Need some insight on this question. Please help.

 

I have a decision to make here and have no real good info to help support me going one way or another on it - so I thought I'd pose the question here and maybe I can get some good insight from others to help me figure this out.

I have been trying unsuccessfully to get my husband to quit smoking pot for about 9 years now.  I push the issue, he says he will, he tries to and maybe stops for about a month at the most, then goes right back to it every time.  He has back problems and says he needs the pot to relieve his pain, and that's why he can't stop.  He says he doesn't want to smoke, but we have no health insurance and  he's getting no treatment for his back issues, so no hope right now for that to get better. 

I have been trying to get him to begin some sort of treatment for his ADHD (he's been officially diagnosed since 04) for eight years.  He shows significant problems in day to day life with time management, memory, ability to deal with responsibilities, low frustration tolerance, and impulsivity.  Hence, my desire to get him treatment and help.... and thus getting my relationship and his relationship with his 4 year old help as a result (as is, all is connected).  When we decided to try treatment, the first condition to that was that he needed to stop smoking, which seemed to me necessary because you can't effectively monitor improvements in memory, following through, time management, etc when you are smoking pot daily.  Since he has not quit, we have not been able to begin any treatment. 

After 9 years of failing to get him to stop, I'm beginning to resign myself that he may never do so, or at least no time soon.  I can't force him to, he needs to want to, so it's out of my control. 

So, here's my question.  Is it worth it to try medication for the ADHD symptoms despite the fact that he is smoking - or is it not worth it because the effects of smoking will just counteract the treatment?  Does anyone have any insight to this?  Honestly, any improvements will be welcome as our family suffers regularly from the effects of adhd.

As a final note. I have tried a few alternate treatments (ie, offering fish oil daily, changing our diets, etc, but those have not provided any significant differences).  

Thank you for your time and insight, I very much appreciate it.  

 

 

 

Pbartender's picture

"So, here's my question.  Is

"So, here's my question.  Is it worth it to try medication for the ADHD symptoms despite the fact that he is smoking - or is it not worth it because the effects of smoking will just counteract the treatment?  Does anyone have any insight to this?  Honestly, any improvements will be welcome as our family suffers regularly from the effects of adhd."

So, just be aware that most all of the medications for ADHD are stimulants.  A lot of ADHDers who are undiagnosed and/or untreated, will self medicate with a massive daily intake of caffeine, for example.  It could be that the nicotine, also a stimulant, from the cigarettes is playing the same role for him.  So long as the doctor who is medicating him is aware of his smoking habits and doesn't advise against it, there shouldn't be a particular reason to not try ADHD medication.  If anything, proper medication might make is less necessary for him to continue smoking, and may make it easier for him to quit.

 

Pb.

different kind of smoke

Pb., thanks for taking the time..... unfortunatley, if you read the top part of my post, the smoking refers to pot.   He does drink a fair amount of caffeine every day, which I know is another part of his self-medication.  The pot, I know, is a form of self-medication as well - albeit not a helpful or effective one. 

Pbartender's picture

Aha!  That's a different

Aha!  That's a different story altogether...

Huh.  I must have read right past that detail...  typical ADHD.  :P

 

Pb.

gave me a good laugh..

Pb, that was just what I was thinking after I read your comment.... you gave me a good laugh because I was thinking... "What did I expect, I posted my question in a forum where many of the members have adhd."   Anyhow, thanks... a smile is always a good thing.  :) 

Substance abuse issues of any

Substance abuse issues of any kind are complicated to say the least.

Such heavy cannabis use is not ideal obviously (daily use of any intoxicant is unwise - sober time is vital), but he does not seem ready to quit. I think that instead of being pressured into completely abstaining, he should be encouraged to cut down - this might be a lot more effective.

Either way, I do not think that delaying treatment is wise. If he is self-medicating, what is the core issue? Is it simply the ADHD, or are there comorbidities present? A good psychologist could really be of help I think, and competent professional should be able to assist in managing the cannabis usage, the ADHD and any other issues.

Also to consider: sustained, daily cannabis usage can cause many issues - if he was diagnosed with ADHD whilst smoking heavily, it may be a good idea to review this once he has some sober time under his belt.

Thanks for your time almond.

 

>> Substance abuse issues of any kind are complicated to say the least.

Yes indeed, you are very right.

 

>>Such heavy cannabis use is not ideal obviously (daily use of any intoxicant is unwise - sober time is vital), but he does not seem ready to quit. I think that instead of being pressured into completely abstaining, he should be encouraged to cut down - this might be a lot more effective.

I'm not sure I'd categorize his use in the "heavy" area.  I think "frequent" is more appropriate, where it is pretty much every day... although the quantities are very very small.  I would agree he is not ready, or in another way of putting it... he can't, although I do feel that he wants to.  We are doing exactly that right now... cutting down.  I've always made it clear that I'm not against it's use for medicinal purposes (severe back pain), but am against it being used daily, becuase that just causes other problems to replace the one he's trying to remedy.  Unfortunately, all these years of trying has led us both to the realization that for him -  it's all or none.  He's said this.  He's never been able to find an in-between.  

>>Either way, I do not think that delaying treatment is wise. If he is self-medicating, what is the core issue? Is it simply the ADHD, or are there comorbidities present? A good psychologist could really be of help I think, and competent professional should be able to assist in managing the cannabis usage, the ADHD and any other issues.

I totally agree that this situation needs a professional's approach and insight.  Without health insurance, we can't afford the help.  While I'm no professional, I do know a lot about ADHD and human nature.  Knowing my husband for as long as I have, it's clear to me that his pot use is both a self-medicating method for the adhd and his anxiety.  He also suffers from occasional bouts of depression, more so in the winter (which are all commonly coupled with adhd).  So, he uses copius amounts of caffeine during the day as a stimulant so he can focus and get through his work, then in the evening when he's over-stimulated, he then smokes which relaxes him and calms him down and allows him to sleep at night.  That's his method of dealing with what he has going on, and has been for a long time.  It's a viscious circle.... we all need to work better as a family so we can coordinate our careers and responsibilities as parents better so we can earn more money to get the health coverage we need to get the treatment he needs -  but without the treatment, we are working inefficiently as a couple and I can't manage to take good care of my family, cover the extra responsibilities that he struggles to do because he has adhd,  and earn more money to get us to the point where we can get insurance for him again (although, I am trying my absolute hardest to accomplish all this).  

 

>>Also to consider: sustained, daily cannabis usage can cause many issues - if he was diagnosed with ADHD whilst smoking heavily, it may be a good idea to review this once he has some sober time under his belt.   Luckily, I was able to get him to completely stop for 1 month before he went for his testing (he started right back up the day after his testing).   While I have no doubt that smoking worsens/exasperbates the adhd symptoms, he definitely shows all the classic adhd symptoms when he is not smoking - and has a family history that presents itself as the adhd being passed down through the family (father & brother as well). 

 

If we can't afford to get health insurance right now and get him to see a psychologist, I can likely do my best to pay for some doctor visits and get his pcp to prescribe an adhd medication to try and see if this helps him.   I know that he needs more than just trying out a med, and that effectively treating adhd has a multi-modal approach...... but I'm thinking any improvements will be a good thing if it helps, and we won't know unless we try.