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A question from someone who is unmedicated

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I have ADD. My doc says that the only effective treatment for this is stimulants. He refuses to prescribe them because i have a history of addiction and abusing stimulants. Does anyone have some advice for non medication coping tips? My ADD is really impacting my life and I don't know what to do.

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There are non-stimulant meds approved for the treatment of ADD: Strattera and guanfacine so you might try asking your pdoc about them. Therapy can also be useful. As to specific techniques, I find that making lists and adhering to them is helpful. When I was in school, I would make outlines to study because I knew that I was unable to go back and read over the material. I'm sure other people will come along with more useful techniques I have since I now take Ritalin.

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I suggest maybe finding another doctor. My doctor was questioning whether stimulants were right for me and he asked if i had ever taken street speed. I told him I used it for about 2 years and he asked how i felt and i replied that it just made me able to concentrate, social, motivated, slowed my speech, relaxed, etc. and hes like "oh perfect, I think well try adderall." If you try another doctor try to sense what kind of doctor he is and whether you can reveal past stimulant abuse. I planned on never telling him but I could feel that he would understand and he did. Anyways, good luck.

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I immediately thought of Strattera also

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I second the recommendation to find a new doctor. My pdoc knows about my drug abuse history and didn't hesitate to Rx me Adderall, because he knows me well and that I am very careful with meds.

Lists are definitely usefull. Dry erase boards are great-- you can write down what you need to do, wipe it off as things get done, and start all over again when you're all done. I have one large dry erase board in my kitchen that is set up as a weekly calendar, as well as having boxes for general things to do, things to do in the house, chores and a box for each kid to write wants/needs in.

I also utilize my iPhone's calendar ALL the time. If I lose that thing, I am screwed. As soon as I learn of an appointment, or think of something that needs to be done, I put it in the calendar, usually with alarms to go off.

Those are things I did before getting medicated, and I continue to do with meds. Meds aren't magically effective for me-- they definitely help me stay focused and with task completion, but they don't help my memory or drive to do anything. I still have to work pretty hard at things that seem to come easily to the "norms."

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I take adderall, but there are plenty of non-drug tools I use, mostly tech, and mostly geared around eliminating opportunities for disorder.

I try to keep appointments in my phone, so I can get a reminder of where to go when.

I use a tablet to along with Dropbox and Evernote so that I don't have to corral paper, instead I can search for them and essentially carry all of them with me (so I never have to worry about forgetting an important paper).

I try to schedule things where I need to be focused in the AM, since that's when I'm sharpest.

I keep things like instant messenger turned off, otherwise I'd do it all day!

I think getting a second opinion might be a good idea, if not finding a new pdoc all together. If he believes stimulants are contra-indicated, I'm not sure why he'd deny you one of the non-stim drugs.

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Actually it's all about calming down, so you can think clearly and in the moment to focus on whatever you need to focus on at the moment. things like caffeine, red bull, cigarettes can make add a lot worse. cut down on those types of things and try some relaxing hot tea, a hot bath, etc to reduce stress and or anxiety. practice being calm and soothed at home so when you enter into the real world you will still be calm and then can think clearly.

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Actually it's all about calming down, so you can think clearly and in the moment to focus on whatever you need to focus on at the moment. things like caffeine, red bull, cigarettes can make add a lot worse. cut down on those types of things and try some relaxing hot tea, a hot bath, etc to reduce stress and or anxiety. practice being calm and soothed at home so when you enter into the real world you will still be calm and then can think clearly.

Umm, while those tips can be helpful parts of a treatment regimen, some of us really do need meds. Calming down, thinking clearly? Waaaay easier said than done, for me. And I actually managed to teach myself how to do quiet-mind meditation before I went on meds - can only grasp it for a few moments, took me years of practice just to get there.

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I have a history of drug abuse, mostly speed and ecstasy, that my pdoc knows about and she still rxd me stims. She said as long as its not current its okay. I think its unfair to deny someone treatment for having made mistakes in the past. Substance abuse is so common in ADD. Its possibly lack of treatment that causes it.

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Actually it's all about calming down, so you can think clearly and in the moment to focus on whatever you need to focus on at the moment. things like caffeine, red bull, cigarettes can make add a lot worse. cut down on those types of things and try some relaxing hot tea, a hot bath, etc to reduce stress and or anxiety. practice being calm and soothed at home so when you enter into the real world you will still be calm and then can think clearly.
Umm, while those tips can be helpful parts of a treatment regimen, some of us really do need meds. Calming down, thinking clearly? Waaaay easier said than done, for me. And I actually managed to teach myself how to do quiet-mind meditation before I went on meds - can only grasp it for a few moments, took me years of practice just to get there.
It is also all about what other tactics etc work for people. We are all individuals so what works for us works for us and while we might say what works for us it may not work for the person asking.

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I hesitate to say your doctor doesn't know what he's talking about, but... your doctor maybe doesn't know what he's talking about.

 

This is a great article, written by a nurse practitioner, on the subject. I'll quote the relevant bit.

 

 

Perhaps the greatest disservice to patients with ADHD is the belief that because a patient has or is abusing substances, it is dangerous to prescribe stimulants due to fear of addiction or diversion. Some providers even require that a patient avoid all substances for at least 6 months before beginning stimulant treatment. Several researchers have disproved the notion that stimulants lead to addiction.7In fact, there is evidence that stimulant treatment for an adolescent with ADHD is actually protective - or at worst does not increase - the likelihood of moving on to other substances.15

The adult population with ADHD self-medicates, and the drugs they use to do that are also stimulants (cocaine and crystal methamphetamine). They are prompted to do so because their brain seeks dopamine, which is in short supply in the synapses. Repeated experience in my focused practice shows that when you treat the ADHD, drug abuse ends because the patient no longer has to illegally give the brain what it needs.

The most extreme example of what I am talking about is a patient I'll call "Meg." Meg is in her mid-30s and has been in drug rehabilitation 12 times for cocaine abuse. She has been incarcerated for cocaine possession and sale. I reviewed her medical records and learned that she had been diagnosed with ADHD. But no one had treated her with a stimulant because of their misplaced fears of addiction. Other providers had tried many of the alternative medications, but these had no effect.

I prescribed lisdexamfetamine, and since she began taking this drug she has not used cocaine and reports no craving for it. She is working to repair her relationship with her family and just enrolled in community college. This was a woman who sometimes lived on the streets. How many more Megs are being refused proper treatment because of tradition, poor information and a fundamental misunderstanding of ADHD? The thing that people with ADHD are most likely to become addicted to is full use of their brain, not a substance.

 

So it's possible that going on stimulant medication would not only help your ADHD, but perhaps also your addiction cravings if you have them. I'm no doctor, but I agree with everyone else that you should get a second opinion.

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I know this is a pretty old thread but yeah I wanted to agree on the stimulant therapy and addiction cravings thing.  I'm out of Dexedrine and not able to afford more for a while, and every time I've run out of my stimulant medications old cravings for alcohol, marijuana, cigarettes, etc. come flooding back.  In fact I started smoking again, this time.  Not to mention the massive caffeine consumption.  I manage to keep away from anything harder than cigarettes or pot (even keep away from alcohol) but it's difficult and frustrating.

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The link provides access to a pretty old articles as well.

 

Posted on: December 29, 2008
 
While I think we can all agree with the premise I do wonder if the new member signed in simple to post his/her link?
 
I know that I am a curmudgeon and a cranky ole witch, but I do hate when that happens.

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