Infuriating appointment today
Infuriating appointment today
Sorry if this is the wrong place, I just really need to vent somewhere.
I had a followup today to discuss the next steps since neither guanfacine nor atomoxetine worked out. I've been waiting for this because I know stimulants are the first line treatment and I've had nothing but awful experiences with the other meds. He had me take a drug test ahead of time - to make sure I wasn't already taking stimulants, he said. I've been open about everything I'm on and he said it would be fine. That was a lie.
I tested positive for a bit of weed, which I told him about. It's legal in my state. Despite saying it was fine before (I asked, specifically), now he changed his tune and said he's going to keep testing me and if I test positive three times he won't prescribe me any stimulants.
The kicker? I even have a prescription for it, because I worry about exactly things like this. It's for chronic pain, but tbh helps my depression and anxiety too. I don't even use much - about $150 in edibles over the last year. But if I spent that much on alcohol every weekend, that would be no barrier to getting a prescription.
I went in for help and was nothing but honest, and I left feeling attacked over prescription medicine that's been helping me. What the fuck. I'm so frustrated and angry I just want to cry. Why is it so hard to get help?
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He seems completely incompetent altogether. I expressed concern that a stimulant would not be right for me, as even coffee has an extreme effect when taken after a long pause. But everybody, GP, therapist and psychiatrist, insisted that we should try MPH or AMP, as it is so much better, even though the whole prescription process is complicated for a schedule 2. And it worked out great from the very start.
He seems to worry about the wrong things. To rather let a patient in his care suffer with 3rd choice meds for months (?), followed up unmedicated than take the chance that you might be a 1%er who abuses it. For which there isn't even much indication, as you have a prescription.
However, if I really try to give him the benefit of a doubt: A quick search shows that there are some risks in combining weed and medical stimulants. The positive effect can be reduced, and cardiovascular risks of stimulants increase. So, without medical training, I don't know if that means that you have to search for alternative for either of those first (switch either the pain meds or the ADHD meds), and then continue treatment for both, or if it really is so risky that you absolutely must keep one of the conditions untreated. As far as I understand, weed is rarely the only option and, at best, only slightly better than the next best alternative. For ADHD, on the other hand, MPH or AMP or so much better than the next best alternative. I tried Modafinil myself, and the side effects were severe.
So maybe his tone was just off, and he should have explained those careful considerations for the best therapy options, rather than be like "eek junkie, get out until you are clean".
I might be completely wrong here, it's literally what spins off in my head after 2 minutes of search.
I don't think it's a medical reason. If my cardiovascular health were at risk, stimulants alone would be a bad idea. I'm healthy enough and my usage is minimal. He tossed out some BS about working memory, but if I go down that rabbit hole this comment will get 5x as long.
The benefit of the doubt here is he's covering his own ass. The DEA has been threatening to crack down on stimulant prescribers for a while, especially over telemedicine (which this was). If he gets audited and has to justify why he's prescribing stimulants to a drug user, he could lose his medical license - or he may just not want to deal with the research and extra work needed to write up that justification.
To that end, it fucking sucks, but I can't really blame him. I just wish he had been more honest and up front with me like I was with him. We could have waited a month to take the drug test and I'd have passed it, then this whole thing could have been avoided. Instead he looks down on me and repeatedly hasn't truly listened to what I've told him. I won't pass judgment on him the same way he did to me, but I will say his style is incompatible with me as a patient. I'm an active participant in my own care and I need a doctor who will form a collaborative relationship with me, not dictate treatment decisions.