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Loved One On Methadone, Still Struggling With Other Drugs

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123peace reaches out about her Loved One who is using a combination of drugs while also on methadone. Amidst the chaos of his use and heavy spending on drugs in the past few weeks, this family member needs help sorting out what she can do.

My son is on methadone, has been on crack and drinking – recently he heard about adderall and that it could curve his desire for crack. He went to his doctor and she said she did not feel comfortable giving him the prescription. Well now he is buying it on the streets – very very expensive – he has bought 2 different kinds – one in capsule form the other in pill form. He feels it helps him and he is working on determining the right dose for himself (he is having a hard time with this). I am not sure if he is still doing a lot of crack – it seems that it has subsided. He did have a drink last night and hopefully that will not affect his dose of methadone today. When he was very young – a counselor suggested putting him on rydalin or something of that sort. I disagreed with putting him on the medication. Recently I mentioned this to him and he now blames me: when he was in school he had a hard time focusing, etc. and that if I let him have that prescription he may have never gotten into drugs (he said the drugs made him feel normal). Now he is playing with adderall and I don’t know what to do. In the recent weeks he has spent over $3000 on drugs and some alcohol. HELP -WHAT AM I TO DO

Your son is on methadone for opioid use disorder, and he is still using crack cocaine, alcohol, and now Adderall, a drug used to treat attention deficit disorder. Adderall is a stimulant so it may be helping him not to use crack. I can understand why he would want this. Crack is a crazy drug. You smoke it until every trace of it is gone, needing another hit every 30 minutes or so. People do this for days at a time….every 30 minutes another hit. It’s as if the person is chained to the pipe.

The methadone clinic should be addressing the crack. I’m not sure whether they would test for Adderall. Methadone clinics typically don’t test for alcohol. He won’t be thrown off the program for the alcohol. The clinic will be addressing the crack, tightening up the therapy, taking away the ability to take home methadone (something that is earned through “good behavior”). The clinic however is limited in what it can do. It is focused on the opioids.

I feel for your son. I have been where he is. Being blocked from my drug of choice, in this case the opioids with methadone, I was desperate to get high on SOMETHING! The addiction machine inside us isn’t turned off with one drug (methadone) addressing the other (opioids). The machine is at full speed internally. One is desperate for something to get high. Lots more input is needed: medications, therapy, a community of concern. Your son sounds trapped.

What if you helped your son get to a prescribing nurse practitioner or psychiatrist for a full evaluation that could determine if in fact the Adderall is helpful. It would have to be carefully metered out, for he could abuse it. The evaluation could determine whether your son can be helped in other ways that would help quiet the cravings…perhaps an antidepressant, an intensive outpatient program and other medications for cocaine (

Your son needs more help and the methadone clinic may not be the only answer. With the right kind of evaluation he may be able to access the Adderall without such an expense. The more structured support, the better. See about the different types of programs available in your area, build your list of treatment options thoroughly. And take care of yourself. You have a community of support here – lean on us.



In your comments, please show respect for each other and do not give advice. Please consider that your choice of words has the power to reduce stigma and change opinions (ie, "person struggling with substance use" vs. "addict", "use" vs. "abuse"...)

  1. Thank you – update:

    My son had an evaluation to know whether so he could receive Adderall by prescription – the evaluation showed that he would benefit from Adderall and has an appointment with his physician to get the perscription. That is a relief – he has really cut back on drinking and has done crack about once per week and plans to stop completely – now knowing that he will have the meds.

    He has been on an antidepressant. Just in case – what other medications are for cocaine? Perhaps there would be something better.

    Thanks again for everything. You have been most helpful.

    1. It’s great to hear of this progress. Thank you for keeping us updated. Your son must feel relieved to have made headway within the system and have this evaluation completed. It sounds like things are moving the right direction.

      As far as your question about medications, there is currently no approved medication for cocaine. Contingency management has the best evidence for cocaine. There isn’t a whole lot of info out there on potential medications for cocaine addiction, but there is some. Here is a link to an article we have suggested in a previous post: …In addition, you might want to check out this article on quitting cocaine from addictionblog: Some practitioners use OCD medications like prozac but that is off label use. What your son is looking at is a good start. However with Adderall it’s especially important that his dosage be monitored closely. Having to check in regularly with a doctor for this can be a helpful piece of the puzzle in his recovery.

      We are heartened to hear this hopeful news, and applaud all of the efforts you have made to practice CRAFT with your son. You have been through some extremely trying times. And it’s clear that your work – in setting your limits and embracing change in your approach – is not in vain. You have been his only support in so many ways for so long, and we celebrate any ways in which he is finding other sources to lean on.

      In a previous comment you talked about internal and external changes – you are absolutely right that external change can lead to internal change – and vice versa. The map isn’t the same for each family. But embracing any kind of positive change and sticking to it leads to substantial transformation in time. You’re doing a great job. Keep us posted about how things are going.

  2. Thank you.
    My son is having evaluations for ADHD – one more to go – also he is on an antidepressant.
    The clinic doesn’t check for Adderall, however they do give him a breathalyzer from time to time. The court mandated him to stay free of alcohol and drugs, other wise he goes to a jail. This is worrisome.

    I didn’t realize there are medications for cocaine – can you please let me know what they are and how they work and how he could obtain (would it be through a clinic or doctor’s office?) This may be very helpful.
    Thank you, thank you

  3. My son is on methadone and does crack (mainly on weekends when he gets his check). During the week he is taking adderall from off the street, however, he is having counseling and testing to get a prescription. He seems hyper and agitated when he takes it. When he does a low dose it is much better.

    He just got his driving license back, but no car. I am willing to give my car to him – so I do not have to drive him to the clinic, work and appointments. I get harsh anxiety when driving him. My only worry is that he will use the car for other things……….
    What should I do – I just can’t drive him. He has used uber when going to purchase, etc. very very expensive ($50 / day). Should I put the responsibility on to him and pray all is ok or should I keep driving him for eternity. (horrible – between 5:15 am and 9:30 pm). I really want to put the responsibility on him, but if he does something not acceptable – I will feel very guilty.


    1. You want your son to drive himself to work and to his medical appointments. You wish to put that responsibility onto him. Yet you are worried if you do give him the car that something will happen that will cause you tremendous guilt.

      On the flip side, you get such deep anxiety when you drive him, whether it be to work or the MAT clinic, that you would give away your car to rid yourself of having to be his chauffeur and take the chance of your son driving.

      Read Dominique Simon-Levine’s full response to 123peace here:

  4. Good news –
    I wrote earlier about my son being completely in chaos using many drugs and alcohol while in a methadone program.
    I did tell him that I wanted to Section him – however – he chose to go to a rehab for 4 weeks – he washed his own clothes and packed all he needed to take. He did this on his own and am relieved. He went on Saturday and it is a relief!
    Thank you for all your support. Sincerely

    1. What a wonderful piece of news! I just breathed a big sigh of relief reading this – and hope you are doing the same. This is a respite from the chaos which represents a lot of hard work on your part. Well done!

    2. Well- so much for being relieved… son left the rehab in about 9 days (on Monday)— that night he he went to his friends got high on crack and alcohol right through Wednesday. Earlier he said I could section him if he could get a bed in a place they would provide him his methadone. – I sectioned late Wednesday and held off until he could be sure to get a bed. Thursday morning the court called and they had a bed for him thru the sectioning. Picked him up and brought him to the methadone clinic to get his dose and then straight to the court. He was completely messed up…. When I got to the court, he jumped out the car and took off. When I finally found him, he said he would go back to the rehab which he left earlier. Brought him there and they could not take him on Wednesday because of the time limit since he left. He was able to go on Thursday and so back we went. He is to be there for only 2 weeks……….He was such a mess – he said he didn’t sleep for 3 days and his mind was all messed up. I feel two weeks is not enough, but if he starts to fall apart again – when he leaves the rehab – I will not hesitate to section him again and if he doesn’t go with me I will have them arrest him. I just don’t know what else to do – I am so scared for him – there isn’t a time when he is straight to talk with him. At one point he was making animal sounds very loudly and then just started laughing. Very scary. Is there any suggestions what else I can do. He called from the rehab, but I didn’t know what to say, except that I was proud of him for going. I am still in panic – not knowing if he will leave the rehab.

      1. You are proud of him for going! And that is the perfect thing to say. He scared you. You can also tell him that. Tell him you are scared, petrified really, and that you hope that something well within him can see a better life and so give abstinence a chance.

        Your son is reaching for recovery. It is terribly messy, but he is back in treatment after a short relapse. Remember the graphic from Learning Module 1: the relapses get shorter and the abstinence period get longer in the cycle. The cycle feels like chaos until you realize there is a pattern and your son is in treatment, trying. Read Dominique Simon-Levine’s response to 123peace here:

  5. Just sending love. Keep breathing. Sounds as if he’s making efforts in the right direction, even if in the wrong way. I count that a tiny success–and I hope they add up for you.

  6. This is an extremely challenging time for both you and your son, and Dominique is absolutely correct. You must take care of yourself first. Your son does need additional help and a complete neuropsych evaluation could well show that he does have ADHD or other diagnoses. Adderall is extremely effective for treating ADHD. In the correct dosage, it helps clear the fog of anxiety and helps a person think and focus and prioritize which in the long run could help his recovery. The fact that he is going to a clinic Is good, but yes, he needs more supports, and perhaps even a residential treatment center for a few weeks or months. Wishing you lots of strength during these challenging times and again, hope that you will take self care very, very seriously. It’s a challenging thing to do, or at least I find it extremely challenging to put a protective barrier between myself and my loved one’s trauma. I was advised to step back, and understand that his trauma is not my trauma. Easier said than done!

  7. I am very desperate to find out what I should do – HELP – can no longer go on

    My son is on methadone, using crack and drinking. It has been going on – starting with drinking and heroin for about 14 years (he was 17 years old). However he works, but his is not on a set schedule. He has no car (totaled) and working on getting his license back. So I was driving him – to methadone then to work and picking him up from work. I finally have his cousin help with the transportation – but I feel he is getting tired of it. When I pick him up – he always has to go somewhere and I have to drive him (I feel he is buying crack). I get so stressed and he screams and has slammed the car – I get petrified so I drive.

    At night he walks miles to a store to get something to drink – we live far from transportation. He has said to me that alcohol and crack go together for him.

    Last week he had 2 court cases – but nothing happened – they just told him to do good – and one case is continued to May with a court appointed lawyer. He is still on probation until April. He was very high the night before each case and got high the same days. going on and on and on……

    Last week he told me I could section him if he asked me for another ride to do whatever………..But last night I had to give him a ride and he said I will be sorry if I section him. Sometime – I feel he could be suicidal – or perhaps it is just a threat.

    I have anxiety 24/7 – have medication but I don’t want to always take it – that is no answer.

    What do I do – help – There have been times that I did not drive him – then he calls me in the middle of the night all messed up and I have to pick him up.

    I can no longer deal with him – what can I do? I want to take the chance of sectioning him, but am scared. He won’t even talk about rehab.

    1. Your son is on methadone, yet he is drinking and smoking crack. His use and the problems associated with it have gone on for so long. The methadone clinic doesn’t seem to be addressing it. The probation officer is not drug testing him? Goodness, where is the support in this situation?

      I’ve worked with you locally over the years. I know firsthand how difficult this is for both of you. Getting rides and having a place to live at this point is probably not helping with your son’s drug use; it is supporting it. I know you know this and have tried to pull back over the years. It is very hard to step away when your son is practically all the family you have.

      But this isn’t working and your anxiety is very high a lot of the time. This is no way to spend your retirement years. We’ve had your son in treatment before. He needs to go again. What has happened before is not a predictor of what will happen with a new treatment. It takes multiple treatment episodes for some people. Pushing for treatment is your softest landing right now.

      It seems like a civil commitment could be the quickest step to take at this point. This will only work if he cannot come back home to your place and is helped to step down into a residential setting. Can you consider this? Realistically, your son will need more than just a brief stint in a civil commitment. He needs a structured living program. Ideally, we patch together 9-12 months of intensive treatment for him. To give both of you a real chance of turning things around.

      You know the CRAFT program. Please look back through the modules, especially Learning Module 7 on hard emotions. If you’re not getting a little therapy, please consider it. You struggle with anxiety, and are shouldering a tremendous burden. This is too hard a position to be in without support.

      The situation you describe is just not working. You have been trying to support him in positive ways by giving him rides to the clinic and back & forth to work. But between his outbursts, threats and late-night calls for rides, it sounds like way too much. You are in a position where you are getting tangled up in the drama and the chaos. This has worn on you for so long that you aren’t able to stay neutral, calm, and compassionate around him. Your energies have been spread so thin that you are in desperate need for help. You both need a change.

      You mention being afraid about sectioning him. It’s hard to think about taking such a drastic step, but maybe even harder to imagine continuing on like this. You have done so much. But it may be wise to let someone else do the work now. He is going to need plenty of time and a cohort of supporting professionals to find his path to recovery.

      Treatment is clearly what he needs. If you can think about a civil commitment as the swiftest course of action to begin to get him that help and reclaim your own life, it may help you to face the fears you have about this process. We want to support you in this and help you feel the strength you need to take these next steps. Whatever you do, it will require strength to make a big change. From your description, a big change is certainly in order. Let us know what you think.

      1. 123Peace I am so sorry for the pressure you are feeling while your son is abusing substances. I hear your call for help. Do you hear another voice in your head that is telling you to take different action from what you typically do? One that has drawn a line between you and your son? It may be the solid ground you are searching for. Separate your own needs from your son’s problem and look to self care first and foremost. It really does help; I know from my own experience that we are powerless to change someone else’s behavior. They make the choices each day but they can see the light.
        Imagine yourself as a calm centered person who is catering to her own needs, and who has clear boundaries established to keep herself well. Stay on your side of the street.
        I love this quote from Dominique that I read today. “CRAFT cleans up your side of the street and provides a light onto the street (s)he should walk down to get help. It’s not 100%. It doesn’t guarantee they will walk down that street, but it is the best position you can take.” And that is where your limits lie. Module 7 is loaded with self help ideas and should be revisited often. Once you are centered on your own well being, you can work with the boundaries you set up to protect yourself. Be calm and clear about your boundaries.
        It does sound like sectioning is advised. Be sure you have current examples of imminent threats to himself or others so the court agrees. You can really work on boundaries that remove you from the addiction supports he demands. Once the commitment is over and he knows your firm boundaries, you can have a safe environment that doesn’t have him in your home. Your future support is for his recovery only. I wonder if Vivitrol is a good MAT option for his alcohol abuse. Maybe find a counselor or friend who can listen and support you.