I was diagnosed with ADHD - PI seven years ago, and since then, I’ve managed my symptoms with a daily prescription stimulant. Depending on what my financial circumstances and prescription coverage, I either ask my doctor for the cheapest old school generic available or the extended release version of the cheapest old school generic. This is almost always some version of Adderall, which is just a fancy name for amphetamine.
It’s a Schedule II drug, and I have no problem meeting the various requirements the state and federal governments demand. I can only get a one month prescription at a time. I have to get the prescription filled within seven days. In California, I could only get the prescription from a psychiatrist. At least in Texas, my PCP can prescribe it.
So when I saw my doctor yesterday for a post viral cough the OTC meds were not helping, I mentioned that I was coming to the end of my last Adderal XR prescription. My doctor was happy to write the prescription for the next month, but she said that changes in state medical board regulations now required that she have all of her patients on stimulants take a bi-annual urine drug test. The reason, she explained, is because there are many recreational drugs that are contraindicated for use with stimulants, and they can cause serious health problems. No one, she stressed, gets into trouble, but the test provides a baseline to provide counseling and determine the most appropriate medication for the circumstances. She mentioned marijuana twice while explaining this.
Okay, I get that people lie to their doctors. I think it’s an incredibly unnecessary and dangerously stupid thing to do. After all, my doctor does not get to rat me out if she learns that I’m using illegal substances. I also get that drug interactions can be extremely bad, if not downright fatal, especially when the doctor doesn’t know what’s going on. So, I accept that from here on out, I’ll be peeing in a cup twice a year or I won’t get my ADHD meds.
Here’s where I’m confused:
I can’t find any contraindications for amphetamine other than heart disease, hypertension, or glaucoma. I checked Wikipedia, PubMed, and the online Merck manual, and there’s no mention of specific medication interactions.
The only thing I’m aware of being bad to mix with amphetamines is other stimulants.
Urine tests for recreational drugs are notoriously unreliable. If I were the kind of person to lie to my doctor about what I take for happy-party-time, I would also be the type of person to detox before taking a urine test so the results would be clean.
While people with ADHD are well known for self-medicating, we tend to self-medicate with stimulants (nicotine, caffeine, cocaine, meth) when we don’t have access to legally prescribed stimulant medications.
I can’t find an online source for what the Texas state medical board requires physicians to do when prescribing Schedule II drugs, so I can’t confirm what my doctor told me. I trust her, and I’d like to think she trusts me (I know, trust but verify), but this whole megillah doesn’t seem to have any connection to the stated reason. So I’d really appreciate answers, thoughts, and speculation by any of the Dopers in the medical community or related areas.