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Suspected Vyvanse Abuse & Reporting to State Authorities
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worryingwife posted:
I suspect that my husband may be abusing his vyvanse. I'm not certain, but feel pretty confident. He tells great stories and always has an answer so it's hard to tell. I went so far as to call his prescribing psychiatrist because that's how concerned I am about his health and behavior. The doctor wants me to bring my husband in to see him, along with myself and my husbands father so we can have an "intervention."

I've indicated my suspicions to my husband and that I want to go with him to the Doctor, although I did NOT say that I already spoke to the doctor. My husband does have a history of abusing prescription pain killers so it didn't come as a total shock to him, but he's pretty mad and refusing to go to the doctor with me.

This is what I really need to know. His main reason for not wanting to go is that he's terrified of the "red x" that's going to haunt his records forever. That he will be stigmatized and flags will be sent up anytime from now on when he tries to get medication - even if it's legitimate. He keeps telling me that if I already told his doctor of if we go see him he'll be legally obligated to report it to the state. Even if it's just a suspicion and not confirmed. Is this really true? Now that I've already started to conversation, and "planted the seed" does that mean his doctor has reported him? And what's going to happen when my husband needs his next refill? I can't imagine the doctor will refill it after what I said. I'm terrified of what will happen but maybe if I can reassure my husband that he won't be turned over to the state it won't be so bad?
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Patricia Quinn, MD responded:
Vyvanse, because it is an amphetamine, is a controlled substance. There are strict laws governing its prescription with penalties for illegally selling or distributing it. A physician can only write a 30 day supply in most states and a new prescription must be written for each refill. Your husband's physician should be monitoring the number of pills he prescribes and the frequency that your husband is requesting refills. You did not say how you suspect your husband is abusing the medication. Vyvanse is a prodrug
(converted to an active form in gi tract) so it cannot be snorted, etc. Is he skipping doses and doubling up at other times? If he has a problem with substance abuse that needs to be discussed and addressed in treatment.

Treatment of ADHD is often necessary in those with a history of abuse but the abuse needs to be addressed and the stimulant treatment monitored closely. You have already informed your husband's psychiatrist. It is his responsibility to deal with this issue with your husband as part of his treatment. If your husband is abusing his medications this will need to be addressed and will become part of his treatment records and summary that may be passed on to other therapists and physicians if your husband releases them. As far as the state is concerned, the law is aimed at the illegal use of prescription medications. Your husband has a legitimate prescription for these medications.

Urge him to go to his therapist. I suspect the therapist will not be writing another prescription until he does so, but your husband needs help in this area.
 
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Robbeastie responded:
Honestly I just signed up to reply to this and I won't hide the fact that you probably did some damage to you're marriage, you're husbands doctor wasn't a smart move. A family meeting or intervention is one thing but you basically just put a lot of private things into a mess. You're obviously thinking about him but more selfish than anything you want to admit.


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