folks. Really, I'm friendly with and have worked with all these people at the hospital where I am an RN. (I am NOT a nurse practitioner, as I've only a bachelor's degree. Even if I was, which I won't...I would not prescribe drugs to myself).

Find someone who out trust and that trusts you. Even if you must pay from pocket to do so. It will be worth it. Someone who understands the problem or is willing to learn.

FogNoggin
11-05-16, 04:40 PM
. (I am NOT a nurse practitioner, as I've only a bachelor's degree. Even if I was, which I won't...I would not prescribe drugs to myself).


It's my stubborn, independent nature.

If I see a potential remedy, and after tons of reading and research, I think I am qualified to try prescribing to myself.
Especially if the benefits outweigh the risk.

Either that, or have my life fall apart, become an alcohic, and smoke more dope.

People die all the time using their Dr. prescribed drugs.

Life is full of risk, safer than skydiving or eating a poor diet.

karenparker
11-05-16, 05:00 PM
Find someone who out trust and that trusts you. Even if you must pay from pocket to do so. It will be worth it. Someone who understands the problem or is willing to learn.
So true. On top of that, even though private healthcare is expensive, I think with ADHD it's worth taking into considerations all the indirect costs of not receiving any help: substance abuse, lack of impulse control (gambling, shopping), not being able to get a better job despite potential etc. The last one is really ironic. Some people won't fight for the access to good healthcare, because they can't afford it, but a lot of them would be able to have a much better salary if they received the treatment.

Honestly, I'm just not quite grasping that Ritalin is something anyone would want to abuse or that it would even be fun to take.
Well, I you don't only abuse drugs to get euphoric etc., an example of abuse would be healthy people using it to improve their focus while studying etc.
But I honestly wonder if that's such a bad thing. We can talk about fairness and so on, but there are so, so, so many factors that make life unfair, so many things that make our chances unequal, that I'm not sure there's any point dwelling on that particular one.

Still, if people abuse some substance to get euphoric and recreationally high, then they'll use any other drug, so what's the difference? I would go as far as to say it's better for them to abuse illegally obtained Ritalin or Dex than just as illegally obtained street amphetamine. For two reasons: quality control and no support for organised crime. Honestly, I'm not that bothered by the fact that someone buys drugs to have fun (and I still fail to see the why it's worse than using alcohol), but I'm very much bothered by the fact that by doing so, they're indirectly supporting people who, apart from selling drugs, are doing a lot of really, really nasty things - human trafficking comes to mind, and that's just one example.

Joker_Girl
11-05-16, 05:04 PM
It's my stubborn, independent nature.

If I see a potential remedy, and after tons of reading and research, I think I am qualified to try prescribing to myself.
Especially if the benefits outweigh the risk.

Either that, or have my life fall apart, become an alcohic, and smoke more dope.

People die all the time using their Dr. prescribed drugs.

Life is full of risk, safer than skydiving or eating a poor diet.

Oh, I have no doubt that I know enough about adhd treatment that I could treat it as well as most general practice physicians, PAs, and NPs. For one, I have first hand knowledge of it, and the medications to treat it, and how they work. Hopefully, most psychiatrists would know more about it than I do, but I wouldn't bet that all of them do.

And I am someone they could be honest with, because I actually GET it....if someone has ADHD and a coke habit, my first inclination isn't oh my God lock up all the drugs...it's finding out more, and why...and possibly treatment with ritalin or amphetamine, because taking a pill is a lot safer, cheaper, and better on your nose.

But if I WAS a care provider, I wouldn't prescribe to myself, not because I think I wouldn't even able to safely, but because i could see it looking like a conflict of interest.

FogNoggin
11-05-16, 05:10 PM
It's my stubborn, independent nature.

If I see a potential remedy, and after tons of reading and research, I think I am qualified to try prescribing to myself.
Especially if the benefits outweigh the risk.

Either that, or have my life fall apart, become an alcohic, and smoke more dope.

People die all the time using their Dr. prescribed drugs.

Life is full of risk, safer than skydiving or eating a poor diet.
Take my advice at your own risk.
Sometimes my ego is bigger than my smarts.

I wouldn't want anyone to cause risk to themselves by following my example and potentially bad advice.

Thanks.

Joker_Girl
11-05-16, 05:28 PM
Take my advice at your own risk.
Sometimes my ego is bigger than my smarts.

I wouldn't want anyone to cause risk to themselves by following my example and potentially bad advice.

Thanks.

Trust me, I get it.

If I am not on adhd medicine and an antidepressant, there is a 100% chance I am experiencing severe mental distress, hating myself, wanting to die, seeking stimulation, and praying for psychological relief.

If this is the case, I will literally be a drug sniffing dog, I could get hired at border patrol. If there are some drugs around, that I can get to, I am going to find them or die trying. It's like radar. I can hear someone cutting lines with a credit card a mile away. I can hone in my drug radar and find a pot seed under the back floor mat in a 12 year old minivan. And if there's no drugs, I'll try booze.

I need to be medicated for my own sake, and so I am not a horrible influence. But, I'm a lot of fun.

karenparker
11-05-16, 05:35 PM
If I see a potential remedy, and after tons of reading and research, I think I am qualified to try prescribing to myself.

This a difficult area. You can't openly say "yes, I think people can self-diagnose and self medicate" (stuff other than common cold), because, obviously, most people are completely incapable of that and most would simply hurt themselves.
Even minor thing, like the popularity of alternative medicine, springs to mind. I'm stunned every time I see people believing in all that (be it homeopathy, acupuncture or treating serious diseases through weird diets), despite no evidence whatsoever. But that's the issue - people can't generally evaluate that. Majority of people are not nearly critical enough towards what they're reading/hearing. People (as a whole, not particular individuals) can't correctly interpret the information, even if it's coming from a reliable source, and then anyway most people can't differentiate bad vs good quality source.
So basically, you can't say "people should be able to self medicate", because even if the doctors are bad, they're usually going to do better, than their patients would do.

But then, what I wanted to say is, I do see where you're coming from. Even though I'd never recommend it, I do think some people would be better of treating themselves in some situations. Simply because some people are intelligent enough to be able to gain decent knowledge and become better educated in some aspects that the bad doctors they're visiting. And even though going to a good practitioner would be much better, that's not always possible.
Nevertheless, again, it's just my private opinion of what can happen in rare cases. And, to be honest, I think if someone is smart enough to do that, they do it already - if they need to.

I, for one, can say that after my experience with healthcare I learned that if I need help, I'm much better off using Google (and through that - reliable sources, not anything that pops up) combined with my judgement, and then going straight to a specialist, while doing necessary tests prior to the visit. Saves me time, energy and, funnily enough, money.


As a digression:
I've been diagnosed with hypothyroidism (subclinical, no treatment necessary or helpful, for that matter) and the things I came across over the net were crazy. The amount of bad, unqualified advice was terrifying and it wasn't all just some innocent, minor tips. I've seen very popular blogs and websites where people would go as far as to recommend ditching "mainstream" treatment, and then would explain the mechanisms of the diseases and the proposed solutions and would "prove it" with research. The catch? People don't get that the fact that something can be found on Pubmed, doesn't mean it was a reliable study. People don't get, that the fact that someone uses scientific language, doesn't mean that this person actually knows what they're talking about. I could go on, but I'll stop - the point is, I think vast majority of people is much better off with a s.hitty doctor, simply because, even if he's an idiot, he's likely at least a better educated idiot.

karenparker
11-05-16, 05:47 PM
If this is the case, I will literally be a drug sniffing dog, I could get hired at border patrol. If there are some drugs around, that I can get to, I am going to find them or die trying. It's like radar. I can hear someone cutting lines with a credit card a mile away. I can hone in my drug radar and find a pot seed under the back floor mat in a 12 year old minivan. And if there's no drugs, I'll try booze.

I need to be medicated for my own sake, and so I am not a horrible influence. But, I'm a lot of fun.
I wonder if my complete, 24/7, lack of interest in alcohol, since my meds started working, is a side effect of them, or I'm simply feeling less like sh.it.

But what I know for sure, is that if not for ADHD I'd drink much less anyway. My incapability of being productive and the frustration resulting from that would often lead me to downing a bottle of wine in the evening while watching some tv series, just because it was better than trying to get myself together and failing yet again.

I personally have never self-medicated with stimulants. I've been using a lot of coke when I was in my late teens (and I don't think it was self-medicating at that point, though in a way it certainly was a result of my ADHD and feeling I am useless and have no future) and never had an intention to going back to that, but I'd lie if I said I never considered using amphetamines. And the thing is, I was never thinking about using it to have fun, but I remember multiple times wondering if it would be such a bad thing to get some and just use it as a help to LIVE. It was a few years ago and I had no idea I had ADHD.
Now it makes perfect sense.

aeon
11-05-16, 05:57 PM
In the distant past, I tried a few stimulants with the goal being some kind of fun...back in the days before I got clean and stopped any and all substance use and abuse.

My main drugs of interest were not psychostims, but I was curious, and always willing to experiment with something new with some cautions...


Ritalin
Dexedrine
Desoxyn (Ovation Pharma!)
Cylert

Result: Iím not wired to experience pleasure from those drugs, which in the list above span 2.5-3 chemical families. I took enough to know if something was going to happen, and things happened, but they were neither good nor bad.

To be fair, I have had some phenethylamines which I enjoyed, but they donít include those used to treat ADHD.

In particular, I found Ritalin/methylphenidate to have the least potential of all of them. Which of course says something about me, and not the drug.


Cheers,
Ian

FogNoggin
11-05-16, 05:57 PM
Being intoxicated is preferable to brain fog.

But that's not the main reason I would drink or smoke.

My drug resume is impressive, but I do avoid hard drugs, simply because I already smoke dope everyday, and something like methamphetamine, I know for a fact I would not be able to control myself with that, so best to never try it or other things addictive like it.

Joker_Girl
11-05-16, 07:26 PM
When I'm properly medicated, or even somewhat properly medicated, I have zero interest in abusing drugs. Well, not zero, maybe, but very little. I might glance at a line of coke with mild longing, or accept a hit off a joint. I will drink, but it's definitely social drinking, 2 or 3 drinks once a month or so. But I'm not going to actively try to get myself messed up.

If I'm not medicated, all I can think about is quieting the pain in my brain and soul, and Idgaf how. And I don't care what happens to me. I am a mess of self loathing, chaotic, angry nihilism, and I can't help it. I can't snap out of it without altering my brain chemistry, and believe me, I've tried. It's not fun, it's not a good place psychologically. Very dark. And if I don't have a pill to make it better, I am on a quest to make it better on my own.

Stimulants were my drug of choice, when I was a druggie, and my favorites were crystal meth and coke. Despite what I'd heard, people with ADHD absolutely CAN get high on stimulants. It just takes ALOT. And it doesn't last as long. I was an equal opportunity junkie, though...if I didn't have an upper, I would do ANYTHING.

But if im medicated, I don't WANT to be high. I don't need to be. Because I'm not miserable.

FogNoggin
11-05-16, 07:37 PM
Unmedicated 8-12 beers, no problem.
On stims, 3-6 usually.

My unmedicated brain commands the elbow to hoist brews at an accelerated pace.

Medicated, I can open a case, and forget to even crack the first can open.

Weird liquor store story, was listening to Motorhead's last album on the way there, and in the liquor store, they were playing Ace of Spades on the liquor store PA.

Never in my life has this happened.

RIP Lemmy and Phil

https://www.youtube.com/watch?v=aSsqavYIgNc (http://www.youtube.com/watch?v=aSsqavYIgNc)

aeon
11-05-16, 07:47 PM
My unmedicated brain commands the elbow to hoist brews at an accelerated pace.

:lol: classic!

Fortune
11-05-16, 08:22 PM
Thread locked for moderator review.

Fortune
11-06-16, 04:22 PM
Thread reopened.

mctavish23
11-07-16, 12:14 PM
In keeping with the OP's original question, it should also be noted that the

same data I previously referred to, also points out how methylphenidate is

reportedly abused less than other stimulants, due to a lesser impact (on the

feeling of euphoria; due to it's chemical composition). Hope that helps.


tc

mctavish23

(RObert)

mildadhd
11-08-16, 12:55 AM
In keeping with the OP's original question, it should also be noted that the

same data I previously referred to, also points out how methylphenidate is

reportedly abused less than other stimulants, due to a lesser impact (on the

feeling of euphoria; due to it's chemical composition). Hope that helps.


tc

mctavish23

(RObert)

I started drinking alcohol regularly about the age 10.

During high school we frequented the local bootleggers in the mornings before classes.

(It was surprisingly very busy during the weekday mornings at the bootlegger.)

I have been taking methyphenidate (SR) for about 10 years.

I have not wanted to drink alcohol for about 10 years.

In other words I agree with the research information you presented so far.

But in regards to the OP question, i do not think prescribing methylphenidate would be something we would do to help reduce methyphenidate abuse.


G

mildadhd
11-08-16, 01:05 AM
Reducing the number of misdiagnosis, would help reduce methylphenidate abuse.

I need to learn more about misdiagnoses.


G

mctavish23
11-08-16, 12:49 PM
mild,

I wasn't suggesting we'd prescribe meds, I was simply pointing out the data on stimulant

abuse in general.

tc

mctavish23

(Robert)

Lunacie
11-08-16, 01:28 PM
I started drinking alcohol regularly about the age 10.

During high school we frequented the local bootleggers in the mornings before classes.

(It was surprisingly very busy during the weekday mornings at the bootlegger.)

I have been taking methyphenidate (SR) for about 10 years.

I have not wanted to drink alcohol for about 10 years.

In other words I agree with the research information you presented so far.

But in regards to the OP question, i do not think prescribing methylphenidate would be something we would do to help reduce methyphenidate abuse.


G


Not everyone who is mis-diagnosed and prescribed methyphenidate ends up abusing it. If it's not the right med they'd be more likely to stop taking it, no?

ginniebean
11-08-16, 06:33 PM
No private health care, all that does is offset prescription drug costs (?) and gets you a nicer hospital room.
Dental (except emergencies) and eyecare is not covered by gov. health care which is why people here buy private health care insurance primarily.

Since it's state funded, people go get medical help when they need it, because it won't cost anything out of their pocket and won't saddle them with life crushing debt.

But at the same time it creates waiting times and the need for more Dr's, and sometimes it feels rushed, like get em in and get em out.

Sure beats bankruptcy though.

What also causes wait lists is the shortage of psychiatrists. psychiatrists are alao stigmatized and it's avoided as a specialty.