Just wanted to say, fuck yeah for standing up for yourself. I didn’t, a while ago, and I’m still suffering from the experience.

Growing up I was taught to never lie to your doctor, lawyer, or mechanic. But after getting some life experience; I will absolutely, positively never admit to smoking pot to a medical professional. Being honest about that has done nothing but worsen my quality of service.

Find somewhere to report this person. Lying to a patient about the requirements for being prescribed a particular drug is reprehensible.

tl;dr They probably aren’t discriminating against you because of autism, you may have accidentally made your situation worse, but you can fix it by being proactive

So I’m saying this to help you. You just sent the largest red flag imaginable to every provider in that practice to not prescribe you controlled substances.

Immediately bailing and demanding a new provider when asked to submit to a urine drug screen screams “I’m going to fail that test.” It doesn’t matter what the truth is, or what your intentions were - that is the message you just sent.

I say all of this as a physician who has been practicing for the better part of a decade. They are more than likely NOT persecuting you for having an autism spectrum disorder.

Vyvanse is a Schedule 2 drug, with the same restrictions as Dilaudid, Oxycodone, and Fentanyl. You admitted to using a federally illegal substance at a federally funded institution, while asking for a highly controlled substance and then bailed the instant they mentioned getting drug tested. That sends a massively negative message that I guarantee other providers in that practice will be aware of.

Some other information you should know is that while there may not be legal requirements for testing, there may be practice level requirements that the psychiatrist has no control over (and every other provider at that VA will be bound to as well). For example, my old practice expressly prohibited provision of medical marijuana prescriptions until the patient had been with the practice for 90 days, had at least two visits, and had a urine drug screening. I could do precisely zero to change that, and this was in a state where medical marijuana was legal.

Lastly, patients lie. All. The. Time. I’ve had patients lie straight to my face about things I literally caught them doing on camera (in an inpatient setting). Patients with substance use disorder can lie and manipulate and fabricate ridiculous things in the all consuming pursuit of feeding their disease. They will say whatever they need to, to get what they want. I don’t hold it against them, because it is the disease doing it, not them.

Still, if I had a dollar for every patient that claimed they only used weed, but later admitted to using fentanyl every day, I wouldn’t need to work as a physician.

Your best bet is to reach back out to the psychiatrist to ask if you can stay with her, and agree to the drug test. This is the fastest, simplest, and quickest way to get the medication you need.

If you truly feel like your trust with this provider is fractured and you absolutely cannot work with her further, then you need to be very proactive and upfront with the next provider as to why you asked to switch, and be enthusiastic about submitting to a drug test if they want one.

At the end of the day, as frustrating as it is, whether you think Vyvanse being a Schedule 2 drug is right or wrong, it’s irrelevant. You just performed the equivalent of walking into a brand new doctor’s office, asking for a prescription for Dilaudid, and then becoming irate when they ask for a drug test.

The psychiatrist may be making assumptions about you, may be demonstrating biases, or may be profiling you - I wasn’t there, so I don’t know. However, if it went down pretty much how you described, then it’s likely you misconstrued what was being asked of you, and are likely unnecessarily making your situation more challenging. Healthcare can be incredibly frustrating to navigate, and the VA doubly so. I’ve worked in the VA system, and I know first hand how these types of situations can be handled on the back end. I don’t want you mislabeled as a “drug seeker” or “doctor shopper” based on a misunderstanding.

Best of luck, and I hope you get the care you require with a provider you trust and respect.

My doctor was required to read some biolerplate about my stimulant meds because of state law and mentioned I may need to submit to drug testing but also told me it was to make sure I was taking the drug rather than selling it.

I know it feels shit but is it possible they were just going through these motions?

I was never drug tested btw

My old psychiatrist did exactly this. They said it’s due to the weed use. I got a new psychiatrist and he’s much better.

Fwiw, I got on my first adhd meds (generic Adderall )with out any of these “requirements”… I did have a blood test the same day I got my first script but it was just a standard panel for becoming a new patient with my pcp. My new doc at the time just talked to me for about 30 mins and had me do a adhd survey. Also told my doc that I was using medical marijuana previously and she said that it made sense and even supported it. I also drink and listed as such but my level of drinking isnt anything concerning. I might have a six pack of beer a week. I took a chance and found this new doc as my old PCP was an asshat that acted like he never believed anything I was saying. I had stopped using medical marijuan already for a job that still believes weed is like meth or whatever which is annoying but it’s a good job. My doc is my age and gets it… When I described my depression systems as “millennial garden variety depression” she was like “where everything just kinda sucks?” I was like yeah! Find a new doc. This isnt normal. Best of luck. I’m on vyvanse now and its definitely been the best fit for me. I wasn’t diagnosed till my 30s. Wish I would of done this twenty years ago when I realized I was different.

Aside from the nicotine use and having ADHD traits without ASD, I’m pretty much with a similar history. After trying intuniv and having BP issues my doctor was fine with prescribing me Concerta. (I did take a different one though, years ago, when I was still a kid) He never mentioned anything about needing drug tests or the like, just need to keep up with the check-ins. (I’m still waiting for it to become available though, as you will very likely also)

The only time I’ve ever heard of, (aside from something like methadone) or had to have a drug test for a med was to determine the dosage to get the correct blood concentration

What state are you in? Many states require drug testing for amphetamine prescriptions now.

Texas, specifically is like this.

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This is pretty normal when someone asks for a specific drug that is restricted. They want to monitor blood levels for abuse.

If this had come up when you already had a relationship, they likely wouldn’t request the same.

This also might be standard practice for her employer. But the fact that you got so defensive is telling of drug seeking behavior honestly.

Was it possible that she meant that regular drug testing with Vyvanse is a standard for her hospital/clinic/whatever? There doesn’t seem to be any national standard for this, but googling brings up a bunch of other folks who have been required to have regular drug testing with this prescription at the VA specifically. So she might have been telling you the truth that she’s expected to require this. It might also mean that your next doc would make the same demand.

That doesn’t make it any less invasive, obviously, and I’m not saying that there’s anything wrong with your reaction to the demand. But it might be worth talking with the doctor about your reaction to this situation before you decide to entirely cut off communications with them (whether that’s with this doctor or the next–it seems like this may not have been the first straw with this particular doc), because it’s possible that neither of you has much alternative, and if the doctor is sympathetic there may be ways they can make the imposition less onerous.

It all kinda sucks, but, y’know, that’s true of most US healthcare and often particularly for the VA.

I’m glad you stood up for yourself. But you also listed that you had basically every legal addiction and some illegal. And did you say you had any caffeine issues?

She doesn’t know you, and she’s responsible for not making an addict. It’s a CYA move on her part.