Expert: Charles I. - 8/7/2009

Question
My daughter (29) is living with me post rehab for Heroin addiction. I found a script for Adderall in her bookbag which she said was giving to her in rehab for ADHD. Four pills were missing. I put them in my purse with the aggrement that I would dispense one (30mg) daily. Two days later I found 7 more pills missing. She, of course, is adamant that she did not take the pills. I also think that she may be opening the capsules, taking some of the meds out and then closing them back up, although that may just be my anxiety, as I found them difficult to open without crushing the capsule. Anway, she has no money that I am aware of to buy Heroin, so she may be selling the Adderall, although she came up negative for opiates on her pee test yesterday. I just need some advice. Thanks so much.

Answer
Hi Lisa,

Let me start by saying I am not a doctor, so I would absolutely insist that you gain information from a qualified medical professional as to options that your daughter may have. Adderall is a medication that is given for people with ADHD and narcolepsy. It is comprised of 2 powerful psychostimulants: Dextroamphetamine and amphetamine. It is classified as a schedule II drug which means: (1) The drug has a high potential for abuse. (2) Abuse of the drug may lead to severe psychological or physical dependence. This may be a problem for an individual who already has a demonstrated propensity for addiction. Adderall helps to provide the user with mental clarity, the ability to focus and complete tasks, increase in energy, and the feeling of well-being.
I would recommend that you guys speak with your family physician about other possible medical therapies that could be beneficial to your daughter without so much danger for becoming hooked on another substance. Understand that I'm not saying Adderall is necessarily a bad drug. When taken as directed by individuals without a history of substance use disorder it can be very beneficial in controlling the symptoms of ADHD. But with people who are in recovery it can be a dangerous drug for their recovery. The bottom line is the drug is nothing more than "speed"...you know, the stuff trucker supposedly used to take to stay awake for the long hauls. We find today that Adderall and Ritalin and very often abused by high school and college students cramming for tests and exams. Excessive use of this drug can lead to many problems including paranoia, psychosis, heart attack, stroke...to name a few.
You mention that you are consistently finding pills missing...is she taking them? I don't know. Is there another family member who might be diverting them...could be another possibility.
If you want to know if she is using the Adderall you can have them test for amphetamine when she has to submit for a urinalysis. Obviously if there isn't the presence of amphetamine in her urine then she isn't taking them and maybe selling them...it is a possibility.
This is a sticky situation because there may be a legitimate underlying medical condition that requires this type of medication. We do know that if the symptoms of ADHD are not controlled very often the individual will self-medicate to help them feel better.
If your daughter is willing I would recommend getting a second opinion on the diagnosis she was given and on the possibility of other medication she can take to help control the symptoms if she does have ADHD.
I apologize that there isn't a cut and dried answer to your situation. I do hope that this gives you a little information you can work with to help decide your daughter's next move. Thanks for your question and know you will be in my prayers.

Charles