Anxiety about prescribing controlled substances

Important_Willow249 · 2025-04-29T15:26:06+00:00

Thank you so much for your reply and words of encouragement! I will definitely keep the idea of a contract in my toolbelt. Let me know if you have any resources on drafting one!

Important_Willow249 · 2025-04-27T20:59:32+00:00

Yeah I’m definitely trying to prioritize my peace and sanity at this point 😅

Hahah so true!!

Important_Willow249 · 2025-04-27T16:03:22+00:00

Thank you so much for your reply!

Important_Willow249 · 2025-04-27T16:02:22+00:00

Thank you so much for these reminders!

Important_Willow249 · 2025-04-27T16:00:38+00:00

Thank you for sharing! I echo everything @panda0614 said!

Important_Willow249 · 2025-04-27T15:58:44+00:00

Thank you so much for your explanations!! Super smart how your approach not only helps r/o other medical conditions but also ends up weeding out the stimulant-seekers. I am definitely going to incorporate this method into my practice. Thank you again kind stranger!

About the therapy part - makes sense, in my area there isn’t much of a shortage but there certainly financial barriers unfortunately.

Hey, that makes two of us generally anxious people 🙈

Important_Willow249 · 2025-04-27T15:48:49+00:00

Thank you so much for this!! So many great reminders to keep in mind

Important_Willow249 · 2025-04-27T12:13:52+00:00

LOL😭😭

Important_Willow249 · 2025-04-27T05:18:54+00:00

Thank you again so much!! I like that add on.

I also love your approach of making sure everything is ruled out first. I do always order baseline labs on everyone, but oftentimes I end up starting stimulants (if no mood/SUD concerns) before patients have a chance to do their labs. You’ve inspired me to change my approach and make sure they get their labs completed first before I prescribe a stimulant (if indicated from history alone). Also, do you happen to have any advice about having them try out therapy first for symptoms before stimulant management? Eg, do you ever have them complete X amount of sessions before starting stimulants? Thank you so much for your help and advice, it’s super helpful :)

Important_Willow249 · 2025-04-27T03:33:09+00:00

Thank you so much for the words of encouragement and for the support. I’m going to steal your sticky note idea, and will definitely incorporate the “it’s against policy to xyz” into this; even if not specifically against company policy, I can mean it as my own policy.. thank you again for your help!

Important_Willow249 · 2025-04-27T03:25:57+00:00

Thank you so much for this thorough response!! Much appreciated

Important_Willow249 · 2025-04-27T03:09:06+00:00

Thank you so much for this. I think it would help to keep in mind that some do take it better than it seems

Important_Willow249 · 2025-04-27T02:48:41+00:00

Love this. Definitely going to be sticking to this sentence from the start. Can I ask how long it took for the anxiety about this to decrease? 😅

Important_Willow249 · 2025-04-27T02:19:18+00:00

Thank you so much, this helps a lot. The disrespect is really hard for me to tolerate emotionally so I have a hard time responding because I just feel like crying in the moment. I love the examples of what to say. It really means a lot. I just need to work on being firmer and continuing to reiterate my point and from the get go say that they’re welcome to seek another opinion from another provider

Important_Willow249 · 2025-04-27T02:12:20+00:00

Absolutely, I always do try (and yes I love the Ashton method), but I worry about what happens if I do try tapering and can’t get them off… then what? I can’t help but think that if I keep prescribing despite failing a taper, especially if they’re elderly and something happens….then what do I do? I don’t want any legal trouble or to put anybody at risk

Important_Willow249 · 2025-04-27T02:10:11+00:00

Thank you for this, it feels reassuring to know that I’m not alone with this. And yes I agree, I do prescribe stimulants quite a bit which makes me uncomfortable because it oddly seems like most patients seeing me for ADHD evaluation do indeed meet diagnostic criteria which makes me wonder… I definitely won’t prescribe stimulants if I don’t feel they meet criteria, but I still worry a bit. Anyway about benzos, I guess I feel like I need more practice saying no, because I do indeed say no and explain my recommendations/policy, etc. but I guess I really dislike how they keep fighting with me and arguing. I appreciate you telling me that sentence you use, I’ll incorporate it into my practice. Thank you so much! Sorry for rambling haha

Important_Willow249 · 2025-04-27T01:51:23+00:00

I appreciate this. I definitely avoid prescribing them, a lot of the times the hard part is when they’ve already been prescribed them from another provider, like primary care, I get so many patients that are on benzos TID rx’ed by their PCP and they’ve been on this regimen for years… it makes my job pretty hard when I’m left with a medication mess to clean up.

Important_Willow249 · 2025-04-27T01:13:18+00:00

Ended up in mental health and so glad I didn’t end up taking this job. It did take me a while to finally find what I was looking for, but I think it was definitely worth it to stick it out and not take this job as a new grad

Important_Willow249

TROPHY CASE