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My dd26 lives with my husband (her dad) and me.   We support her.  She is unable to complete classes, etc.  We just let her try a class after her not trying for the past 5 years . . .she wanted to try again and it's going downhill real quick.  For the class she went back on Adderall, I am in charge of it and give her the 60mg a day.  The adderall has made her stay awake for DAYS and she has NO appetite.  Due to the sleep deprivation and not eating I see her being confused and unable to cope/function in an effective manner.  She was addicted to crystal meth for the first six months in 2009.  From my understanding you do not give amphetamines to a crystal meth addict.  I do feel that her taking adderall has triggered the addiction.

   Here's the question:  I would love to have an open/honest talk with her with what I am seeing and for her to come to the conclusion herself that the adderall is not working.  Con: previous attempts at a conversation like this leads to denial and anger.   I would really like our relationship to be built on honesty . . .and yet, I feel that that is difficult to do as her end of the conversation is anything BUT rational.

The other choice I have is to tell the psychiatrist (behind her back) what we are seeing with the adderall and for him to gently and diplomatically switch her from adderall.  My dd26 has not been forthcoming about her past substance abuse history to the psychiatrist.

I realize that the ideal situation is being open and honest and let the chips fall where they may .  . yet, we are going to have to live together for the rest of our lives . . .so maybe we need to buffer our relationship by going behind her back to let the psychiatrist know?   I would love other peoples thoughts/opinions and any additional pros and cons!

I can't give you any input about Adderall and crystal meth.  However I have 2 children, one with BPD one without, that are both taking Adderall and have done so for quite some time.  You are correct, one of the side effects is difficulty sleeping and no appetite.  We've found another symptom is irritability.  (Yikes! Just what is needed - a super irritable pwBPD on a rant!)  One way we combat the side effects, is to not take the med during weekends or other times when being focused is not of prime importance - a mini drug holiday, if you will.  (Sounds weird, but if they suddenly need to focus, soda with caffeine is a help and it even helps them relax and sleep.  Sometimes in the evening when the Adderall is wearing off, a caffeine drinks helps them study.  My kids never have trouble sleeping because of the caffeine in fact, quite the opposite.  I know that sounds counterintuitive.)   Another tactic might be to reduce the dosage.  While my  ds has in the past taken up to 80 mg my ddwBPD takes a lot less.

I can offer no insight into how to approach someone who has an addiction.  Since both my children a now away from home, I have no control over the Adderall.  From past experience, I have not experienced a problem in approaching my kids saying, "You know, I've noticed lately you seem to be experiencing XXX or YYY.  :)o you think it is because of the Adderall?  As a mother I worry, if you think it might be a problem, please do me a big favor and ask your doctor about it?"  

Lastly, it has never been suggested to dd that her add is a part of BPD.  Her brother has it.  Other classmate have it.  It is just something lots of folks have to deal with and not something uniquely 'wrong' with dd.  I think I might receive a more negative and defensive reaction to discussing the Adderall if I somehow linked the add and BPD.  Unlinked, it's no more threatening than suggesting taking Tylenol over Ibuprofen for a headache.  Linked, she might perceive that as  suggesting she is one really mentally messed up 'sicko'.

Just some thoughts - hope it is of some help.          

My first thought was that that level of adderall is high. Is it possible to have a conversation with your daughter about that? My dd is on 30mg and she struggles to sleep too but she has always struggled with sleep issues.

I think that it is a really positive sign that your dd is taking classes again. Maybe this is a good way for her to take responsibility for her meds. I do think there is a way to talk to her about her meds without causing drama.