6 ms·

The reality is that many doctors these days will not prescribe large amounts of benzos, certainly not just willy nilly.

ldjkfkdsjnv 4y ago
I'm not just talking about benzos, but also anti psychotics, amphetamines, statins, and basically the whole gamut. My brother is a pharmacist, and is constantly shocked by the prescriptions that healthy people bring in to get filled. The medical field has been unjustly given too much prestige.
- cstejerean 4y ago
  And how does he know they are healthy?
  - anonymoushn 4y ago
    maybe my pharmacist can tell that I don't need methylphenidate because I have all my documents in order while I'm already on methylphenidate :)
    - sascha_sl 4y ago
      "You can't have ADHD, if you had ADHD, you could not have driven here for an hour" -- real thing that happened to someone I know.
      - throwaway284534 4y ago
        This is a exactly the kind of puritanical catch-22 that entrenches every corner ADHD treatment. “Oh, your justification for access to the high-inducing, party drug of amphetamine is that it’ll cure your lack of focus? Well, if these dangerously addictive drugs so effective, then surely you can handle 30 day prescriptions with no refills.” God forbid your prescription runs out on a weekend or holiday when your doctor’s office is closed. And don’t even think about shopping around for multiple scripts because that’ll just label you as a drug addict. The only winning move is to take half-doses on down days and build up a small stash of emergency medication.
        opportune 4y ago
        100% this. The worst part about ADHD treatment is all the disruptions of care to prevent people trying to abuse it. I personally don't give a rat's ass if people want to take adderall to go out and party or masturbate either. They'd probably have fun with less negative health effects or risk of fights/belligerence compared to alcohol... But for some reason the government (the FDA) and medical field in general cares about abuse a lot. In the past few weeks, Cerebral got labelled a pill mill by the FDA/execs and as a result almost all ADHD telemedicine patients are having a hard time getting prescriptions filled. Sending a prescription to multiple places sequentially (because they keep refusing to fill it) or calling a pharmacy in advance to ask if they'd fill the prescription runs the risk of being labelled a drug seeker, and any power-tripping retail pharmacist - who doesn't know anything about you at all - can just refuse to fill your prescription if they want. Asking your provider for a higher dose is also anxiety-inducing for similar reasons. The worst part is, people with ADHD still build a dependence/tolerance on amphetamines/methylphenidate. So running out of your medicine is really disruptive - not only do your symptoms go untreated, but they become worse than they'd be if you were unmedicated for a long interval, plus you have to deal with things like not feeling fully awake, being hungrier, lethargic, sleeping more while your body adjusts back to being unmedicated. But for some reason that's acceptable as long as we prevent people from taking amphetamines for fun.
        sascha_sl 4y ago
        I found it really useful to cycle single doses between 5mg/10mg and ocasionally skip it entirely, when I know it wouldn't be essential. (Usually the skip sorts itself out when I forget I have them. You'd think lingering processing deficiencies would be obvious enough to remind me, but apparently not.) I've been avoiding higher doses because this setup works well enough that I don't want to disrupt the status quo and I keep hearing from friends that build a dependence and even one who went off them entirely after adverse reactions on very high doses. Fortunately I have a doctor who agreed this was a good idea and writes me prescriptions for different strengths.
        hombre_fatal 4y ago
        It's pretty obnoxious how pharmacies and especially pharmacists have this kind of discretion. Just put my pills in the bottle, dude. I got turned down for filling an Adderall prescription at a CVS because the pharmacist didn't like that I was paying in cash (credit card) as an uninsured uni student. Didn't offer to call my doctor's office to confirm the script. Just said oh, I don't like that you're paying in cash so I'm not going to fill this :). I fortunately get 90-day prescriptions (how long will that last?) and every time I refill, I have anxiety throughout the whole process (the checkup, the pharmacy) until I have pills in hand. Every time I feel like it's going to be the day I somehow have to jump through more hoops like my friend who has to have his pills counted every two weeks for his painkillers.
- cwzwarich 4y ago
  > My brother is a pharmacist, and is constantly shocked by the prescriptions that healthy people bring in to get filled. While I definitely agree with your general point, how does your brother know that they’re healthy or don’t need to take the medication? I’ve never had any discussion with a pharmacist (in the US or Canada) where I’ve revealed this information.
  - ldjkfkdsjnv 4y ago
    What I mean is a mother of 4, with no medical history, is feeling stressed and worn out. Maybe she has trouble focussing. All of a sudden she comes in with an amphetamine prescription. A year later, she's a full blown dependent on a serious drug. She was actually just burned out and probably just needed a break from her kids and a vacation. Very common. There's no transparency, no public understanding of doctors who are prescribing like this. It's only in a pharmacy do you get a birds eye view.
    - anonymoushn 4y ago
      I sort of expect that the psychiatrist spends more time with the patient each month than the pharmacist.
      - rhexs 4y ago
        It's sort of a sad indictment of our system, but odds are the pharmacist sees the patient far more than the psychiatrist does.
        tptacek 4y ago
        I have literally never had a discussion with a pharmacist. I drive up, hand them my script through the drawer thingy, and they hand me back my drugs. In fact, in the last couple years, I barely even do that anymore; our doctors just call in our scripts, and we get a text message when it's time to pick them up, and that's that. The idea that pharmacists have any meaningful diagnostic role in the US is risible.
- ZanyProgrammer 4y ago
  Your brother is not a clinician, definitely not those people's clinician.
- anonymoushn 4y ago
  antipsychotics are horrifying. do therapeutic doses of stimulants cause problems other than heart disease over the long term?
  - aaaaaaaaaaab 4y ago
    No, long-term stimulant use is totally A-ok! /s
    - mtlmtlmtlmtl 4y ago
      Actually, at therapeutic doses, it is.
  - maleldil 4y ago
    Antipsychotics are terrifying, but I'd rather deal with the physical side-effects than the disorder, and they're pretty effective at treating that.
    - deleted 4y ago
      [deleted]
  - matheusmoreira 4y ago
    Depends on how you define "problem". Amphetamines may cause a lot of side effects: lower appetite, agitation, insomnia, irritability, bruxism... The list goes on. Whether these risks are acceptable or not is an individualized choice. Some side effects may even be beneficial: lower appetite for weight loss, insomnia for narcolepsy.
- sascha_sl 4y ago
  If your brother told you that with this exact framing, he's in the wrong industry. Health, and especially not mental health is very much not visible or even obvious. Just ask any disabled person that is not bound to a wheelchair 100 percent of the time.
- cycomanic 4y ago
  I believe blaming this on doctors only is way to easy. I believe many people demand medication when they go to the doctor. If they go because of a cold they don't accept being told to rest for a week, but demand antibiotics, if they feel depressed they don't want to be told to exercise, but want a quick medication etc.. I definitely see this since coming to Sweden, where it's difficult for doctors to prescribe antibiotics and lots of expats complain that they went to the doctor and were told to rest for a week. They feel they are not taken seriously if they don't get medication (that is not to say that there are no problems with how healthcare is done here, but restrictive prescriptions of antibiotics is not one of them).
  - hombre_fatal 4y ago
    I'm sure you can find examples of failings on all sides, but doctors are the ones that pull the trigger. When I got an amphetamine prescription in uni (like everyone else), I felt like I was lucky to have a doctor that started me off on the lowest dose. Everyone I knew was on a much higher dose than me just starting out. People would get a dual prescription of XR capsules + IR tabs when they need a bump. Then when they couldn't sleep, the doc would just add another pill to the mix. And not just a mild one, but an extreme one like Seroquel. Your doctor just isn't a specialist, and certainly not someone specializing in you and your specific ailments despite what we seem to pretend in these threads. Best strategy is to be informed and meet them in the middle.
- opportune 4y ago
  If they're healthy, couldn't that be because of the medicine? A lot of people have conditions that medicine treats so well you wouldn't even know they had a condition at all. I know many people who have taken antipsychotics, amphetamines, and statins for decades and it was perfectly fine for them. I also personally know some judgmental pharmacists too. All I'll say is, there's a reason pharmacists and doctors are distinct professions.
  - matheusmoreira 4y ago
    > If they're healthy, couldn't that be because of the medicine? It's very likely. This actually has to be explained to a lot of people with chronic diseases like hypertension and type 2 diabetes. Way too many of them just stop taking their medication after their condition improves.

I'm not just talking about benzos, but also anti psychotics, amphetamines, statins, and basically the whole gamut. My brother is a pharmacist, and is constantly shocked by the prescriptions that healthy people bring in to get filled. The medical field has been unjustly given too much prestige.

cstejerean 4y ago
And how does he know they are healthy?
- anonymoushn 4y ago
  maybe my pharmacist can tell that I don't need methylphenidate because I have all my documents in order while I'm already on methylphenidate :)
  - sascha_sl 4y ago
    "You can't have ADHD, if you had ADHD, you could not have driven here for an hour" -- real thing that happened to someone I know.
    - throwaway284534 4y ago
      This is a exactly the kind of puritanical catch-22 that entrenches every corner ADHD treatment. “Oh, your justification for access to the high-inducing, party drug of amphetamine is that it’ll cure your lack of focus? Well, if these dangerously addictive drugs so effective, then surely you can handle 30 day prescriptions with no refills.” God forbid your prescription runs out on a weekend or holiday when your doctor’s office is closed. And don’t even think about shopping around for multiple scripts because that’ll just label you as a drug addict. The only winning move is to take half-doses on down days and build up a small stash of emergency medication.
      - opportune 4y ago
        100% this. The worst part about ADHD treatment is all the disruptions of care to prevent people trying to abuse it. I personally don't give a rat's ass if people want to take adderall to go out and party or masturbate either. They'd probably have fun with less negative health effects or risk of fights/belligerence compared to alcohol... But for some reason the government (the FDA) and medical field in general cares about abuse a lot. In the past few weeks, Cerebral got labelled a pill mill by the FDA/execs and as a result almost all ADHD telemedicine patients are having a hard time getting prescriptions filled. Sending a prescription to multiple places sequentially (because they keep refusing to fill it) or calling a pharmacy in advance to ask if they'd fill the prescription runs the risk of being labelled a drug seeker, and any power-tripping retail pharmacist - who doesn't know anything about you at all - can just refuse to fill your prescription if they want. Asking your provider for a higher dose is also anxiety-inducing for similar reasons. The worst part is, people with ADHD still build a dependence/tolerance on amphetamines/methylphenidate. So running out of your medicine is really disruptive - not only do your symptoms go untreated, but they become worse than they'd be if you were unmedicated for a long interval, plus you have to deal with things like not feeling fully awake, being hungrier, lethargic, sleeping more while your body adjusts back to being unmedicated. But for some reason that's acceptable as long as we prevent people from taking amphetamines for fun.
        sascha_sl 4y ago
        I found it really useful to cycle single doses between 5mg/10mg and ocasionally skip it entirely, when I know it wouldn't be essential. (Usually the skip sorts itself out when I forget I have them. You'd think lingering processing deficiencies would be obvious enough to remind me, but apparently not.) I've been avoiding higher doses because this setup works well enough that I don't want to disrupt the status quo and I keep hearing from friends that build a dependence and even one who went off them entirely after adverse reactions on very high doses. Fortunately I have a doctor who agreed this was a good idea and writes me prescriptions for different strengths.
        hombre_fatal 4y ago
        It's pretty obnoxious how pharmacies and especially pharmacists have this kind of discretion. Just put my pills in the bottle, dude. I got turned down for filling an Adderall prescription at a CVS because the pharmacist didn't like that I was paying in cash (credit card) as an uninsured uni student. Didn't offer to call my doctor's office to confirm the script. Just said oh, I don't like that you're paying in cash so I'm not going to fill this :). I fortunately get 90-day prescriptions (how long will that last?) and every time I refill, I have anxiety throughout the whole process (the checkup, the pharmacy) until I have pills in hand. Every time I feel like it's going to be the day I somehow have to jump through more hoops like my friend who has to have his pills counted every two weeks for his painkillers.
cwzwarich 4y ago
> My brother is a pharmacist, and is constantly shocked by the prescriptions that healthy people bring in to get filled. While I definitely agree with your general point, how does your brother know that they’re healthy or don’t need to take the medication? I’ve never had any discussion with a pharmacist (in the US or Canada) where I’ve revealed this information.
- ldjkfkdsjnv 4y ago
  What I mean is a mother of 4, with no medical history, is feeling stressed and worn out. Maybe she has trouble focussing. All of a sudden she comes in with an amphetamine prescription. A year later, she's a full blown dependent on a serious drug. She was actually just burned out and probably just needed a break from her kids and a vacation. Very common. There's no transparency, no public understanding of doctors who are prescribing like this. It's only in a pharmacy do you get a birds eye view.
  - anonymoushn 4y ago
    I sort of expect that the psychiatrist spends more time with the patient each month than the pharmacist.
    - rhexs 4y ago
      It's sort of a sad indictment of our system, but odds are the pharmacist sees the patient far more than the psychiatrist does.
      - tptacek 4y ago
        I have literally never had a discussion with a pharmacist. I drive up, hand them my script through the drawer thingy, and they hand me back my drugs. In fact, in the last couple years, I barely even do that anymore; our doctors just call in our scripts, and we get a text message when it's time to pick them up, and that's that. The idea that pharmacists have any meaningful diagnostic role in the US is risible.
ZanyProgrammer 4y ago
Your brother is not a clinician, definitely not those people's clinician.
anonymoushn 4y ago
antipsychotics are horrifying. do therapeutic doses of stimulants cause problems other than heart disease over the long term?
- aaaaaaaaaaab 4y ago
  No, long-term stimulant use is totally A-ok! /s
  - mtlmtlmtlmtl 4y ago
    Actually, at therapeutic doses, it is.
- maleldil 4y ago
  Antipsychotics are terrifying, but I'd rather deal with the physical side-effects than the disorder, and they're pretty effective at treating that.
  - deleted 4y ago
    [deleted]
- matheusmoreira 4y ago
  Depends on how you define "problem". Amphetamines may cause a lot of side effects: lower appetite, agitation, insomnia, irritability, bruxism... The list goes on. Whether these risks are acceptable or not is an individualized choice. Some side effects may even be beneficial: lower appetite for weight loss, insomnia for narcolepsy.
sascha_sl 4y ago
If your brother told you that with this exact framing, he's in the wrong industry. Health, and especially not mental health is very much not visible or even obvious. Just ask any disabled person that is not bound to a wheelchair 100 percent of the time.
cycomanic 4y ago
I believe blaming this on doctors only is way to easy. I believe many people demand medication when they go to the doctor. If they go because of a cold they don't accept being told to rest for a week, but demand antibiotics, if they feel depressed they don't want to be told to exercise, but want a quick medication etc.. I definitely see this since coming to Sweden, where it's difficult for doctors to prescribe antibiotics and lots of expats complain that they went to the doctor and were told to rest for a week. They feel they are not taken seriously if they don't get medication (that is not to say that there are no problems with how healthcare is done here, but restrictive prescriptions of antibiotics is not one of them).
- hombre_fatal 4y ago
  I'm sure you can find examples of failings on all sides, but doctors are the ones that pull the trigger. When I got an amphetamine prescription in uni (like everyone else), I felt like I was lucky to have a doctor that started me off on the lowest dose. Everyone I knew was on a much higher dose than me just starting out. People would get a dual prescription of XR capsules + IR tabs when they need a bump. Then when they couldn't sleep, the doc would just add another pill to the mix. And not just a mild one, but an extreme one like Seroquel. Your doctor just isn't a specialist, and certainly not someone specializing in you and your specific ailments despite what we seem to pretend in these threads. Best strategy is to be informed and meet them in the middle.
opportune 4y ago
If they're healthy, couldn't that be because of the medicine? A lot of people have conditions that medicine treats so well you wouldn't even know they had a condition at all. I know many people who have taken antipsychotics, amphetamines, and statins for decades and it was perfectly fine for them. I also personally know some judgmental pharmacists too. All I'll say is, there's a reason pharmacists and doctors are distinct professions.
- matheusmoreira 4y ago
  > If they're healthy, couldn't that be because of the medicine? It's very likely. This actually has to be explained to a lot of people with chronic diseases like hypertension and type 2 diabetes. Way too many of them just stop taking their medication after their condition improves.