Hey folks, I saw a chronic pain pt in consult recently, and was wondering if I could get your expert opinion in regards to management of his ADHD condition. During psychiatric review of symptoms: He filled out a PHQ-9 questionnaire for depression and scored 11 points, which fell into the self-rated category of " moderately depressed." Didn't satisfy the DSM-IV criteria for a major depressive episode. He also filled out a GAD-7 questionnaire for anxiety and scored 15 points, falling into the self-rated category of " severe anxiety " , likely fulfilling the DSM-IV criteria for a generalized anxiety disorder. He denied panic attacks. He was taking : Percocet " 3 tabs / day" Ativan " 1 mg QHS " , and Ritalin sustained release unspecified dose. I performed an on-site urine drug screen, which was negative for : both oxycodone and benzos. He then informed me that he had run out early on both the Percocet and Ativan. Of significant note, the pt has a history of crack cocaine and alcohol dependence in remission x 4 years. He was recently started on Ritalin for a diagnosis of ADHD 2 months ago by Psychiatry. I should note that he was initially tried on an unspecified anti-depressant , " that made me worse." He hasn't worked in 2 years. My question here is: given the above significant risk factors, and the fact that the patient isn't working, what would the rationale be for continuing this medication ? What is your opinion on taking both a stimulant and a benzo ? In this case, the patient was using Ativan for insomnia.