dropped by provider, no taper, no referral, help!

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This topic contains 6 replies, has 4 voices, and was last updated by  MsUnderStood 2 days, 22 hours ago.

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  • #135619

    medved
    Participant

    My adult child, without warning, was dropped by their NP last week. He was on 60 mg Vyvanse long term. Previous appt he was given a surprise drug screen (STDs too,both unwarranted and humiliating.) He came back neg for everything (Angel Dust, really ?!?) However, being pure is apparently also a problem because they believe it means ‘not taking medication as prescribed’. I know for a fact he has been. Is there any testing that can prove long term usage?
    *Unfortunately they have erroneously decided to drop him from all stimulants (secondary meds were suggested — he’s already been trialed on everything over the last 15 years with either ineffective results or scary side effects). So dropped. No taper offered, no referral to more qualified medical professionals. Withdrawal has been a nightmare, clinic is stonewalling all requests for help. I’m in the process of requesting records, but I’m concerned going forward he will be black balled because of poor process. Has anyone else had this happen to them?

  • #135651

    quietlylost
    Participant

    I can’t speak to this as it hasn’t happened to me. But to your question about testing, there are other tests out there that can verify drug tests either via blood testing or urine. It can be worthwhile to seek testing through a primary care provider or even an emergency room. There’s a chance the initial test was a false negative, and subsequent tests might be helpful.

    Vyvanse, while long-lasting, can clear out of your system within 24 hours. So if your child missed a dose it is likely that the drug test would come up negative. Providers should realize that and have asked follow-up questions.

    Also, typically there is no physiological withdrawal from Vyvanse. If so, it’s not typically problematic or concerning. Of course individual experiences differ. Typically the Vyvanse works for 10-12 hours and then is out of the system anyway.

    I’d advise the child to petition the clinic for a review of the case or to speak with another provider.

    Drug testing is not perfect and it is humiliating. As an adult with ADHD I experience this myself. However, it is also a necessary part of the process now due to prescribing guidelines and clinics being concerned about misuse and liability. Hopefully there can be some resolution.

    • #135734

      medved
      Participant

      Withdrawal was atypical and painful. He’s moved back home, will not be able to work professionally until treatment starts again someday.
      I’ve had to dig into the larger process in an attempt to understand. There is weak to no evidence that drug screening ADHD patients impacts amphetamine misuse (meth, whole separate unrelated area.) Similarly urine testing for the pharmacokinetics of ADHD meds to optimize dosing — sadly, truly not a thing. I keep getting the feeling that this new trend is about reducing costs cloaked in an abuse prevention excuse.

  • #135714

    micro41
    Participant

    Most practitioners have a duty of care to provide transitional care(Rx refills) until you find another practitioner. Check with state board of NP in your state for their ethics. Speak of writing this/her board and they will come around.

    If you son truely disobeyed their rules of conduct for their patients they are with their rights to drop immediately.

    Otherwise talk with your lawyer.

    • #135737

      medved
      Participant

      I’ve been managing his ADHD since elementary school, only recently handed over to him. By far and away the worst provider experience ever, they’re erratic enough that I don’t want him getting anywhere near them again. I’ve just requested full records, and have contemporaneous notes. This has been so egregious that I am evaluating complaint and legal avenues. I don’t want this to happen to anyone else. And I believe they’re doing it with some recent frequency (comments).
      My son’s ‘patient agreement’ (newly introduced to everyone at this clinic) is a lopsided, open ended rights invasion, with little specific performance by the provider. They don’t even pretend there’s goodwill. Erroneous false negs or positives are not followed up (which is a standard), you’re just hard dropped. Patient abandonment is not well regarded, for valid reason.
      So yes, because my son didn’t hit the relatively high tolerance value for the amphetamine line item he was technically non-compliant. How do I know he’s not just some disorganized kid who wants to stay that way and divert his script? Ironically for the last 3 months I had been working on location 24/7 with my son on a project. I know for a fact his usage, coupled with years of experience that he needs every pill to function and guards his bottle like a food aggressive dog with its bowl. Mild levity, this not symptomatic of dependence, rather I’ve noticed that since about 2015 there’s been a downward drift in dosing to where I would say he was undertreated. These people are just trying to survive in a world that is wired differently.

  • #135758

    MsUnderStood
    Participant

    I am a 46 year old female and this happened to me when I moved to a new county. They changed my diagnosis without a proper assessment because they dont like Adderall. I tried to advocate for myself and it made it worse. The questions that I asked resulted in a insulting judgement response. They closed my file per my request which was a lie. I tried to see what l could do. Everything I’ve read says they were wrong. But the fear of asking for help consumes me. Every day I keep trying to manage life and usually I fail one y or another. The more I ask for help, the more “med seaking” I even. The more information I gave them, the more I was accused of “knowing how to play the system”. I wanted to drive my car into a tree after every session. They validated everything negative I was told as a child. I just keep trying to change what my brain can’t learn.

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