"A guest at the Century Plaza wants his Adderall refilled. Can you go?" asked someone from the office of a local concierge doctor.

"I can go, but I don't do Adderall," I said.

"No problem." She would find another doctor. Prescription refills are easy house calls.

You've heard of childhood attention-deficit disorders. Psychiatrists have discovered that it also affects adults. Treatment is the same. That includes drugs related to amphetamines; the most popular for adults is Adderall. As a hotel doctor my only experience with attention-deficit disorder came from guests who needed more Adderall.

Few sounded like drug-seekers. All were happy to pay my fee for a visit during which they assumed that I would check them out and write a prescription. One does not diagnose adult attention-deficit disorder on the fly, so I told them I'd have to speak to his or her doctor. Those few that I spoke to agreed that requesting an Adderall refill from an unfamiliar doctor sounded suspicious, and they left the decision up to me. I gave up on Adderall.

It's been decades since I made a similar decision on narcotics. Guests regularly forget their heart or blood pressure pills, but soon after becoming a hotel doctor, I grew puzzled at how many needed more Vicodin or Oxycontin. Some sounded suspicious from the start, but many seemed in great pain. Their distress tore at my heart, and they often produced a sheaf of X-rays and letters from a doctor. With no reliable way to tell the fakes from the genuine, I gave up on narcotics.

Mike Oppenheim