prescribing stimulants to self reported daily cannabis users

[roastedcapers]

Thoughts? I have researched this and don't see any direct contraindications, if the client understands risk of tachycardia and not to use cannabis until stimulant wears off. I.e., rationale, treat mental health and substance use at same time, treat the ADHD to help all the symptoms, while client decreases substance use.

---

Members don't see this ad.

 

[Yoyomama88]

Not contraindicated but the cannabis could be a major player in the inattention itself.

Also don't know the data but wouldn't be surprised if cannabis users may have higher proclivity to misuse the stimulants.

Certrianly not as bad as giving to pt actively using cocaine, methamphetamine but would try to find out why they use cannabis bc if it's anxiety you may just make things worse with the stimulant

 

[Sushirolls]

No.

Clear UDS first.

 

[erg923]

I'm not sure you would withhold treatment for a disorder, that when properly treated, is empirically shown to actually reduce the risk/occurrence of substance abuse, but it certainly makes the actual diagnosis of ADHD alot more difficult/unreliable, no? Unless there is solid documentation of said disorder in absence of the cannabis abuse?

 

[Sushirolls]

I offer non-stimulant options to your point about not with holding treatment. But people don't want non-stimulant options. So, they quickly stop cannabis to get what they want.

 

[nexus73]

stimulants with ongoing cannabis use is pretty enabling. I mean, cannabis isn't helping anyone's mental illness. I think if you can motivate sobriety it's better for the patient. And cannabis is going to prevent the stimulant from being effective for concentration deficits.

It's like if you're 400lbs and have a bad knee, the orthopod will make you lose weight, like down to 350, before getting the surgery. I don't think of this as manipulative.

 

[MacDonaldTriad]

"I'm sorry, but I can't recommend heroine unless you cut down on your caffeine."

 

[erg923]

I offer non-stimulant options to your point about not with holding treatment. But people don't want non-stimulant options. So, they quickly stop cannabis to get what they want.

Now THAT.... is sly "strategery..."

 

[Psych19]

Now THAT.... is sly "strategery..."

Strattera-ergy?

 

[erg923]

Strattera-ergy?

Bushy goodness...

 

[birchswing]

Bushy goodness...

I wish I had his self-esteem.

 

[Sushirolls]

"I'm sorry, but I can't recommend heroine unless you cut down on your caffeine."

Heroines prefer caffeinated companions over un-caffeinated companions.