September 13, 2017 at 5:13 pm #60995
I am a 29 y-o adult who has suffered from inattentive ADD my entire life. After ending up homeless after a string of failed jobs, I ended up finally seeking treatment at 27. I started going to a local medical center, and there were some early warning signs that treatment wasn’t going to come easy. My first therapist only offered treatments like list-making, post-it notes, things that I would have obliviously tried before, and met my incredulity that those were ridiculous suggestions with a shrug. The second conceded that I did indeed need actual medical treatment but asked me “Why do you want to get diagnosed so much?”. I dunno, maybe because I’ve been told i’m stupid and lazy my entire life and maybe I actually might be suffering from a treatable disease?
He eventually gave me a script for Ritalin, which has made my life ten times more livable. Since then, I’ve kept down a job, had less anxiety and depression, and actually been more social, especially romantically. I feel the most stable I have in my entire life.
About a little more then a year ago, my therapist suggested transferring my care over to my primary care because I had been so stable. This is where the problems really started. The first three doctors to prescribe my Ritalin were different because the doctors kept quitting. The Doctor I have now has requested a urine sample every eight weeks (every-other script) and now wants to do regular pill counts- even though I have no history of ever abusing drugs, I’ve never even smoked a cigarette. I have no history of any law-breaking, hell, I’ve never even had a speeding ticket. When this first started I put up a fight- it was frankly, ridiculous to do this so often despite no evidence I was abusing my script. I had a talk with the head nurse and when I stated they had no reason to suspect me to be an addict/dealer she replied dead pan “you’d be surprised” (aka, everyone who seeks a Ritalin script is suspected to be faking it for the drugs). My current doctor, who barely remembers who I am, is trying to claim this is all “policy” despite never dealing with this with my therapist. When I try to ask what is the policy everyone shrugs and says they don’t know.
The worst part is since this has all been going on my insurance decided to stop covering mental health care, so even if I wanted to, I can’t go back to my first therapist.
Am I being unreasonable to be outraged here? I already struggle enough with my self esteem; facing an entire building of people that assume I am faking my illness is enough to make me dread going to pick up my script and gets me nearly crying every month. I’m terrified one time I’ll go and someone will have messed up the pee test and they’ll refuse to treat me anymore, taking away my hard-fought for mental and financial stability. Basically, will I run into this every doctor I go to? Is is worth changing hospitals/doctors?
September 14, 2017 at 2:09 am #61016
September 14, 2017 at 4:02 am #61030
I do have a question, though. I’m the type who comes into an orthopedist’s office for a look at a messed up joint I just injured (I’ve got the grace of a drunk giraffe), and the doctor writes me a prescription for Percocet without me even mentioning painkillers. I’ve never had anyone suspect that I’d ever misuse any drug. I apparently look extremely trustworthy.
What is your hair like? How do you dress? Tattoos visible? Piercings? Do you use alcohol or tobacco? (I don’t use either at all–I’m actually just as dull and reliable as doctors believe me to be.)
Any appearance of sketchiness is going to raise red flags, no matter how wrong they are. Doctors are taught to profile patients for all kinds of health risks, and there are associations that they make, however unfair.
September 14, 2017 at 7:41 pm #61127
I am a blond, fat, glasses-wearing white girl. I wear pretty normal clothes, jeans, tee-shirts, blouses- the same stuff I’d wear to work. I had a co-worker once tell me I looked like a vegetarian. I am college educated and have no piercings but my ears and two tattoos that are not visible when I am wearing clothes, generally. The same practice has a dental subdivision that I have been to for a wisdom tooth removal- they gave me a silly number of percoset for it without blinking, no follow up, nothing.
Every one else I’ve talked to agrees with that conclusion as well.
I get different answers usually, but every-other appointment is apparently their policy.
I’m going to share this story with you all- The reason I joined on here and made this post yesterday was because I was yet again asked to come in for a pill count.
I get called in, sit down with the nurse, she counts the pills, and then drops this bomb: Apparently, my last test came back with no meds in my system so now my doctor is requesting an observed urine test. I’m immediately confused and outraged- I’ve been taking my meds faithfully, every other test has been clean, and urines for me are hard normally. She repeats everything over and over, I signed this contract, blah blah blah- I insist they give me a print out of the test results and this contract I signed (that said nothing about observed urines as far as I can remember). She leads me into the bathroom and as soon as I sit down I lose it, sobbing uncontrolably. I couldn’t believe they were doing this. I can’t even calm myself down enough to try to force myself to go. We take a break and I spend my time chugging tap water and trying to disassociate so I can just get this over with and stop crying. She has another nurse come in to try with me and this one has the nerve to try to keep the door to the hallway open while I go!!!! After the second nurse realizes i’m not just going to be able to squat and go she has me go back to the room. I eventually force myself to go with the first nurse present, and that’s when she gives me the test results. She says, here, look, it says negative for amphetamines, pointing it out (I assume reassuring herself that that torture she just witnessed was justified.) I am at this point completely miserable and unable to think straight, but I think… wait, I didn’t think Ritalin WAS an amphetamine??? Why would my doctor test me for a series of drugs that Ritalin isn’t even included in?
The moment I got home, I realized the horrible truth that most of you probably know- Ritalin, or Methylphenidate, is NOT an amphetamine, so would not show up on a test for it. The only thing the test results the nurse gave me proves is that I am not taking any other drugs. I call the office (which has closed at this point) and leave a message for someone to call me back today. I’m ready for murder at this point. A nurse calls me first thing, and I explain what happened. She tells me that I should be talking to some manager/supervisor and that person will call me back. I thank her graciously and await this phone call.
So, She calls me… She says “Oh, I wanted to clairify our policy with you”. I respond that this has nothing to do with the policy, my doctor made me go through an invasive and humiliating test because he doesn’t understand the difference between Ritalin and Adderall. She then starts to insist that i’m completely incorrect, that this was a “random” test that I had apparently agreed to do when I signed a mysteriously missing contract. I tell her exactly the nurses actions, I tell her I have the test results in my hand- why, I ask, would my doctor test me for a group of drugs that Ritalin isn’t on? That was the whole point of the urine tests, wasn’t it? Her only response to that was that she asked him to not do that anymore but he TOTALLY didn’t request the test. It was completely random despite a nurse telling me it wasn’t random at all. She spends the entire conversation gaslighting me- I’M the crazy one for pointing out the inconsistencies in her story, her hands are tied, this is how they treat every patient and no one else “misunderstands the policy” but me, apparently, every other hospital does this too. I tell her she can hide behind her “policy” all she wants but she is in the wrong for treating her patients like criminals. I tell her I’m no longer going to see anyone at this hospital If this is how they treat people.
How can these people sleep at night?
September 14, 2017 at 9:12 am #61038
Some physicians are requiring this type of oversight with ADHD medication prescriptions — you’re not the first one to mention this here. It does seem overly cautious for a patient without any history that might signal abusing or selling your medication.
Mental health coverage is required of the insurance companies in the U.S. now
ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism
September 14, 2017 at 5:35 pm #61123
When we began the journey of getting medication for my son, I thought it was a bit of a pain. Every month I’d have to go to the doctor’s office to pick up a paper script, they’d make me show my ID and sign the prescription out. Then off to the pharmacy, same thing – have to show my ID and a bunch of other regulations.
Many ADHD medications are considered controlled substances and are regulated in the same manner as painkillers. My husband has a chronic back condition and his doctor prescribes him a controlled substance. Every other appointment he has to take a drug test. Last time there was no drugs in his system, which was a problem and he had to explain to his doctor that no, he was not selling his pills but just takes as needed and he didn’t need one the last couple of days. My husband’s doctor KNOWS he’s not an abuser or dealer, but regulations make the doctor check. Husband is a very clean cut guy, no even remote “appearance” of drug use.
My child’s doctor doesn’t urine test him, but he does ask who administers the medication; if the medication is kept in a safe place; and regularly has him come in to make sure he’s on the right track.
Don’t feel ashamed or embarrassed if asked to take a drug test. You might ask the doctor if it is routine for his office to perform the urine tests on all patients receiving a controlled substance or if it’s just you. I bet its routine, especially given the nurse’s response.
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