I'd add that even if a person is using daily they may not need substance use disorder treatment. A person who uses opioids may be managing untreated chronic pain. Someone using meth may not be able to access ADHD medication. One-size-fits-all treatment is a poor fit for many PWUD
If a person has chronic pain that doesn't respond to ibuprofen, they luck into finding a safe supply of heroin or Rx opioids, they use a dose comparable to prescribed doses, their QoL improves, and they aren't using compulsively, how does that person benefit from SUD treatment?
If an ADHD patient can't access meds in a doctor's office but they can buy Adderall, they take it as if prescribed, they aren't using compulsively, and their life improves, how would that person benefit from SUD treatment? Their issue isn't SUD, it's untreated ADHD
It's really frustrating to know how SUD works, know the kind of negative impact actual SUD has on the person and their family & friends, and to see prohibitionists like PROP equate minor or non-harmful unapproved drug use with the thing that ripped my family apart
• • •
Missing some Tweet in this thread? You can try to
force a refresh
Diversion is often just patients who are most likely to be considered human beings in a Doctor's office- white, financially stable, employed, privately insured, cis, abled, preferably male- keeping their loved ones alive bc the medical system refuses to do so. We keep us safe.
Poor & marginalized ppl often have no choice but to stay alive, stay stable & functioning, off of the good will of people higher up on the socioeconomic ladder. You're uninsured or can't access effective treatment, so you covertly beg for help & hope that someone steps up for you
Rx drug diversion is almost certainly saving lives right now. The issues ppl seek drugs for- pain, ADHD- don't disappear if left untreated. Ppl are saving lives by diverting rx opioids, stimulants, even antidepressants to loved ones, instead of leaving them to seek illicit drugs
In retrospect getting impatient waiting for a taxi (an hour late when I left) & being so restless/uncomfortable that I walked nearly 3 miles home w a raging kidney infection, was prolly impulsivity? Usually anxiety steps up to stop impulsive me, but I just didn't care last night
I was mad abt the taxi, mad my partner insisted I go last night instead of going today (he was trying to help, I was in bad shape). I think the meltdown circuit got activated & adrenaline was like "fuck it, I'll get you home." I might've had other options, but didn't think abt it
That's how impulsivity can be for ADHDers. Sometimes impulsivity meets a valid need in an unreasonable/unhealthy way. Sometimes impulsivity sees a problem & pushes you in the direction of whatever you thought of first, bypassing more suitable options to get the desired result
I can only imagine what my medical records say. I used to go to appts & explain my issues through quips & comedic hyperbole. Being entertaining is a masking behavior ingrained by decades of undiagnosed ADHD, but later I discovered it's considered a red flag for "drug-seeking"
Although it feels like the moment I was diagnosed w bipolar (in a low-income clinic, rarely seeing the same disinterested provider twice) I became a "drug-seeker" regardless. I had been getting 30 5mg pain pills a month, that's when I got cut off, didn't put it together til now..
And at the time that was totally fine, I didn't argue, my pain from the initial back injury was finally improving, so makes sense. But then a few years later the undiagnosed endometriosis pain intensified. I was working a low wage job, made like $100 too much a month for Medicaid
I'm tired of showing up in a doctor's office, being polite, respectful, courteous, bringing as much info to the table as I can, getting minimal response from the provider, crying (bc medical PTSD) & then getting a lecture about my attitude & how treatment is a partnership
One time I showed up at an appointment with a list of topics and questions so I wouldn't start rambling and forget what I needed to talk about. The doctor laughed when I pulled it out, and warned me about Dr. Google. So maybe I'm not the one who needs reminding about partnership
That guy then proceeded to sell me 5 Epidural Steroid Injections, tell me there was no risk bc he's "very good," and then when I asked about diagnosis- the thing I was really desperate for- he said "oh don't worry about it" like it wasn't critical to my mental & physical health
"Can't prescibe first line stimulant medication for your ADHD because you might get high on them. So instead we'll fail to adequately treat your ADHD, leaving you to self-medicate and putting you at increased risk for substance use disorder" - psychs
People with ADHD should get to do whatever works for them. This shit is so uncomfortable, exhausting, frustrating, emotionally and physically painful. You just fuck up over & over again while people tell you how bad you're fucking up, and then at some point you die I guess?
I managed to avoid substance use disorder somehow, but goddamn I understand why my dad (who I suspect had ADHD as well) drank so much. Yeah, of course he did, ADHD is torture sometimes. NTs or ppl who were treated young tend to think it's harmless, but it can ruin your life
You can tell that white, wealthy people are the majority of ADHDers who actually manage to get diagnosed and treated by how often you see "get a maid/hire a housecleaner" in ADHD advice articles. Ma'am I do not have money, on account of the severe, untreated ADHD
The other genre of ADHD article is How to Train Your ADHD Child So They Don't Embarass You, which also fits. Very little in the way of "so your child with emotional dysregulation is having regular meltdowns after your eviction and has stopped engaging in school"
Not many "how to explain parental substance use disorder to your ADHD child in a way that lets them know that their parent isn't rejecting them" articles. Not a lot of "you worked a 12 hour day & then tried to force your kid to do homework and you both screamed til 1am" articles