Dr. says I must completely quit marijuana?

I realize that this turned into a wall of text. See TLDR.

I made the decision to seek psychiatric care for what I believe to be ADHD. At my new patient appointment, after being drug tested at the door, we discussed my occasional use of marijuana. They made me agree to completely stop consuming weed and in no certain terms said they would drug test me in a month's time to make sure I actually quit.

I understand that there is some concern that marijuana can worsen ADHD. I am not in a position to challenge my care provider on the science of the matter. What I don't understand is why they are taking such overbearing measures to make sure I abstain from marijuana.

For example, when I had a colonoscopy performed a couple of years ago, I was advised by my doctor not to consume any food or liquids within a certain window before the procedure. I simply agreed to fast during that period and that was it. They trusted me to be an adult and follow their instructions. They didn't check for food in my stomach when I arrived at the hospital.

I should note that this practice primarily practices substance abuse treatment. Could this be a side effect of some zero-tolerance policy? Or do they really believe that smoking marijuana is that detrimental to my well-being?

TLDR; Dr asked me to quit smoking weed in order to get access to treatment. And said they would drug test me.

  1. Did your Dr also mention marijuana?
  2. Did they drug test you?
iquanyin,
@iquanyin@lemmy.world avatar

no that didn’t happen to me. i’m pretty sure it’s because it’s a substance abuse place. they treat everyone that way. id find somewhere else if it’s an option for me u, because you won’t like being treated like an addict every time e you deal with these folks.

DevonCode,

They never tested me, but the advice was to not "combine drugs". They also asked questions to make sure I was not addicted to anything. ADHDers have a higher % of substance abuse, so there's that.

In my opinion it's always better to test treatments in the "cleanest" state possible, so you know better how the medicine works. ADHD medications also take some testing to understand what's "best". I ended up naturally avoiding coffee too (I didn't need it anymore)

The way the posed the testing though, it seems either a requirement from insurance or the specific clinic or the country you are in.

otter_bee,

I live in WA where it's legal, and used to smoke probably 2-3 times a week..

  1. No they didn't
  2. No they didn't

Them wanting to drug test you is incredibly dumb, but if I had to guess it's because they want to see how serious you are about this. In my experience, THC just made my ADHD so much worse, and not using it for awhile now has helped fairly noticeably.

RedMarsRepublic,

Doctors don’t approve of anything they aren’t allowed to prescribe themselves. Sure there can be side effects but that applies to the drugs they get kickbacks to push too.

Nahvi,

I'm not sure that a facility that primarily focuses on substance abuse treatment is the best ADHD facility, unless you are trying to get clean of something too.

Also, I suspect that the places that are regularly testing their patients, are more concerned that the patients are selling their amphetamine based prescriptions or are amphetamine addicts than the well-being of the patients.

ilovesatan,
@ilovesatan@lemmy.world avatar

It's one of the only places near me that does diagnosis. Hopefully now that I have a diagnosis my PCP can now help come up with a care plan.

Nahvi,

Hadn't considered that. Glad to hear you were able to receive the diagnosis then. Good luck with the PCP.

tubabandit,

It’s personal, not professional. They’re treating you like a child.

Worth noting that THC turns my ADHD up to 11, so cutting it out is definitely the right answer for me. YMMV.

OneDimensionPrinter,

YMMV indeed. For me, obviously there are downsides like bad memory while high (it's terrible anyway so fuck it) but it's about the only way I can get my brain to shut up for a moment. Obviously it's a case by case basis, but I am all in once the day is done. Can't when things still need to be dealt with, but at like 9-10pm I'm just done anyway and I'd like a break from the council in my head

ilovesatan,
@ilovesatan@lemmy.world avatar

At the end of the day, they are the experts, so I'm gonna follow their instructions. But I will keep my options open for a provider that can treat me with respect.

zipperlips,

I'm sure it all depends on the individual, but from my experience my heavy cannabis use enhanced my adhd symptoms. My ability to recall information was compromised, as was my ability to comprehend larger, more complex topics. I would routinely forget what I was saying mid-sentence. It also severely affected my anxiety levels, and promoted general depression.

I decided to quit at the beginning of the year, and since then my memory has drastically improved. I almost never loose my focus mid-sentence, and if I do, I am now able to recover. More involved, complex topics I needed to ingest for work became much easier to accomplish, where as I simply could not do it when habitually smoking.

As for my psychiatrist, she was well aware of my marijuana use, and advocated for cessation, but wasn't adamant about it. I still got my methylphenidate filled every month.

rave_demon,

A lot of beliefs about cannabis are outdated and stigmatized, even in the medical community

spectrologist,

I have found in my experience that yes weed worsens my ADHD. However I've never been drug tested for it by my doctor. The only justifiable reason I could imagine would be if they put you on a medication where there are known drug interactions, or something, but even then it seems a bit odd to me. It sounds like this is an atmosphere that comes from their substance abuse specialization.

Maajmaaj,

I get my ADHD medication from my general practice doctor, to avoid speaking with a psychiatrist. My GP does not drug test me and I'd change doctors if they even suggested doing something like that. I'm not sure if you went to a substance abuse treatment center on purpose, but please go look for a doctor that specializes in ADHD. it's almost common sense.

sylvanSimian,

While it depends on the individual, adhd treatment is one of the reasons a doctor can prescribe medical Marijuana. It's literally one of the things it is currently approved for it to be medically dispensed to treat, at least in Virginia.

I've had doctors tell me not to smoke plenty of times. Usually it comes from a good place but not a super informed one, as a lot of people havent done any research into Marijuana or ever used it. Generally they just give me a talking to and move on to more important things.

I've never had myself drug tested by a doctor but I think some do if they are prescribing stimulant adhd meds or pain killers. I heard it was to make sure you were using them and not selling them though.

Gormadt,
@Gormadt@lemmy.blahaj.zone avatar

My doctor drug tested me and also has me do drug tests every 6 months. They also said that I needed to stay away from weed and alcohol. They mentioned that a big part of that is seeing how the drugs are working without having to factor in the effects of other substances.

I only started treatment for my ADHD a few months ago and so far it's going great

I've been sober now for 5 years and that's also honestly great.

Edit: I also live in a legal state.

earlgrey0,

I have been moving around over the years and have been shocked at the varying quality of care I have received for my ADHD. Some Drs just took my old prescription no question asked. Others required me to come in once a month for 3 months to “establish care” before giving me the option to request refills without physically seeing them (it’s much more common for them to only want to see me once every 4 months and they will write prescriptions in-between). One actually gave me a very unpleasant lecture about how he didn’t believe I should be taking be taking the medication at all because that and taking birth control would ruin my chance at having children. To answer your question, I have never been required to take a marijuana drug test before getting a prescription , that just sounds crazy and controlling. You mentioned hat the facility mainly provides substance abuse care, and I think you might be on to something there. If you choose to continue with that facility ask them questions about their medication policies is general. Like is this a one time thing or are they going to withhold your prescription if you can’t pass a monthly drug test? Is it their facility’s policy that patients are expected to abstain from all non-prescription drugs to receive care, or is it just this instance? If you have your diagnosis and dosage you may want to consider changing the Dr, care facility, or both. Best of luck.

Dr_Cog,
Dr_Cog avatar

It definitely worsens my ADHD and makes the medication less effective.

ickplant,
@ickplant@lemmy.world avatar

I live in CO, which is a legal state, so things might be different. My psychiatrist didn't drug test me and didn't care that I use cannabis. Well, we absolutely had a conversation about usage, and how it can increase risk of psychosis for some people (I also have bipolar, so that's relevant), but he trusted me to make my own choices after providing basic education.

I'm also a therapist, and I know that in substance use treatment, the "old school" way is abstinence from all substances before you can access treatment. The "new school" way is about harm reduction, not abstinence. Sounds like your doctor could be old school? Are you in a legal state?

ilovesatan,
@ilovesatan@lemmy.world avatar

I live in Missouri. It was made legal recreationally last year. Perhaps not enough time for medical opinions to drift. Missouri is also a predominantly conservative state so that could have something to do with it.

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