9 ms·

EDIT: The following may be specific to the U.S. state. Also ridiculous but only tangentially related: Psychiatrists (or similar functions) cannot send prescrip

• jetti 6y ago
  This is not true anymore, Adderall can be sent electronically to the pharmacy. It makes things so much easier since I don’t have to find time to get into the office to pick up the paper prescription.
  • verst 6y ago
    Since when? In Washington state it was still true 2 months ago.
    • ohyeshedid 6y ago
      It definitely depends on the state. Something to possibly check into, if you have a primary care doctor you can ask them to conference with your psychiatrist so your primary can prescribe it through normal means. I don't know Washington regulations for that, so it might not help.
    • jluh 6y ago
      I've been getting my adderall prescription sent electronically for the past 6 months, since I moved here. Another post claims they've been getting it sent electronically for a few years: https://news.ycombinator.com/item?id=23215206 https://news.ycombinator.com/item?id=23215206
    • jetti 6y ago
      I did a quick search and found that Washington State Senate Bill 5380 [0] that was signed into law in May of 2019 says that Schedule 2 substances can be prescribed electronically in 2019. There are exceptions to that and your prescriber may not participate in it. [0] http://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/Senate%20Passed%20Legislature/5380-S.PL.pdf?q=20200518084150 http://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/Sen...
• marcinzm 6y ago
  This isn't the case in NY from my understanding as I've seen psychiatrists send ADHD prescriptions digitally to both physical pharmacies and delivery pharmacies (Capsule). So it might be a restriction imposed by your state.
  • verst 6y ago
    Interesting! Maybe it's a Washington State thing then.
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    • Sndra54 6y ago
      xxx
  • BonesJustice 6y ago
    They actually must be sent electronically now in NY, or at least that’s how my doctor explained it to me. I’d assumed that was for all prescriptions, but it could just be controlled substances.
    • ethagnawl 6y ago
      I was recently told by a pharmacist that this applies to _all_ prescriptions in NY. YMMV, though.
    • 6y ago
• colejohnson66 6y ago
  > Also ridiculous but only tangentially related: Psychiatrists (or similar functions) cannot send prescriptions for ADHD drugs (Adderall / Amphetamines etc) to pharmacies (by any method). You need to pick up the physical prescription from the health care provider, then take it to any pharmacy. The pharmacy may not even have the medication, and certainly will need some time to fill it on the spot. This is not true, at least in California. I take a certain ADHD medicine that’s a Schedule 2 drug. So I’m limited to 30 day prescriptions with no refills (so my doctor sends in 3 at a time), but my doctor can most definitely send them direct to my pharmacy.
  • meej 6y ago
    This is exactly what my doctor in Oregon does. I've never had to deal with a handwritten prescription.
  • verst 6y ago
    My psychiatric nurse practitioner certainly wanted to reduce her own possible COVID-19 exposure here in the Seattle area but stressed that she could not call or send in the prescriptions for Adderall because of government regulations. Unclear who that regulating body is however.
    • colejohnson66 6y ago
      IANAL So I looked it up because that is very perculiar, and my quick skimming of the laws seem to imply that Schedule II through V drugs can be sent electronically:[0] > (1) Information concerning a prescription for a controlled substance included in Schedules II through V, or information concerning a refill authorization for a controlled substance included in Schedules III through V, may be electronically communicated to a pharmacy of the patient's choice pursuant to the provisions of this chapter if the electronically communicated prescription information complies with the following: > ... [0]: https://app.leg.wa.gov/RCW/default.aspx?cite=69.50.312 https://app.leg.wa.gov/RCW/default.aspx?cite=69.50.312
      • verst 6y ago
• deleted 6y ago
  [deleted]
• vharuck 6y ago
  In PA, my doctor's only been able to send Adderall prescriptions directly to the pharmacy within the past couple years. If yours doesn't, check that it's not a rule from your insurance. My insurance makes me sign a form to choose the only pharmacy location I can use for those meds, amd I need an appointment with my doctor every 6 months. It's hard to tell what's a federal law, a state law, or my insurance company judging me as a likely junkie.
  • Klathmon 6y ago
    I had a hell of a time when I chose that in PA and the pharmacy didn't have the medication in stock. It was 2 months before I was able to finally get it, because I made the mistake of trying to change my pharmacy to one that had it in stock.
• SilasX 6y ago
  Uh what? This seems like the kind of thing solvable with routine electronic authenticated messages from doctor to pharmacy. The problem there is mandating the dubious paper method as the only way.
  • sandworm101 6y ago
    > ...with routine electronic authenticated messages from doctor to pharmacy. These are professions that still use fax machines. The concept of sending scrips between random doctors and pharmacies over electronic means is too daunting (HIPPA, privacy lawsuits, child protection laws etc). They would rather stick them in envelopes. Giving it to the post office won't get them sued.
    • SilasX 6y ago
      Perhaps for some, but for the last 5-10 years all my doctors have had me specify a pharmacy and the prescriptions gets sent their directly without me having to hold anything physical.
• metalforever 6y ago
  Why do they have to make this such a pain in the ass? They are trying so hard to restrict abusers that it makes it almost impossible to get treatment if you actually have ADHD. Do you know what people with ADHD do? Forget to make appointments because they got distracted. Essentially the system is set up to be hostile to ADHD sufferers to actually get help . I ended up having to pay concierge mental health to consistently be able to fill this script. The doctors would sometimes refuse to see me because of this diagnosis, and the pharmacies would lie to me that they were out of the medication and to come back on x date. If I do this they just repeat the same statement and choose a different random day. This was so much trouble that I spent years without treatment and it affected my life terribly. I did things like cause 10s of thousands of dollars in damages to apartments due to Inattention, almost getting myself fired, driving extremely poorly, almost failing out of school. This condition is preventing me from doing things I really want to do with my life because theres a wall of motivation I have to get over, even for things I enjoy.
  • lonelappde 6y ago
    Why would doctors and pharmacists refuse to serve you? What's their incentive?
    • pnw_hazor 6y ago
      Legal liability or the general threat of having to expose themselves to additional scrutiny of government agents. If a government agent determines that the doc is over-prescribing they can get into big trouble. It is because of the US Opioid crisis, but the regulations are directed toward all controlled substances, not just oxycodone.
  • verst 6y ago
    I sometimes forget to take my ADHD medication on several days and only realize after the fact that I was very unproductive. My friends will also notice that my mind was more cluttered again. I dive from tangentially related thing to the next, only connected in my mind by emotion. Eventually I reach a stack overflow - I'll have no idea how the conversation started or what the real topic or task were.
• api 6y ago
  Meanwhile meth is ridiculously easy to get and can even be ordered on the dark web with little chance of getting caught. The whole system is just shockingly stupid.
• prepend 6y ago
  This is what my doc told me, that prescriptions had to be via paper in my state. Another doc said he sent electronically but had to pay a high fee to set up a system to do it for him. During covid, my doc all of a sudden started sending electronically. I’m not sure if my doc was wrong, or lying, or just didn’t understand the stupid regulations around some meds.
  • jessaustin 6y ago
    Lots of small clinics that don't write lots of prescriptions use paper. (I do some IT for one.) It's not regulation, it's cost. As long as it's cheaper to buy the paper and take the time to print on it than to pay monthly fees to the appropriate online clearinghouses, some doctors will do exactly that. Lots of prescriptions that don't see "abuse" can be communicated to the pharmacy with a phone call. Amphetamines are not such a drug.
• oefrha 6y ago
  It’s funny 90% the time people throw out the claim “blockchain is a good solution for this”, what they really have in mind is just an append-only database controlled by trusted parties. (Before someone tells me the story of Coca Cola’s supply chain, thanks, I’ve heard dozens of times.)
  • megablast 6y ago
    What is this Coca Cola supply chain story?
  • nostrebored 6y ago
    Yeah, the 'decentralized' part of blockchain seems to slip people's minds a lot. A centralized ledger database is the right solution sometimes.
• mschuster91 6y ago
  > I know it's a running joke to throw out the term Blockchain, but this really is where Blockchain might be a good solution. Why so complicated? Most use cases for Blockchain could be solved by public-key cryptography, technically backed by using a national government issued, RFID capable ID card (drivers license, passport, whatever) and it's trust chain.
• boomboomsubban 6y ago
  So from my understanding, most prescriptions are handled over the phone/fax, and regulated drugs require some kind of verifiable signature that a fax does not comply with. I believe mail works fine though, as none of this makes sense. There is an e-signing program that I think lets the pharmacy watch the signature being made or something that is now fixing this issue, but I hear it is both expensive and rather difficult to use. Look for a pharmacy that offers delivery, they can make the trip to your doctors office for you as again these regulations are ridiculous.
  • michaelmrose 6y ago
    Physical signatures are nearly worthless a digital signature ensures that the prescription is valid unless the doctors computer or the pharmacies is compromised. This would presumably be no worse than keeping people from forging paper prescriptions. It would logically be based on a public private key pair like gpg.
    • boomboomsubban 6y ago
      I was a bit mistaken, the law requires a full written prescription, not just signature, and it can't be a copy. The system in place allows for electronically writing prescriptions so they will still comply with the written requirement. There are more security requirements like what you describe, but much of this is about making a new standard comply with laws from the 70's.
• alasdair_ 6y ago
  Every month I end up playing the game of "will they have my medicine?" and regularly have to drive around different pharmacies to find one that can fill the prescription that day (because they only fill one every thirty days, and there is exactly a thirty day supply given, so there is zero buffer). This becomes far more problematic if I have to travel for work (which was very common pre-COVID) and I'd literally have to drive an hour to a 24hr pharmacy and wait until 12.01am on the day of my flight, then wait half an hour to get the prescription filled, drive an hour home, then leave at 5.30am to get my morning flight. And if the refill date occurs when I am away, I'm SOL - CA won't take a prescription from WA for a controlled substance. I usually have to ask my wife to go in early to pick it up, then spend a ton of money to overnight the medicine to my hotel. There needs to be a system that allows for people who have been taking the same stuff for years to have SOME kind of buffer or slight flexibility. The current system is bullshit.
  • GordonS 6y ago
    > Every month I end up playing the game of "will they have my medicine?" and regularly have to drive around different pharmacies to find one that can fill the prescription that day (because they only fill one every thirty days, and there is exactly a thirty day supply given, so there is zero buffer) This is an utterly absurd situation - surely the people coming up with this stuff must realise this? If anything, stupidity like this could actually cause more people to go to the black market.
    • alasdair_ 6y ago
      It is deeply annoying for me. What is genuinely enraging however, is when my son runs out and we can’t get him his medicine. His symptoms are honestly pretty bad and he is aware of them but can’t do anything about it. Hearing him ask “daddy, why can’t I have my medicine?” is both heartbreaking and enraging. In the end, we asked the doctor, who agreed to issue us a slightly different prescription for him a few days after we filled the first one. This let us get the second prescription Refilled immediately so we thankfully have a small buffer for him now. Laws like this are bullshit.
  • CBLT 6y ago
• isbjorn16 6y ago
  I don't know if it's because you're talking about a psychiatrist or not, but my wife takes Vyvanse for ADHD, prescribed by her family doctor. Ours just retired, and while he wasn't allowed to do more than give her a paper prescription to pick it up each month, the NEW doctor can, because she is set up to send it electronically. Most other prescriptions he could call in, but I think in WA there's a special system you have to get set up with to do it yourself. Now my wife doesn't need to physically pick it up anymore. If it would be useful to you, I can find out from my doctor's office what system they had to be part of to allow them to call in prescriptions like that.
• akhosravian 6y ago
  This isn’t true in Washington. My psychiatrist has been sending my ADHD meds for digitally for a few years now. https://www.addcenterofbellevue.com/ https://www.addcenterofbellevue.com/ If you’re interested in a new doc.
• robbiep 6y ago
  I know this is only dealing with a tiny portion of your comment, but why do people think digital prescriptions require a proof of work database, when matching a UDID and changing a 0 to a 1 would suffice?
• lottin 6y ago
  I don't understand why it has to be so complicated. In most of Europe you go to a pharmacy with your health insurance card and 30 seconds later you walk out with the drug you have been prescribed. On the rare occasions when it is out of stock you can come back later (usually it takes only a few hours) or go to another pharmacy around the corner where the chances are they will have it.
  • ajmurmann 6y ago
    A odd, underdiscussed, difference I noticed between the US and Germany (and presumably other European countries) is around packaging. In Germany pretty much any medication comes packaged for retail in a cardboard box with tablets on one of these bubble sheets. Similar to most over the counter stuff in the US. In the US the pharmacist puts the tablets into an orange container with the precise counts requested by the prescription and with an individualized label. I wonder how much of the logistics issue in the US is from the individual packaging work required.
    • lottin 6y ago
      Yes, I have seen that in American sitcoms and films. In Europe, as you say, they come in cardboard boxes. The pharmacist will cut out and keep the barcode in the case of prescription drugs.
• morpheuskafka 6y ago
  It would be enforced by the DEA, but as far as I remember, the requirement that only paper prescriptions are accepted for C-IIs is written into the law itself. So only Congress could change it. There is actually a way to e-prescribe, but there are strict security requirements and I think it varies by state. IDK why blockchain is needed though, an ordinary digital signature ought to be enough and that's what the e-prescribing rule requires.
• freddie_mercury 6y ago
  I find this post interesting because the OP lept to blaming "The Feds" and specifically the FDA and DEA (two frequent targets of popular ire) even though subsequent replies make it clear the OP has no factual basis for any claims made.