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Avatar universal

Doctor accused me of selling my meds.....

Two months ago I went to a doctor to receive treatment for ADHD.  I am 28 years old and have never been treated for this before, always just scraped by in school and college and "dealt" with it.  So anyway, I have my first real "adult" job now and want to be successful, so I decided to seek treatment.  The doctor talked to me and gave me the diagnosis of ADHD and prescribed me methylphenidate (generic Ritalin).  I got my first script and took it as prescribed and a month later went for a followup appointment.

At the followup appointment, I explained to him that the medication is extremely effective in helping with my inattentiveness, but that the side effects are pretty intolerable.  He said since the medication is working so well on my symptoms that I should take propranolol along with it to minimize the negative side effects.  

When I got the refill, the pills were different (the first ones were green, the second ones were white) and it felt like a very different medication.  It did not feel nearly as strong and to get the desired effects, I took more medication than prescribed (I was prescribed 20 mg a day and began taking 40 mg a day).  The side effects were still pretty bad in the evening and to deal with it, I would usually have a beer when I got off work.  I began losing weight and not eating to the point I was looking like a scarecrow, so I began smoking a little pot before bed so I could sleep good and eat before lying down.  

So I go for another med review yesterday.  I told the nurse who saw me before the doctor came in that I had been taking more medication than I was prescribed and that I suspected the doctor would be a bit upset with me over this, but I was prepared for him to switch my medication or whatever he wanted to do.  The doctor came in and I explained to him the difference in the medication and that I was taking more than prescribed and he expressed that he was not too happy about it, but he did agree to increase my morning dose and leave my afternoon dose the same so that I could get the desired effects from the medication.  I then proceeded to tell him about the anxiety I was dealing with in the evenings and that I felt the need to drink a beer in the evenings when the medication was wearing off because the anxiety is so bad.  He then accused me of drinking more than just "a" beer, insenuating that I was drinking more beer than I was letting on.  I explained to him that a beer is all I have.  He left the examination room, brought back some paperwork for me to sign (later found out it was authorization to drug test me), took me out of the examination room to a bathroom and instructed the nurse to stand at the door to ensure that I did not wash my hands or flush the toilet while I provided the specimen.  

I provided the specimen and was instructed to go back to the examination room.  The doctor informed me that he was drug testing me to ensure that I was really taking my medication and not giving it away or selling it.  I said that was fine because I had just taken a dose that morning so it would be in my system.  Well, the results came back and he told me that since I did not test positive for methamphetamines that that meant I was not taking my medication.  He also pointed out that I tested positive for marijuana.  I admitted, yes, that I had used marijuana.  He told me that he didn't think that I "used" marijuana, but that I "use" marijuana.  He said, "well, you are obviously not taking your medication and you are taking medication other than what I prescribed, so bye." and he showed me to the door.  

I called the doctor's office receptionist as I was driving off crying, to let her know that I was not paying for my appointment that day.  Today, I spoke to the office manager who stated that she talked to the doctor about the way I was treated and she stated they are going to change the way they do things in the office.  For example, the drug test he gave me was a 5 panel drug test that did not pick up on the medication that was in my system, so they are switching to 10 panel.  I explained to her that I realize what I did wrong as a patient--I took more medication than prescribed and I also used marijuana to cope with the side effects....But for him to assume that because I admit to drinking a beer that I am having several beers or because I tested positive for pot that I am this big druggie, is unfair and borderline unethical.  To kick me out of his office because his drug test did not pick up on the meds that were in my system was definitely unethical, especially since he did not even provide a taper dose for me to come off the meds slowly.  What I want to know is where is the physician-patient relationship here???  For the rest of my life, I will never admit to drinking an ounce of alcohol to a doctor....I will never take another medication that is labeled as a controlled substance as long as I live.  They will label you as a drug seeker/dealer just because of what they prescribe.  Also, I felt that he could have offered medication that is not labeled as a controlled substance since there was obvious concern that I was taking more than prescribed.  Okay...Well, this is really more of a vent off than a question, but I am curious if anyone has ever been through something similar with a doctor.  Rant Over.
23 Responses
480448 tn?1426952138
Well, while your doctor was a bit over the top, you DID handle things wrong I'm afraid (as you realize) and a doctor can dismiss you at any time for any reason, especially if they suspect something shady is going on.

It's always better to be honest with a doctor about everything.  I understand what you're saying about the alcohol, but unfortunately, you're doctor is actually right.  Most people will only admit to a portion of whatever they really use, be it alcohol, cigarettes, etc.  That's a normal gut reaction as a doctor...and for most people, he would have been right.

Take this as a learning lesson...for one, you don't change a prescription. If something isn't working, you talk to your doc about it, not take matters into your own hands.  Also, if you're asked to sign something READ IT!  He got your consent for the drug test...it's not his fault you didn't read what you were signing.  If you had, you could have told him about the MJ.

"They will label you as a drug seeker/dealer just because of what they prescribe.:"
In fairness,it DID look like that...and you weren't upfront about the MJ, so this is kind of your fault to an extent.


If you're still interested in treatment for the ADD, find a new doctor (obviously) and just be up front,.  Have you ever looked into non-medication methods of improving ADD?  

Sorry this happened, it's unfortunate.  Sounds like a little bit of some poor practices (the test) in the office and a knee-jerk over the top reaction by the doc...but you most certainly played a pretty big role in how things went down.  Lesson learned.
4204073 tn?1361835076
Doctors now days are under intense scrutiny about prescribing or what may be considered over prescribing of addictive/narcotic medications.   Addiction is so rampant anymore that they are more likely to believe their is a problem until you prove their isn't.   It is very unfortunate that the addicts that abuse the medical system ruin it for those that are not.  And I too played a role in that by buying someone elses prescribed opiates, so I am not guilt free even though I didn't get them from my Dr.   Although, I did go to a pain management center and they call you in for random tests and pill counts.   I was at the time taking them as prescribed and one day they said I tested positive for methadone.  I didn't even know what that was at the time.   Another time I went in and was short on pills and I was honest and told them that my now ex had helped himself to them.   It was the truth.  I didn't tell him he could get into them.    Then there was a time when someone stole my meds at work out of my purse.  I reported it to the police and the Dr office, but they said they were my responsibility and couldn't prescribe me more.   The last incident was when they called me in for a pee test and I told them I couldn't get away from work.   They dropped me for being non-compliant along with the other aforementioned issues.   At the time I was really upset because I didn't do anything wrong!!    But now I can see that they have to protect themselves from the DEA.   Your Doc is probably concerned that with a positive MJ result and your using more of the meds than prescribed that he was setting himself up to look like he was prescribing to an addict.   I'm sorry this happened to you.   Perhaps a new Doctor will be more understanding?    Or maybe you saved yourself from getting in deeper with narcs since you were mixing beer, mj and ritalin.    That really is how addictions get started.   We aren't getting the desired result (and I saw you used that term a couple times) so we self medicate and keep adding more to the mix as our tolerance builds.   I myself wound up turning to the streets after the pain management clinic cut me loose.   I wish I had never stepped foot in that place to begin with.  
4113881 tn?1415853876
Well, its funny how people see things differently....but anyways, your doctor was very unprofessional and as you said, "unfair and borderline unethical". I would report him and what happened to the Medical Board. Here is your states medical board complaint form....use it!

http://www.tmb.state.tx.us/consumers/complain/Complaint-Form-10-5-11.pdf
______________________________________________________________

Yes, your doctor should be notified of all medications including illicit drugs you are taking for possible drug interactions. Even if its one beer and one hit of weed...he needs to know for your safety...But to act like that and throw you out without tapering you plus assuming and making accusations that your an alcoholic because YOU disclosed to him you had 1 beer is an example of malpractice. So you didn't test positive for amphetamines...those dipstick tests they use in the doctors office should be banned. So you tested positive for marijuana...a lot of people are afraid to disclose there recreational drug use to there doctors...it doesn't give him the excuse to act the way he did and throw you out.

And here's a little information for you that might help you understand why your doctor got so upset, methylphenidate and alcohol interact. It doesn't excuse his behavior but it may explain why is boxer briefs got all in a bunch.
Yes it was only one beer but his concern was obviously that you were drinking more...which would cause the interaction. Its probably why he wouldn't give you a refill...didn't want to risk it. Alcohol increases the effects of methylphenidate.

Here's study for ya:

"Subjects (three males, three females) received a single oral dose of methylphenidate (20 mg; two 10-mg tablets) followed by consumption of ethanol (0.6 g/kg) 30 min later...... Ethylphenidate was detectable in the plasma and urine of all subjects after ethanol ingestion. ........In view of the known dopaminergic activity of racemic ethylphenidate, it remains possible that under certain circumstances of higher level dosing, e.g., in the abuse of methylphenidate and ethanol, the metabolite ethylphenidate may contribute to drug effects."

http://dmd.aspetjournals.org/content/28/6/620.long
___________________________________________________________

Id still report him...like yesterday. And get a new doctor ASAP.
Good luck

Avatar universal
Just to add a bit more information, before the doctor instructed me to drug test, he had actually handed me a prescription for my Ritalin which he increased my morning dosage and left my afternoon dosage the same.  It was after I took the drug test and the meds did not show up in my system that he discharged me from his practice and took my prescription from me.  

Essentially, he did not perform the correct type of drug screen to test for methylphenidate and that is primarily what he based his decision on.  I was honest with him about the fact that I was having a beer in the evening, that I was taking more meds than prescribed, and while I was not upfront with him about the marijuana usage, I did tell him that I had used marijuana after the results of the drug screen came back, but no matter what I said to him that day, he assumed I was being dishonest...In his opinion I was having several beers a day, I was a long-term regular pot head probably going on for many years (when I had only started smoking 3 weeks prior to deal with med side effects), and I was selling my meds or giving them away instead of taking them.  

As you realize, I do know what I did wrong here.  I was not expecting him to be thrilled about me taking more meds than were prescribed, but I was honest and upfront about this with him and even told the nurse before the doctor came in to see me.  I was prepared for him to either change my meds or at least lecture me about the importance of taking my meds as prescribed.

"I understand what you're saying about the alcohol, but unfortunately, you're doctor is actually right.  Most people will only admit to a portion of whatever they really use, be it alcohol, cigarettes, etc.  That's a normal gut reaction as a doctor...and for most people, he would have been right."

For it to be considered common practice by physicians to ASSUME that patients are having several beers if they admit to having ONE BEER, for example is quite alarming to me.  You state that I should have been honest about the marijuana.  If I cannot admit to my doctor that I am having A BEER in the evenings without him assuming I am an alcoholic, this makes me overall distrustful of the medical profession in general.  Automatically assume that people are being noncompliant or using much more than they say they are.  No trust whatsoever in the physician/patient relationship.
4113881 tn?1415853876
Exactly my thoughts! :)
480448 tn?1426952138
I totally understand what you're saying, and you make very valid points.

For it to be considered common practice by physicians to ASSUME that patients are having several beers if they admit to having ONE BEER, for example is quite alarming to me.  

I understand, but this IS true, to an extent, and actually is common practice among medical professionals to be a little cautious of what is "reported".  There is subjective assessment data and objective assessment data, and both are used to make determinations about different things.  

We were actually taught the exact same thing in nursing school, due to human nature, MOST people will minimize usage of things like cigarettes, alcohol, etc.  Therefore, a doctor prescribing meds would commonly assume if a person says they drink one beer a day, that the more accurate number may be 3 or more.  I understand that that seems wrong, but it's a way to be cautious when making decisions based on that subjective data.  It isn't about making people into liars.

I understand that you were honest and it sort of bit you in the behind, and I understand why you would feel like you do...I'm simply stating that unfortunately, the vast majority of people are not as upfront and honest as you were.  The doctor handled the situation poorly without a doubt, which is why I guess it's a good thing you found out when you did, so you can find a new doctor.

"Automatically assume that people are being noncompliant or using much more than they say they are.  No trust whatsoever in the physician/patient relationship."

As far as that goes, when it comes to Rx'ing a controlled substance, some docs have a much lower willingness to "trust"...who knows, maybe he has been burned before?  The bottom line is, at the end of the day, it's HIS license and HIS DEA # on the line.  I agreed that he overreacted, and the fact that he discharged you based on the faulty tox screen wasn't necessarily "fair"...but again, some are more willing to "give" than others...some never give a patient an opportunity to "prove themselves" at all, where some will be more willing to give a little.  Right or wrong, it's their perogative....and while he may have acted like a jerk, he didn't do anything wrong legally.  They actually legally are not required to even give a reason for cutting off a script.  Some do it with no reason at all.  It's unfortunate that you had this experience...if anything, you now realize the importance of taking your meds as prescribed....as that alone could have led you to a bad place.

Best of luck to you!

2107676 tn?1388977459
It is ridiculous that doctors are more worried about covering their a$$es instead of worrying about their patients. It seems that they have gone from pill pushers to now thinking everyone is an addict.
It's just all business now and the old time compassionate doctor doesn't seem to exist anymore.  If you are lucky enough to find one, hang on to him or her for dear life.  
480448 tn?1426952138
No doubt there are some lousy doctors out there, but the unfortunate reality is, doctors have to cover their a$$es so much because of the level of diversion and abuse of narcotics.  This wasn't an issue at all a few decades ago, and even 10 years ago it isn't nearly as bad as it is now.

They have to be uber cautious, and I agree that it's sad.  Doctors are very hesitant to Rx narcotics, leading to people not having their pain managed as well as they should, and of course, then you see issues like this one, where a patient was honest with the doctor, and he had that knee jerk reaction.

If there wasn't the abuse of narcotics, this wouldn't be nearly the issue it is now.  It's too bad.  I couldn't agree more that if a person does manage to find a good doc....hang on for dear life.  They ARE out there.
4113881 tn?1415853876
I still say report him to he medical board. Even if it doesn't do anything, the complaint will be on record. I'm tired of medical personnel acting above the law and better than the rest....making accusations...billing insurance codes that never happened....balance billing...I'm disgusted by medical care. I have huge medical issues in my life right now...I'm literally fighting for my life ...having said that, I refuse to let any medical personnel treat me any other eat then professional. YOU are the customer, they are the PROVIDER...YOU pay his paycheck...hence, he can't just treat you any ole way. Report him...give him bad ratings on healthgrades and vitals....then, when somebody else reports him or he same thing...hey, who knows.

There are good doctors out there the problem is once the word is out....everybody wants to see them...and appointments are booked for months....
480448 tn?1426952138
It's unfortunate that you're having bad experiences, and certainly, if the OP feels the doctor should be reported to the medical board, that's his right to do so.  I was simply trying to point out that there really wasn't anything "malpractice" worthy here.  It's a good thing the OP found out early enough what this doc was like.

Unfortunately, when one has had a bad experience, it puts a bad taste in his/her mouth and often leads them to be a bit jaded.  While that's completely understandable, it's important to remember that there ARE good practioners out there.  The best thing anyone can do for themselves is be their own advocate, educate themselves about any medical treatment they're getting, and if they're unhappy with the way their care is being handled, to seek out another caregiver. It's a shame that a lot of people would never dare question a doctor...nor will they go elsewhere out of a strange sense of loyalty.  The very best doctors will ENCOURAGE and welcome second opinions.
4204073 tn?1361835076
I had a REALLY good old fashioned Doctor.   Unfortunately he retired.  :(    He would come in and joke around with me, hug me, follow up with me on the phone or email, etc.    He was genuinely concerned about my well being.    I went to an associate in his office and what a complete 180.   My original Dr's nurse went somewhere else, so I followed her and while this Dr doesn't have quite the same bedside manner as my old one, he is what I would consider to be a decent Dr.    He is very cautious about prescribing narcotics and when he does, he makes you come in regularly for appointments to document and follow up.   I understand why.   It is his license and DEA on the line as Nurse Girl said.    While they may be the provider and we are paying their bill, it is still a partnership.   They can't help us if we won't help ourselves or we take matters into our own hands and use our medications how WE see fit.   Before they know it, they are legal drug pushers for us.   It is unfortunate that we as addicts have put the Dr's in this position to have knee jerk reactions.  
495284 tn?1333897642
COMMUNITY LEADER
This really doesnt have anything to do with addiction.  If you feel the need to turn the doctor in then do so and let the medical field decide if he was in the wrong.
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495284 tn?1333897642
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