The loss of a spark can happen regardless of drug use. Work in an unsupportive environment over a long period of time, a breakup, or the failure to achieve a long-sought goal can cause a person to change over time. In addition, the underlying condition that the medication is treating may cause the effect, which could have been worse had the medication not been prescribed.
It's plausible that medications may have understudied long-term effects, but there are too many confounding causes to attribute a behavioral change to long-term medication use.
I've never been tempted to take any more than my prescribed dose, and so it's been a "healthy" relationship, but I'm working to discontinue my prescription for reasons other than this article.
Not to be one of those "well, I use it and I'm fine and aren't tempted", on the contrary - I understand fully why people would feel the tugs of addiction.
It's hard because I know I have an uphill battle to go. I use therapy and have seen benefits from psychedelics and medicinal cannabis, but it's literally a "pick your poison" battle.
But also, it's hard to have a spark when you're not able to live a normal life without assistance.
But in hindsight, I can see that this route has had it's costs and I'm excited to see who I am independent of it.
Completely lost me here. Why does the doctor have air quotes around their medical degree? And what’s wrong with treating disease? Or are you saying insurance requires unnecessary prescriptions? Because that’s definitely not the case, insurance would prefer no prescriptions financially at least and the doc is paid the same either way. Overall I think you just have an axe to grind against medicine for some reason. It’s not a perfect system but I don’t think you really know what you’re talking about and are concerned with the wrong things.
God forbid your prescription runs out on a weekend or holiday when your doctor’s office is closed. And don’t even think about shopping around for multiple scripts because that’ll just label you as a drug addict. The only winning move is to take half-doses on down days and build up a small stash of emergency medication.
But for some reason the government (the FDA) and medical field in general cares about abuse a lot. In the past few weeks, Cerebral got labelled a pill mill by the FDA/execs and as a result almost all ADHD telemedicine patients are having a hard time getting prescriptions filled. Sending a prescription to multiple places sequentially (because they keep refusing to fill it) or calling a pharmacy in advance to ask if they'd fill the prescription runs the risk of being labelled a drug seeker, and any power-tripping retail pharmacist - who doesn't know anything about you at all - can just refuse to fill your prescription if they want. Asking your provider for a higher dose is also anxiety-inducing for similar reasons.
The worst part is, people with ADHD still build a dependence/tolerance on amphetamines/methylphenidate. So running out of your medicine is really disruptive - not only do your symptoms go untreated, but they become worse than they'd be if you were unmedicated for a long interval, plus you have to deal with things like not feeling fully awake, being hungrier, lethargic, sleeping more while your body adjusts back to being unmedicated. But for some reason that's acceptable as long as we prevent people from taking amphetamines for fun.
I've been avoiding higher doses because this setup works well enough that I don't want to disrupt the status quo and I keep hearing from friends that build a dependence and even one who went off them entirely after adverse reactions on very high doses.
Fortunately I have a doctor who agreed this was a good idea and writes me prescriptions for different strengths.
I got turned down for filling an Adderall prescription at a CVS because the pharmacist didn't like that I was paying in cash (credit card) as an uninsured uni student. Didn't offer to call my doctor's office to confirm the script. Just said oh, I don't like that you're paying in cash so I'm not going to fill this :).
I fortunately get 90-day prescriptions (how long will that last?) and every time I refill, I have anxiety throughout the whole process (the checkup, the pharmacy) until I have pills in hand. Every time I feel like it's going to be the day I somehow have to jump through more hoops like my friend who has to have his pills counted every two weeks for his painkillers.
My experience was that I had to ask my doctor to switch, but once I asked, they were happy to accommodate.
Personally, I have no difficulty tapering doses on the weekends, even pouring out half the capsule’s powder. I once asked my doctor if they could prescribe sixty 20mg pills instead of thirty 40mg pills. Half doses when I’m taking the day off, right?
Wrong. Insurance only fills 30 pills per month and they have to be of the same potency. Ironically, if you asked your doctor to give you the 70mg pills, you could dump the excess powder for an emergency reserve and end up with far more medication!
The rules are totally made up and there’s no actual reason for limits other than the projection of “being tough on drug abuse.”
While I definitely agree with your general point, how does your brother know that they’re healthy or don’t need to take the medication? I’ve never had any discussion with a pharmacist (in the US or Canada) where I’ve revealed this information.
The idea that pharmacists have any meaningful diagnostic role in the US is risible.
I suspect pharmacists are the only people that some class of Americans can speak to about medical issues because they have an open storefront.
I don't know what pharmacists know about drugs, but they're useful people to speak to about insurance issues. They know the rules around age cutoffs for optional vaccines, which generics are in stock, when something will be denied by insurance, etc.
Around here (US location) my medical professional friends are all hesitant to prescribe any controlled substances to more than a certain number of their patients for fear of getting flagged.
Whenever I read these stories of people receiving benzos and other scheduled substances for years with no oversight, I can’t tell if this is actually happening regularly somewhere or if we’re just reading a lot of exaggerated second-hand stories.
I know these things happen somewhere, sometimes but the insinuation that it’s just the norm in American medicine is baffling.
I saw multiple doctors for years about anxiety issues and the most I got prescribed was an antihistamine. I also suffer from chronic back pain due to a genetic issue and it's been pretty much impossible for me to get a prescription that does anything for it.
I don't think people are lying about their experiences, I'm just baffled as to where this is going on because it's been totally opposite to my experiences.
I suspect there’s a lot of word of mouth references where patients are telling their friends which doctors prescribe which medications and giving guidance about what to say to get those prescriptions. This was definitely the case in the early opioid crisis years where the bulk of prescriptions were coming from a small number of doctors.
It’s benzodiazepines that are the problem. These should be reserved for short-term use in extraordinary circumstances, but a small number of doctors seem to hand them out too aggressively.
SSRIs and benzos are in entirely different risk categories. That’s why benzos are controlled substances and SSRIs are not.
If therapy is part of the treatment plan, they're often referred down to a psychologist or therapist for that part of things. A psychiatrist can do therapy....but their hourly rate is a whole lot higher.
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As to personal experience, my current psych (ADHD), requires a ~15min "medication management" session about 4x a year. It's not exactly a ton of oversight.
The couple previous psychiatrists I've had when I lived in other places were about the same way once we got past the initial phase.
It is worth noting that my prescription (+ it's effectiveness) has been generally steady for a long time and I don't exactly have a profile in terms of age/dosage/history that suggests abuse risk.
You could always request a more in-depth conversation if necessary.
Benzos are a completely different scenario because, unlike your ADHD medication, they’re not indicated for long-term use except in extraordinary circumstances. They can’t be compared to your long-term ADHD prescriptions.
"No medical history" doesn't mean shit either, it just means you have not yet seeked help. Most don't see mental health professionals at the first sign of issues, often they only do when things are starting to crumble. And that's my experience in a country with socialized healthcare, now translate that to the US where therapy is unaffordable to a large number of people.
What I really needed was my father not being dead when it mattered.
Health, and especially not mental health is very much not visible or even obvious. Just ask any disabled person that is not bound to a wheelchair 100 percent of the time.
When I got an amphetamine prescription in uni (like everyone else), I felt like I was lucky to have a doctor that started me off on the lowest dose.
Everyone I knew was on a much higher dose than me just starting out. People would get a dual prescription of XR capsules + IR tabs when they need a bump. Then when they couldn't sleep, the doc would just add another pill to the mix. And not just a mild one, but an extreme one like Seroquel.
Your doctor just isn't a specialist, and certainly not someone specializing in you and your specific ailments despite what we seem to pretend in these threads. Best strategy is to be informed and meet them in the middle.
A lot of people have conditions that medicine treats so well you wouldn't even know they had a condition at all.
I know many people who have taken antipsychotics, amphetamines, and statins for decades and it was perfectly fine for them. I also personally know some judgmental pharmacists too. All I'll say is, there's a reason pharmacists and doctors are distinct professions.
It's very likely. This actually has to be explained to a lot of people with chronic diseases like hypertension and type 2 diabetes. Way too many of them just stop taking their medication after their condition improves.
SSRIs and SNRIs have a much better risk/benefit profile. Sertraline in particular is a really effective drug. I don't really understand why other doctors prescribe benzodiazepines so frequently but I'm not doing it.
Newer SSRI-like drugs that block the serotonin transporter and activate 5HT1A also exist, combining the actions of both drugs.
It typically takes serotonin receptors about two weeks to downregulate, and possibly even months to see any effects on depression and anxiety. Buspirone is not like benzodiazepines that work pretty much instantly, but it doesn't come with any of the risks benzodiazepines do.