Newbie asking advice on how to deal with gambler son

[SuZir]

Thank you for your input Giulia.

Medical matters in my sons team are of course not handled by coaches, but by the team doctor and other medical staff. Team doctor coordinates all medicine use because most MD's don't know much about anti-doping rules. So even when they use outside experts the medicine use goes through the team doctor who has all the needed knowledge about anti doping rules.

While one can get an exception to any banned drug because of medical reasons, it would unfortunately be very difficult to get it for stimulants for my son. First, it is not a medication he has been before and it would be difficult to show that he does indeed need it now and he would not be getting any unfair advantage because of it. Secondly his sport would also be highly suspicious for stimulants. So it would be unlikely he would get an okay to stimulants.

 

[Giulia]

While one can get an exception to any banned drug because of medical reasons, it would unfortunately be very difficult to get it for stimulants for my son. First, it is not a medication he has been before and it would be difficult to show that he does indeed need it now and he would not be getting any unfair advantage because of it. Secondly his sport and especially his position would also be highly suspicious for stimulants. While he does greatly benefit on his natural ability to over-focus, someone just wanting stimulants while doing the type of thing he does would be a red flag. So it would be unlikely he would get an okay to stimulants.

I've heard your concerns.

However, if a specialist, here a psychiatrist who really knows the why and the hows about ADHD, helps the team doctors about papers for authorization, it is still feasible. His psychiatrist has to talk with the team's doctor, because the team doctor is not a specialist of ADHD, and the psychiatrist is not a specialist about anti doping rules. So they really have to talk together to sort out this situation and help find out the best solution for your son.
The suspects you are talking about can be alleviated if you give too much documentation than too little.

It won't be as suspicious as you think if everything is documented as much as possible, and if both doctors can speak to sort out a solution. Better too much documentation than too little, and I tell you from personal experience with administrative folks and their misconceptions (I've seen a lot in these years I am fighting to make a law change, so I can relate on the suspicion you are talking about).

I tell you because in France, ADHD is not a recognized diagnosis to adults (some doctors even permit themselves to claim that "it's a diagnosis for excusing parents who are failure to love and raise their children, and Social Services would had done better than those good for nothing").
So it leads to incredibly complicated administrative situations, for example with my driving license (if you add the law badly written about driving and stimulants, you have a complete picture of the current mess in my country. I am fighting to make it change, with some success).

So your son's situation is far from desperate, but to help it sort out from a sport point of view, team doctor and your son's psychiatrist have to absolutely speak together to sort out a solution. They cannot work each one in their own corner and expect your son to be a good sporty at the same time.
Otherwise, this problem won't be solved : like soccer, it's a team work to find out a solution with this problem.

If you encounter a problem with the team's doctor, don't be afraid of going above, so the federation. If you don't treat your son because you fear of consequences for his sport, whereas he puts himself in a compulsive gambling, the consequences are far worse than the initial problem.
So for the medicine's problem, don't be afraid of talking above (the federation) to raise this issue. The team's doctor may had not seen such a situation before, but at the federation, they surely saw this situation and more than once.
(sadly, I learnt this trick of going above the hard way, with my own administrative fights and their sometimes dreadful consequences)

 

[SuZir]

Thank you again for your input Giulia, but I want to point out few things because it seems to me you are not very educated about sport medicine and anti doping.

In anti-doping rules there is a clear principal that even for the medical reasons there may not be a exception for certain medication, if it does give an unfair advantages for the athlete. It depends on sport. They do not do that for example in swimming. A swimmer with the ADHD on stimulants is not on advantage to the swimmer, who doesn't have an ADHD and doesn't use stimulants. You have to also show that not having the medication would risk the health of an athlete. My son has stayed healthy over 18 years without stimulants. To get a clearance you also have to show you have exhausted all the other possible treatments (in my son's case meaning all kind of coaching, therapy, non-regulated medications used for ADHD etc.) My son, as any other athlete, would be free to use stimulants outside of competing season because they are only banned in competitions but there has never been even consideration to start him with them.

Stimulants are not any wonder cure. They are commonly abused (and my son has a history of the addictive behaviour) and they do not help many people using them and they do have many common side effects, some that could be difficult for my son. They for example often tend to make people loose their appetite and that could provide a big problem.

And my son is not diagnosed with the ADHD. He has been evaluated for it twice as a child (by the team of specialists) but his overall functioning was too high. If we lived in the USA or other place there diagnostic criteria is often applied more laxly, he would probably have a diagnosis, but not here.

I understand you may have found a lot of help for yourself from stimulants, but please do understand that they are not do all solution for everyone.

 

[Giulia]

I understand you may have found a lot of help for yourself from stimulants, but please do understand that they are not do all solution for everyone.

I didn't say that it was a solution for everyone. Probably I didn't speak English, so my mistake.
What I understood is that he had a diagnosis of ADHD and needed a stimulant but there were issues about anti-doping.
What you say is that he didn't have yet a diagnosis and no recent evaluation (less than a year) has been done. So I apologize for the misunderstanding.

I said that if your son can benefit of it, then, it worthes the effort to manage this situation with the team's doctor and with the federation. But first, you have to get a proper diagnosis and a complete evaluation. The complete evaluation will help if your son were in need for an authorization to take a stimulant before competing.
If the psychiatrist thinks that he can benefit from a stimulant, then he can provide the whole documentation about it, like evaluations and so on. Then, after that you get the whole evaluation and a treatment plan, you will be able to manage the anti doping problem.

Think that an evaluation is a photo taken at a T moment. Exactly when you make a blood drawn, it is like a photo at a T moment.
It may change over the time. The test given during childhood may not be accurate any more.
So I won't encourage you enough about getting him a complete evaluation (not only an IQ test, but a complete evaluation). Also, if you are in need to fight for the anti doping stuff, it will be a powerful tool to help.
I will say that a complete evaluation is a master piece to fight in these kind of situations. Without it, it's preaching in the desert.

You said that he was evaluated as a child.
If I were you, I would make him evaluated to see what does he have exactly, and get him treated for what he has. Therapy may not be enough for him, and leaving him untreated does not improve anything, no matter what is the diagnosis.
Years passed on since he did the tests, and tests evolve with age.
If stimulants are right for him, it can help convincing the federation that he is given them because he needs them. If they are not the right solution medically speaking, then, they are not the right solution medically speaking and it's not a problem.
Not treating the problem, whatever it is ADHD, BiPolar (BP), personality disorder etc... worsens the gambling problem more often than not. Not treating the problem because of fear of antidoping tests won't help him at all. The gambling is a way to self medicate his root issue.

So, to make my saying clear, and with the info you have just had provided to me (I understood before that he had been diagnosed with ADHD, my mistake), the first step is thinking to make him have a diagnosis and the proper treatment for his root problem. Because gambling is fueled by the root problem, whatever it is ADHD, BiPolar (BP), personality disorder etc... and if you want to deal with gambling, you cannot spare yourself from getting him diagnosed and treated for his problem.
Gambling and substance abuse is exactly the same pattern, so the history of substance abuse does not surprise me.
Also, if he has ADHD and is treated with stimulants, he will be much less likely abuse substance (as incredible as it seems). The same holds true if he has BiPolar (BP) and is medicated with a mood stabilizer etc etc...
The right medication/medications combo for a mental health condition is the most protective tool you can offer him to protect him against substance abuse and pathological gambling, along with therapy. But therapy alone is more often than not far from being enough.
If he gets a diagnosis of ADHD at the end and stimulants are not enough efficient/are abused/carry unacceptable side effects, I repeat that non stimulant medications can be used, and it exists. But if a non stimulant is inefficient, it makes no sense to keep it just because of anti doping rules.

If, after all the complete neuropsychologist evaluation, ADHD is diagnosed and a stimulant is prescribed, then, it will be time to deal with the administrative sport problem. But if he were taking a stimulant for an eventual ADHD, you would need the whole neuropsychologist evaluation for the therapeutic authorization.
But it may not even be needed if he does not take a medicine considered as doping. So you don't need to dwell about it right now, it is putting the cart before the horse right now.


Really, the first and foremost problem is having him properly diagnosed and treated. Then, you will have plenty of tools to deal with the anti doping rules problems and its administrative complications. At the moment, the anti doping concern is putting the cart before the horse.
The first and foremost priority right now is getting him evaluated and treated for his condition, whatever the condition is and whatever the medicines he needs. Then, after you have had him evaluated, diagnosed and treated, you will be able to care about the anti doping rules administrative complications if this problem remains after he gets diagnosed and treated.
Don't put the cart before the horse by thinking about the anti doping problem. Instead, hyperfocus about getting him diagnosed and treated, because this is the first and foremost priority. Later, you will be able to manage the anti doping problem if it is still a problem after you got him evaluated, diagnosed and treated.

An administrative problem can always be solved by a way or another, even when it seems impossible to do so. That's also why I was telling you all this about the federation and such (the vast majority of administrative problems follow the same pattern and are solved by the main same solutions), and giving you these tricks I learnt.

But first and foremost, worry about getting him the proper diagnosis and treatment, then the anti doping problem can be solved. For your own sake and his, don't dwell too much about the anti doping problem, because it's not an emergency right now.
Instead, hyperfocus on getting him evaluated, diagnosed and treated for the root problem and pathological gambling.
Take things one day at time, you will be manage to solve all this on a way or another. Baby step after baby step, everything will get better.


Hang in there

 

[SuZir]

Giulia, I do understand you are trying to be helpful. And this seems to be a matter you feel strongly about. I am sorry if I sound blunt but I do know more about WADA's inner workings than you. And I certainly know more about my son's specific situation than you. And my adult son would feel strongly about the idea that because he has an addiction he has been in good recovery from over a year now he should forsake his work and his lifelong dream (which is also his main motivation in recovery and for which he has worked hard thousands and thousands hours for) for life just so that he could use a drug that could maybe help a tiny bit in that recovery. I doubt that would be something he is willing to do.

 

[Giulia]

Ok, but if your son goes back to substance abuse because his illness is not properly treated, what do you do then ?
What would you do and what would he do the day he cannot continue for another reason, like a serious injury ?
Don't get me wrong, it's always fantastic to have dreams and work on it. However, it's quite fragile to say the least.
So yes, I am concerned about the risk of harming his health for a dream. Silly if you want so.

 

[BusynMember]

Guilia, she is his mother.

in my opinion...please don't argue with her. That is not what this board is for. Ok? This is a support board.

 

[SuZir]

Ok, but if your son goes back to substance abuse because his illness is not properly treated, what do you do then ?

How does this be any different if he would be treated with this special type of medication (to my understanding there are some studies that suggest that stimulants can make addiction in people with ADHD little bit less likely and other studies that suggest that in fact there are more addictions with stimulant treated ADHD people)? Regardless if he has ADHD or not, or any other background condition or not, he certainly has a vulnerability to addictions. To have that you don't need to have any background conditions at all. It is very common also with people who do not have any neurological or psychological condition.

How much more likely my son is to relapse or develop new addiction if he has no motivation not to? You do know, that it is very, very common for people on stimulants to have addictions also? Some even abuse their own drugs. (Yes, I know several families, whose ADHD children are having this problem.) You do understand that my son's addiction is currently treated by professionals by their best knowledge?

What would you do and what would he do the day he cannot continue for another reason, like a serious injury ?

That is always a possibility. It is possible his athletic career ends quickly because of physical injury. Or that his development isn't good enough. After that he would most likely go to university (his grades are excellent and his plan B has been medication school, he has always thought it would be cool to be a pathologist.) If the reason would be an injury, money he would get from his athletic insurance because of that would be a great help while studying. But of course it may be, that he falls on his head tomorrow and gets serious brain injury and can't do that. Should he stop going to school also, because it may not work out? Or he could end up to accident and die. Would it be better to simply jump from the bridge right now?

Yes, of course you need plans B, C and D when you are chasing your risky dreams, but it is not a reason to not chase them at all. Life is fragile and anything can happen, but it is lousy way to live your life by just averting risks and just letting go of your dreams because they may not end up working out.

Don't get me wrong, it's always fantastic to have dreams and work on it. However, it's quite fragile to say the least.

You do understand that he is already living that dream? Yes, he has even bigger dreams, but even this is already it.

So yes, I am concerned about the risk of harming his health for a dream. Silly if you want so.

I would be much more worried about addictions with him, if he wouldn't have this dream and these goals. Yes, I'm worried about his sport damaging his health, but it has much more to do with his joints than his possible neurological problems. And he is the one who will live with those choices. I can't make those decisions for him. How would you feel, if your mother would forbid you from going back to University, because stress can damage your health and she would say you should just find a job from McDonald's or something? Would that make any sense to you?

The thing that seems to escape from you is, that my son is an adult. While for example I would find it a positive thing for him to have his third through neuropsychologist evaluation (it really is possible that situation has changed from the time he had his last one five years ago) I do understand that it may not be sonething he wants to pursue at this time.

 

[Giulia]

Well, contrary to what you think, people self medicates their symptoms more often than not. So turns themselves to drug abuse.
Treating a condition with the appropriate medicine, whatever it is, helps with the addiction problem (whatever is a stimulant or not).
It does not do the job alone, but it heps.
And even if an ADHD person is a bit less likely protected by stimulant, it worthes the effort. And studies who suggest that are a bit less likely are, as far as I know, from small samples and with limited data. Combined with information about addiction and therapy, of course. The medicine alone is not doing the whole job, it's a synergy.
On the other hand, denying a person a treatment because "I know other people who abused it" is considering that this person is like the folks you know. The persons you know and have abused the treatment are not your son : your son is your son and those folks are those folks.

And my father refused to medicate his ADHD, he preferred and still prefers to turn to substance abuse. And its devastating consequences, that fall in my hands to manage. So yes, I am merciless with people who consider that treatment opens the substance abuse, because it is the contrary, it has been known for now decades and I saw it on my child's eyes and now my adult's eyes. It is my choice to be as merciless, and no, I saw too much the disasters to wish to change my mind, so be merciful with those.
If you want to manage my father and the disastrous consequences of his drunk driving among other disasters, take my place, it will allow me to leave for a month on a desert island in the mean time. (I sent my father in medical exam for driving license for his drug driving, and I still have to manage his victimization)
In the mean time, you can also manage my fight to make a law change, with its success and its exhaustion it carries on.
You won't have time to get bored, and I'll have time to take some well deserved rest.

 

[SuZir]

Giulia, I'm sorry you are hurting. Maybe you should start your own thread about how to detach from your father and his choices?

And you are right, my son is my son and not those other folks or your father. He is not doing drugs (those pesky little random anti-doping tests would make it very difficult for him to do so and not get caught) and his drinking is not a problem (and most likely will never develop to one, because of his sensitivity to alcohol. He ends up spending his night feeling sick and having nasty itchy rash very easily if he drinks anything more than two or three beers.) He is recovering gambling addict currently doing well enough in his recovery and being very motivated to do so.