Let me start by saying that if you are in recovery, and you assume that your doctor or psychiatrist understands the risks associated with prescribing medication for people in recovery…think again. There is only one medical school in the country at present that requires residency training in an addiction unit (University of Florida in case you were curious). I frequently run into people who are in early recovery from alcoholism or drug addiction that have been to visit a psychiatrist (or worse a primary care physician) who has made a diagnosis of attention deficit disorder, and has put that person at risk for relapse by prescribing them psychostimulant medication such as adderall or ritallin. A physician or psychiatrist who lacks training in addiction will fail to recognize the symptoms of Post Acute Withdrawal (a.k.a. secondary withdrawal) which will lead to the above mentioned misdiagnosis.
Most people familiar with addiction\alcoholism know what primary withdrawal looks like. Though it varies widely from drug to drug, they include things such as gastrointestinal disturbance, flu like symptoms, shaking etc. Following these issues subsiding within about 3-7 days depending on the drug, persons in recovery then will endure the symptoms of secondary withdrawal. Symptoms of secondary withdrawal or post acute withdrawal include: Problems with Memory, concentration difficulties, sleep problems, stress intolerance, mood fluctuations or numbness, and coordination problems. You can see now how this could be mistaken for an attention problem. The symptoms are the result of damage that occurs to the nervous system as a result of substance abuse, and thus take sustained clean time to heal.
Symptoms begin 7-14 days after initial sobriety, and here is the kicker…they peak at 3-6 months. Yes that’s right, they get worse as you stay sober longer, but the good news is they do subside within 6-24 months of continuous sobriety. It is uncanny to me how on cue the peak can be. I have frequently had the experience of working with someone who has been having a pretty smooth time in early recovery only to come in one day to tell me they think they are “going crazy” or some variation of that. When I ask how long they have been sober, it always amazes me how often they tell me a few days within the 90 day mark.
This common misunderstanding is just one issue that can present risk or confusion when working a physician who is ill prepared to deal with some one who has had an addiction. I have made it a personal mission of mine to make sure persons I work with in recovery have physicians that are sensitive to the needs of someone who has had an addiction. So if you have any doubts and would like the name of a trustworthy doctor, or you would like more info on post acute withdrawal, please don’t hesitate to ask. Kindly – David