Daisy, then a high-school sophomore, was crushed that I had blown off the visit. She didn’t blame me as much as Dr. Titrate, whom she called my “enabler.” When her concentration began to wane in school, she, too, had seen him. She, too, had been diagnosed with ADD and prescribed Adderall. But she stopped taking it after a few months. “It changes my personality,” she said. “It makes me mean.”
I stayed on Adderall, but I stopped taking recreational drugs: Downers only brought me down.
Adderall XR, Dextrostat, muscle relaxants, Ambien, Abilify
Four weeks into my second semester, my parents received a late-night phone call from my roommate. I had OD’d again. I vaguely recall staggering around campus in a speedy, woozy haze. I later learned a classmate had found me unconscious and called for an ambulance. An EKG revealed I had come close to cardiac arrest.
The next morning, my father signed me out of the hospital and we met with the college dean. Still in a haze, I rabbited on about all the hard drugs I had taken. My father was horrified. So was the dean, who kicked me out of school. By afternoon, my head had cleared and I realized I had been regurgitating what I had read in Naked Lunch. “I didn’t know what I was saying,” I told my father. He believed me. We met again with the dean, who didn’t.
When I got home, I saw Dr. Titrate in an emergency session. He kept me on Adderall XR and Dextrostat and added Abilify to stabilize my mood. Two days later, the toxicology report came back from the lab—on the night of my overdose, nothing had been in my system except my prescribed stimulants, an Ambien, and muscle relaxants. Now I remembered: I had self-medicated for menstrual cramps. The combination of drugs must have caused the overdose. After Dr. Titrate called the dean to plead my case, I was allowed to return to school. Conditionally.
I submitted to random urine screenings, and passed every one. I got a new boyfriend, a straight-arrow lit major. Soon after that, Dr. Titrate took me off Abilify, but not Adderall XR. The following year, health regulators in Canada would suspend Adderall XR following the deaths of twenty people, including fourteen children, who had taken it between 1999 and 2003.
Adderall XR, Dextrostat, Lexapro, Advil
Feeling anxious at the start of my sophomore year, I phoned Dr. Titrate from college to ask if he knew of a potent antidepressant called Lexapro. My new boyfriend was on the drug for depression. Dr. Titrate said he recommended Lexapro for anxiety, and had a prescription faxed to my off-campus pharmacy. His only warning: “Let me know if it starts making you feel manic. ” I was unsure what Dr. Titrate meant, but I swallowed my daily Lexapro with my daily Adderall XR and my daily Dextrostat.
Over the course of my sophomore year, I did not get any less anxious. I spent day after gloomy day in bed, feeling dizzy and nauseous and paranoid, getting stomachaches, driving my friends crazy, and wanting to kill myself. I became more and more unstable: sometimes moored to my bed, sometimes restlessly ricocheting around campus. I had a couple of scary panic attacks—each followed by sudden eerie moments of composure and lucidity. I became terrified of being alone.
One night, after my boyfriend told me he needed more “alone time,” I went back to my room and screamed and cried and beat my walls for three hours. I phoned Dr. Titrate, who suggested I “dial down” my Adderall use and increase my dosage of Lexapro.
That summer, on an art-class trip to Italy, I imploded. Convinced that my classmates hated me, I tried to slice my wrists with broken glass. When that proved inefficient, I swallowed a handful of Advil with a glass of wine. After a night in the Venice psych ward, I was put on a plane back to the States.
When I finally got home, I threw a huge tantrum—body thrashing, head whipping from side to side. My mom grabbed my shoulders and hugged me, but I struggled against it. “Why are you doing this to me?” I shrieked.
Daisy begged my parents to fire Dr. Titrate. “He can’t read people,” she said. “He doesn’t listen.” But my parents still trusted him, or at least wanted to trust him. And so they took me to yet another emergency session.
Dr. Titrate said he doubted I had “suicidal ideations” and recommended that I be sent to a substance-abuse-treatment facility. He told my parents, “You can, of course, seek a second opinion.” But there didn’t seem to be time for that. Dr. Titrate spoke with great urgency: He wanted me in the facility within 48 hours. I crumpled in hysterics on his office floor.