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The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible

The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle. It's a risk for them to prescribe a stimulant, but zero risk to tell you to eff off. As many have said in this thread, most doctors will tell you to go away or give you Welbutrin (which works poorly, if at all). I feel for your struggle.

SubmarineClub 1y ago
Yeah, it's ridiculous. I've been taking medication for ADHD since the 3rd grade. Why in the good goddamn should I have to go in EVERY month for a refill for a medication I've been taking for over 20 years.
- deleted 1y ago
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- FollowingTheDao 1y ago
  It’s the same thing for me and Klonopin and my psychosis. The Klonopin is the only thing that stops my psychosis yet they only give me 20 tablets at a time and since I’m homeless and driving around it’s really hard for me to get a new doctor and a new prescription. I’ve been taking it as needed for over nine years and they still can’t get it through their thick heads that I’m not gonna abuse it.
  - deleted 1y ago
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  - al_borland 1y ago
    I was in the hospital after surgery and was being treated like an addict who was just there to get pills. It was madness. Like I willed by appendix to burst so I could get a little morphine or a xanax, that makes total sense.
  - edm0nd 1y ago
    i'm curious, are you homeless because of your psychosis?
    - FollowingTheDao 1y ago
      Yes, I have schizoaffective disorder, Asperger‘s, and myofacial pain disorder they put me on disability about 22 years ago. I used to be able to handle living in apartments on my disability, but rent has gotten crazy so I ended up living in a van which actually ended up being kind of OK. I have episodic psychosis. It’s not something that happens every day. And I’m seeming to manage it with some genetic and nutritional understanding I have of myself so it’s not that much of a problem anymore. I just have to be careful with Covid because both times I had Covid I had the worst psychosis of my life. All my disorders are mostly due to a CBS Deficiency.
      - quibono 1y ago
        I hope things get better, all the best to you
- mrandish 1y ago
  Yep. For a while there I was able to work with my doctor and pharmacist to get Adderall from my Kaiser health plan pharmacy in 90 day increments but that stopped with the med shortage. Now that the shortage is over they won't do it again. Neither my doctor nor pharmacist know if this is an actual regulation change due to the shortage or just a health plan policy change. If it's a reg change, it'll never go away. If it's a health plan policy, maybe there's hope. The problem is that Schedule 3 meds can't be shipped and must be picked up in person at the pharmacy (where driver's license # must be entered in an extra procedure not required for other meds). Health plan pharmacies have lines, don't have drug store hours and aren't on every corner. The combo of "in person pickup" + "30 day limit", which were enacted by different people at different times for different reasons creates life disruption and a massive waste of time, energy and money (we're all paying for this in increased prices). I've been on these same meds like clockwork for decades. In such cases they should relax either "in person pickup" or "30 day limit" but, we all know, it won't happen. And if I need to travel on a trip or vacation for a week or two, with the 30-day limit there's a 25-50% chance I'll run out of meds and getting special dispensation to refill early requires contacting and coordinating the doctor and pharmacist in a non-automated, out-of-band loop. There's a two day automatic grace period to account for the pharmacy being closed on weekends but when my 30-day window falls on a weekend, I now have to coordinate pickup on an exact day - like I don't have a life outside of this bullshit. All just to get the meds which help me function normally. Being forced to deal with all this for years has made it so I understand the health plan's back-end IT system capabilities (and lack thereof) better than most of their employees. It's still inconvenient for me but I'm one of the lucky ones. My meds are dialed-in and working, I have a flexible schedule and can parse bureaucratic systems. I got diagnosed and stable on my meds back before every ADHD patient was automatically considered a suspected drug abuser - which is ironic because I've never even had a drink, much less used illicit drugs (ADHD and alcohol/rec drugs tend not to mix well and I was diagnosed as a child). Which makes it meta-ironic I'm required to have a drug screen blood test every year to verify I am taking my prescribed drugs and not selling them - as if I got diagnosed in 4th grade as the ultimate long con knowing these meds would become street drugs worth a buck a pill decades later. I can't imagine a new ADHD patient still struggling to find the right med and dosage trying to figure all this out without giving up.
- hinkley 1y ago
  At least with time release now there's less of a problem of having to sneak to the nurse's office every day at lunch to take medication and have that brat from third period ask you why you're in the nurse's office and what you're taking.
- sekh60 1y ago
  Since you may sell them if you get them more frequently. Now here's a pack of 30.
  - baby_souffle 1y ago
    > Since you may sell them if you get them more frequently. Now here's a pack of 30. But it's already a C/II class medication so the name on the Rx has to match the name on the photo ID and the pharmacy has to keep the records / there are rules for how often C/II medications can be dispensed. If you have a 30d Rx, the soonest you can come back with an Rx for that same medication is ~25d. Regardless, does it matter if I have to re-fill every 30d or every 90d? As long as I'm only in there every 80d to get my 90d supply topped up, how is that any different from a 2d Rx or a 30d Rx being filled every 1d or every 25d?
    - sekh60 1y ago
      Sorry, I was being a little tongue in cheek. My wife is on Adderall for ADHD and the renewal thing is frustrating for sure. Our pharmacy would only let us refill her prescription the day of until our psychiatrist wrote one that said 30 tablets over 25 days. So I get the frustration, I just find it kinda silly that there's all these overblown controls, and then they give a "large" amount when all is said and done. Kinda like security theatre to me, it's just dumb and punishes people that already have a hard time keeping up on appointments and paperwork due to their health.
- hombre_fatal 1y ago
  I was on a 90 day prescription for ten years (vyvanse) when I told my doctor I was traveling abroad. Insurance doesn’t cover 90 day bottles so it was $300/mo but worth it. Nowadays there’s generic Vyvanse which is much cheaper so it probably makes 90 day prescriptions financially viable? I just moved back to the US and had to find a new local doctor who gives me 30 day scripts so I haven’t asked about 90 day yet. I imagine these pill mills are pretty stingy. It takes a lot of time and calling around to find docs who don’t treat you like a fiend in some way. But we need to count our blessings. People on pain killers need to put up with crazy shit like getting randomly summoned to the office so they can count your remaining pills.
  - 1659447091 1y ago
    > I just moved back to the US and had to find a new local doctor who gives me 30 day scripts You may have difficultly getting a 90 day, both the doc and pharmacist have to agree to do it - 3x30 day with 'fill on dates' is more likely. When I had a long out of town trip I was able to get a 60 day script. When I came back the doc sent 60 day script again but the pharmacist wouldn't fill it and only allowed it because what ever code/note the doc added about long term travel. That was self pay so I wasn't even a risk for selling it. Some states won't allow more than 3x30 day. I am surprised you got name brand vyvanse for $300/month, generic is ~$250/month without coupons/discount cards
    - nerdsniper 1y ago
      ExpressScripts pharmacy basically mandates 90-day Rx and will mail them to your home. Excellent for people who suffer from ADHD.
      - notfromhere 1y ago
        I don’t understand how this works when legally in many states they can only dispense a 30 day supply
    - hombre_fatal 1y ago
      Interesting. I got a 90-day bottle from a doc in my hometown until 2022. That's when I moved back to Texas but didn't want to drive all the way to my hometown anymore to see that doc. Now I go to some "psychiatrist" pill mill where they made me take a BS $200 computer test to diagnose me with ADHD (CYA even though I've been taking this drug for 16 years) and they ask me the same goofy questions every televisit (probably more CYA). Yeah, it was $1000-1200 for 90 pills of Vyvanse all that time. GoodRX only knocked it down $200 or so. And the website coupon only applies to 30-day. Now with insurance, Vyvanse is $100 for 30 while generic is $10.
- 0cf8612b2e1e 1y ago
  Not to make light of your situation, but women taking birth control have been in this situation forever. It is only recently that over the counter birth control and/or three month allotments have been available.
  - elzbardico 1y ago
    And the same people who fight against abortion were the same ones who fought tooth and nail to make birth control hard to access. Go figure!
    - aianus 1y ago
      Who, the AMA? Canada is super pro abortion and definitely didn't have OTC BC when I was in college.
  - qingcharles 1y ago
    * In the USA
  - aidenn0 1y ago
    You have to go into a doctor every month and get a new paper prescription for hormonal birth control? In the US? 20 years ago, my wife was able to do an electronic prescription, and it automatically refilled at the pharmacy every month. For stimulants, they can't do an electronic refill, so I literally had to go to my doctor, get a paper prescription, then drop it off at the pharmacy, then come back a few days later (because it's usually backordered) every 30 days. Some doctors would write 3 prescriptions with a "not before" date, but others were not willing to do so.
    - hilux 1y ago
      Definitely for Adderall, and possibly for birth control, the regulations vary greatly by state. Of course, it wouldn't surprise me if hormonal birth control were to be Federally banned before this White House is done.
- dev1ycan 1y ago
  This is why I stopped, when I was starting doing internship at my job I was earning "1000", to go to the psychiatrist to get a prescription it'd cost 250, and the 1 month of pills would cost another 250, half my salary in this bullshit... on top of having to go every month which on itself is a burden. Nice joke really, even after I started earning more after the internship period ended it was just too annoying so I stopped entirely, instead since it was work from home I literally spent 24/7 trying to finish my work so basically, "working" (if you have adhd you know that while you procrastinate, you aren't actually "relaxed" enough to go play games or whatever so it'd basically still being in work mode mentally) 16 hours a day.
- justinator 1y ago
  Are we talking Adderall? I would be amazed if it still works at all on you. It seems research is showing that stimulants work for ADHD, until it doesn't. If it is Adderall, do you cycle on and off, or what's your protocol? (curious is all)
  - astrange 1y ago
    If it stops working, take magnesium supplements. (Glycinate or threonate, not oxide.)
  - terminalshort 1y ago
    It's worked for me for 20 years
    - justinator 1y ago
      You never developed a tolerance?
      - terminalshort 1y ago
        Yes I did. It doesn't hit like it did when I first took it, but that decline quickly leveled off. I think it also helps that I don't take it on the weekends.
- godelski 1y ago
  Or how every month the brand changes or you get a slight variation or they give you half the pills but double the dosage, where all of these things requires a consultation with the pharmacist and it's always a 5 second conversation: "This again?" "yep. Any question?" "no" "Have a nice day" For the last few years I think the actual medication I take changes every month. Is it just amphetamine? Just dextroamphetamine? Both (like Adderall)? These aren't the same and effectiveness is at different dosages. And then I got to figure out how to adjust to the specific version and batch as the manufacturing tolerance is within sensitivity range. Not to mention food interactions. And most of this is a solvable problem!
- insane_dreamer 1y ago
  I'm pretty ignorant of how all this works, never having had to take medication, so I apologize in advance if this comes off the wrong way. But isn't the reticence of doctors a result of the over-prescription of opioids leading to the very serious opioid crisis? Not sure what the correct solution is, but on the one hand we don't want doctors to overprescribe, but on the other hand we want doctors to liberally prescribe without re-checks to make it easier for those who need it to get their meds. That would seem to put providers in a bind.
groby_b 1y ago
This doesn't even account for the perma-drama due to the artificial shortage generated by the DEA. Getting your prescription filled, if you manage to wrangle one, often requires hours of calling around which pharmacy can fill said prescription. And you get to do that every months. And you can't get a prescription earlier, you have to wait a full month. So, essentially: Right when you're forced off your medication that helps your executive function, you need to exercise large amounts of executive function. It's massively stupid.
- totablebanjo 1y ago
  The hoops I have to jump through for a prescription I’ve been on for multiple years is ridiculous. My insurance will wrongly think I’ve filled it at a CVS I sent the script to hoping they’d have it in stock and then I sometimes end up paying out of pocket because otherwise I am exhausted all day and have limited capacity to do tasks. The meds themselves have dramatically improved my life by being more capable of getting tasks and work done. Main downside is the drop off around 8/9pm when I become really tired and unfocused.
  - baby_souffle 1y ago
    > Main downside is the drop off around 8/9pm when I become really tired and unfocused. Talk to your prescribing psych about this. More, but smaller, doses throughout the day may be a way around this. Diet and changing when I medicate helped me a ton. I got another few hours per day out of my meds just by splitting the medication up and administering every few hours, timed just before/after lunch. You do still need to acknowledge / accept that the medication can't be a 24x7/forever cure though; that crash back to sub-optimal levels of function and abundant distractability is inevitable :(.
  - herbst 1y ago
    That's not what you want to hear I guess. But Adderall has a dirty crash, using pure Dextroamphetamine and not one of this mix pills makes the crash more bearable and less tiring
- wombat-man 1y ago
diob 1y ago
Yeah, the journey to stimulants for me was long and painful, with a lot of procrastination on my part. And now even having them prescribed it is a pain dealing with the bureaucratic / expensive nightmare of USA health insurance.
- arcfour 1y ago
  What does the DEA have to do with US health insurance, exactly?
  - gopher_space 1y ago
    They get to decide how many of each pill manufacturers may produce each year, and how they’re controlled.
    - arcfour 1y ago
      Right, so nothing to do with insurance or our system of it.
      - Uehreka 1y ago
        Insurance often refuses to cover ADHD meds, so a lot of us our paying the full price. Which is garbage, and is very much to do with insurance and our system of it.
        arcfour 1y ago
        That has nothing to do with the DEA though. You're conflating different concerns.
        Uehreka 1y ago
        We’re mad and we have ADHD. We’re not interested in staying on topic.
  - 1y ago
mithametacs 1y ago
I literally did the thing you’re not supposed to do. my psych kept giving me everything by Adderall. So I went to one of those online doctors and got Adderall through her. Then I just told my psychiatrist that I have Adderall prescription and she took it over. For the record, she’s actually really reasonable and I like her but very conservative about the stimulants. Which when I finally got them were a revelation. Medication that actually works.
- llbbdd 1y ago
  Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that.
  - baby_souffle 1y ago
    > Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that. There are a few providers out there. The DEA is cracking down on them (they call them "pill mills") and that crackdown is - depending on who you ask - partially/fully responsible for the stimulant shortages the past few years. The /r/ADHD sub has some good discussion(s) from time to time on the latest action(s) taken by the DEA. --- When I was seeing medical help to confirm or refine my suspected/self-diagnosed ADHD, it was a _pain_ to jump through all the hoops. I was nervous getting my first Rx filled but oh my god was it a night and day difference. Within 45 min, it was _clear_ that the medication was working ... exactly how it's supposed to for people with ADHD. That "validation" was my prize for attempting to navigate the american health care system. If I could have replaced dozens of hours / 6+ months of phone-tag/paperwork/assessments for a monthly subscription and a 30 min video call, I'd have jumped at the chance.
    - skissane 1y ago
      > and that crackdown is - depending on who you ask - partially/fully responsible for the stimulant shortages the past few years. Australia has been experiencing psychostimulant shortages in recent years, but they haven’t been due to the DEA (or Australian equivalent thereof-most of the DEA’s functions are state government responsibilities in Australia), they’ve been explained as due to manufacturing issues and growing demand - https://www1.racgp.org.au/newsgp/clinical/further-adhd-medication-shortages https://www1.racgp.org.au/newsgp/clinical/further-adhd-medic... - while I totally believe the US is facing additional issues due to its own regulatory regime, if Australia is having supply issues independent of that factor, why wouldn’t the US too? Since controlled substances prescribing is a state issue in Australia, each state has its own policies - but I know my state (NSW) has been loosening regulation not tightening it - https://www1.racgp.org.au/newsgp/clinical/first-phase-of-gp-adhd-reforms-revealed https://www1.racgp.org.au/newsgp/clinical/first-phase-of-gp-...
hinkley 1y ago
I've heard it argued that ADHD diagnoses should come with a social worker. Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. Three day weekends are the worst. One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a drawer. You only ever withdraw when you've fucked up your re-order.
- pesus 1y ago
  I'm of course not recommending or condoning this, but with instant release it's definitely possible to also get a higher dosage than you actually need and cut the pills up to take the lower dosage you need, and stash the rest to build up a surplus. Or so I've heard.
  - lazide 1y ago
    And yet, the exact same song and dance is required for extended release and prodrugs like Vyvanse.
  - hinkley 1y ago
    The extended release means you only have to remember to take the medication once a day instead of twice. What we need is for these pills to be compounded the way they do opioids: the wax granules are arranged to attempt to keep you from getting a burst dose by crushing the pills. The same process that makes crushing work makes splitting not work. So if you make split pills still time release, no problem. But not for saving pills. Some people are exquisitely sensitive to these medications and you need 25mg per day but it only comes in multiples of 10 up to 50. So you’d like to split a 50 and take 1/2 pill per day. Also the 40mg often costs only 30-40% more than the 20.
    - impure-aqua 1y ago
      Vyvanse is biochemically rate-limited rather than mechanically, so it is ideal for this; there is not really an alteration to the absorption properties no matter what you do.
jackdoe 1y ago
> handle rejection poorly Off-topic but recently I found out about Sensitive Rejection Dysphoria, its not officially recognized as a thing but it is in active study now, and very related to ADHD, and tbh I wish I knew about it sooner
- losthobbies 1y ago
  Same as me. I think about it every day now. I’m 44 and It explains a lot of my behaviours. I found the adhd chatter podcast very helpful https://youtube.com/@adhd_chatter_podcast?si=Ne0isYQ2QCgIeqYI https://youtube.com/@adhd_chatter_podcast?si=Ne0isYQ2QCgIeqY...
  - mthoms 1y ago
    It's nothing personal but I clicked your link enthusiastically and was greeted with nothing but clickbait thumbnails. "THIS COMMON MEDICATION IS DANGEROUS FOR ADHD WOMEN!" & "THIS STRANGE HABIT IN PREGNANCY INCREASES THE RISK OF ADHD!" are just two examples. I'm sure it's a good podcast but I find this practice distasteful at best and absolutely abhorrent when you're directly targeting mental health patients with poor impulse control and self-regulation issues. (I want to emphasize that I know you mean well :-) )
    - losthobbies 1y ago
      Yea that is very annoying. It's copying the Diary of a CEO format, sensationalizing the topic.
- cardanome 1y ago
  Yes, knowing about RSD was life changing for me. Before I had my ADHD diagnosis, I just assumed that I have social anxiety and tried to fix it myself by giving me exposure therapy. I would force myself to seek out any social interaction regardless on how I felt. The result was that I got worse, so much worse because I was basically trained myself to disregard my emotions. Turns out being undiagnosed with ADHD is traumatizing. I did not imagine that people hated me for being different, I never had any phobia. It wasn't "just in my head". The truth is that I am different and lots of people will instinctively hate me for being neurodivergent. I just needed to learn to deal with that. That is why a correct diagnosis is so important. I despise that people are given generic diagnosis like depression or anxiety instead of digging deeper and trying to find out what actually causes them.
wnevets 1y ago
> because doctors fear losing their license like so many did during the pain pill debacle. Which is understandable after the monumental pain and damage oxy caused to families everywhere.
- dodobirdlord 1y ago
  Only if you myopically assume all drugs have equal abuse potential, addiction potential, and negative consequences of abuse. The US federal drug schedule is a clown show.
  - wnevets 1y ago
    I'm sure RFK Jr will have wellness farms that everyone can go to instead of using these drugs.
kanbara 1y ago
funnily, i had zero issue getting vyvanse after a nearly 20 year medication gap, and being hugely successful by most metrics. i went to a psych, did an eval, and got medication. i know there are issues, but it’s interesting how different people’s outcomes are
globnomulous 1y ago
> Welbutrin (which works poorly, if at all) This depends on the person. ADHD medication by itself doesn't work nearly as well for me as ADHD medication+Wellbutrin.
torben-friis 1y ago
Funnily enough, my journey here in Spain was almost the opposite. I didn’t know until my thirties that certain issues with executive dysfunction could be caused by adhd, as it is not a widely known disorder particularly for adults. After I contacted a professional however, and once the relevant testing and assessment was finished, my doctor strongly recommended trying medication as part of the therapy. The whole thing took about $200 for the assessments and medication is cheap. Absolute life changer btw.
aaroninsf 1y ago
This is exactly me. Exactly. I got gate-kept with a massive ten page plus questionaire to fill out. Got half way through the laborious free form text responses. Came back the next day and none of my work was saved. Gave up. Haven't ever gotten back. Because...
pcthrowaway 1y ago
Highly relevant reading, from a psychiatrist who prescribes ADHD meds: https://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo... TL;DR they believe the most responsible thing to do is to give everyone Adderall if they're seeking Adderall, with minimal gatekeeping, because the risk of not giving Adderall to someone who needs it far outweighs the concerns of giving Adderall to someone who doesn't need it.
kstrauser 1y ago
The analogy I've given is having an asthma clinic at the top of Mt. Everest. If I could freaking get there, I probably wouldn't need it. A friend referred me to a telehealth clinic where I could get in quickly instead of waiting for 6 months. They're dialed in to their patient care, too: I get a string of email and text reminders that I have an upcoming appointment. And contrary to some of the horror stories, my doc spent a couple of hours with me on the first appointment before coming up with a treatment plan. It wasn't a 5 minute visit where they through pills at me, but an actual genuine doctor's appointment with someone doing due diligence and customizing a care plan specific to me, with alternatives to try if my insurance didn't cover the first line of meds. I feel so lucky that I got connected with the right people, after a series of PCP visits and a psychiatrist referral who diagnosed me as having anxiety. Oh, you think? Yeah, I'm feeling pretty anxious that my boss is annoyed at me for having all the signs and symptoms of ADHD and how it affects my work. Life is easier now, I tell ya.
hilux 1y ago
There are non-stimulant ADHD meds as well. Most of us don't get a chance to try all of them. In fact, I was surprised to learn that Adderall is highly illegal in many countries, including Japan and South Korea(), both of which have a higher standard of healthcare, and a much longer life expectancy, than the US does. In other words, they're not anti-health. () In theory, you can bring Adderall into South Korea with your American prescription. In practice, not really.
- kayodelycaon 1y ago
  I’m using Wellbrutin, which is a NDRI (norepinephrine–dopamine reuptake inhibitor) antidepressant. The main reason for this is because I’m also bipolar. First-line stimulants for ADHD cause manic episodes.
  - rjh29 1y ago
    Wellbrutin is not dispensed in the UK except for quitting tobacco. Annoying because it seems like a very useful antidepressant.
- habinero 1y ago
  They're kind of famous for having bad mental health care and high suicide rates. I can survive without ADHD meds, but life is a whole lot easier and a lot more enjoyable with them.
flir 1y ago
> People with ADHD are horrible at following through and handle rejection poorly The form my GP gave me (after telling me I probably wasn't) sat in my car for six months, untouched. Went private. No regrets.
cbsmith 1y ago
s/providers/insurers/
vovavili 1y ago
This is actually less of an issue for technically inclined folks, since we can get our initial fix from the darknet using cryptocurrency, and then getting more consistent at planning and sticking to routine becomes cognitively easier. This also has the advantage of the fact that researching darknet is actually quite fun and stimulating, sort of like a difficult video game with lots of little tricks and secrets. That's how I started my treatment, at least.
glennpratt 1y ago
I agree, except I've been much happier with Wellbutrin. After getting through the initial insomnia a few years ago and switching to normal release, not extended, I have good focus and don't have tremors or back pain like I did with stimulants.
veunes 1y ago
The system isn't built for people who need it to be a little easier
sanderjd 1y ago
Yeah, requiring a check in every month to keep getting a prescription always struck me as an ironic requirement when treating people with ADHD.
dimal 1y ago
Hmm. That hasn’t been my experience. Getting adderall or Ritalin was as easy as saying, “I’m having trouble concentrating.”
wordofx 1y ago
And most people who claim to have ADHD don’t have ADHD. But apparently thinking you have ADHD makes you feel better about doing things you don’t enjoy.
deleted 1y ago
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SubmarineClub 1y ago

Yeah, it's ridiculous. I've been taking medication for ADHD since the 3rd grade. Why in the good goddamn should I have to go in EVERY month for a refill for a medication I've been taking for over 20 years.

deleted 1y ago
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FollowingTheDao 1y ago
It’s the same thing for me and Klonopin and my psychosis. The Klonopin is the only thing that stops my psychosis yet they only give me 20 tablets at a time and since I’m homeless and driving around it’s really hard for me to get a new doctor and a new prescription. I’ve been taking it as needed for over nine years and they still can’t get it through their thick heads that I’m not gonna abuse it.
- deleted 1y ago
  [deleted]
- al_borland 1y ago
  I was in the hospital after surgery and was being treated like an addict who was just there to get pills. It was madness. Like I willed by appendix to burst so I could get a little morphine or a xanax, that makes total sense.
- edm0nd 1y ago
  i'm curious, are you homeless because of your psychosis?
  - FollowingTheDao 1y ago
    Yes, I have schizoaffective disorder, Asperger‘s, and myofacial pain disorder they put me on disability about 22 years ago. I used to be able to handle living in apartments on my disability, but rent has gotten crazy so I ended up living in a van which actually ended up being kind of OK. I have episodic psychosis. It’s not something that happens every day. And I’m seeming to manage it with some genetic and nutritional understanding I have of myself so it’s not that much of a problem anymore. I just have to be careful with Covid because both times I had Covid I had the worst psychosis of my life. All my disorders are mostly due to a CBS Deficiency.
    - quibono 1y ago
      I hope things get better, all the best to you
mrandish 1y ago
Yep. For a while there I was able to work with my doctor and pharmacist to get Adderall from my Kaiser health plan pharmacy in 90 day increments but that stopped with the med shortage. Now that the shortage is over they won't do it again. Neither my doctor nor pharmacist know if this is an actual regulation change due to the shortage or just a health plan policy change. If it's a reg change, it'll never go away. If it's a health plan policy, maybe there's hope. The problem is that Schedule 3 meds can't be shipped and must be picked up in person at the pharmacy (where driver's license # must be entered in an extra procedure not required for other meds). Health plan pharmacies have lines, don't have drug store hours and aren't on every corner. The combo of "in person pickup" + "30 day limit", which were enacted by different people at different times for different reasons creates life disruption and a massive waste of time, energy and money (we're all paying for this in increased prices). I've been on these same meds like clockwork for decades. In such cases they should relax either "in person pickup" or "30 day limit" but, we all know, it won't happen. And if I need to travel on a trip or vacation for a week or two, with the 30-day limit there's a 25-50% chance I'll run out of meds and getting special dispensation to refill early requires contacting and coordinating the doctor and pharmacist in a non-automated, out-of-band loop. There's a two day automatic grace period to account for the pharmacy being closed on weekends but when my 30-day window falls on a weekend, I now have to coordinate pickup on an exact day - like I don't have a life outside of this bullshit. All just to get the meds which help me function normally. Being forced to deal with all this for years has made it so I understand the health plan's back-end IT system capabilities (and lack thereof) better than most of their employees. It's still inconvenient for me but I'm one of the lucky ones. My meds are dialed-in and working, I have a flexible schedule and can parse bureaucratic systems. I got diagnosed and stable on my meds back before every ADHD patient was automatically considered a suspected drug abuser - which is ironic because I've never even had a drink, much less used illicit drugs (ADHD and alcohol/rec drugs tend not to mix well and I was diagnosed as a child). Which makes it meta-ironic I'm required to have a drug screen blood test every year to verify I am taking my prescribed drugs and not selling them - as if I got diagnosed in 4th grade as the ultimate long con knowing these meds would become street drugs worth a buck a pill decades later. I can't imagine a new ADHD patient still struggling to find the right med and dosage trying to figure all this out without giving up.
hinkley 1y ago
At least with time release now there's less of a problem of having to sneak to the nurse's office every day at lunch to take medication and have that brat from third period ask you why you're in the nurse's office and what you're taking.
sekh60 1y ago
Since you may sell them if you get them more frequently. Now here's a pack of 30.
- baby_souffle 1y ago
  > Since you may sell them if you get them more frequently. Now here's a pack of 30. But it's already a C/II class medication so the name on the Rx has to match the name on the photo ID and the pharmacy has to keep the records / there are rules for how often C/II medications can be dispensed. If you have a 30d Rx, the soonest you can come back with an Rx for that same medication is ~25d. Regardless, does it matter if I have to re-fill every 30d or every 90d? As long as I'm only in there every 80d to get my 90d supply topped up, how is that any different from a 2d Rx or a 30d Rx being filled every 1d or every 25d?
  - sekh60 1y ago
    Sorry, I was being a little tongue in cheek. My wife is on Adderall for ADHD and the renewal thing is frustrating for sure. Our pharmacy would only let us refill her prescription the day of until our psychiatrist wrote one that said 30 tablets over 25 days. So I get the frustration, I just find it kinda silly that there's all these overblown controls, and then they give a "large" amount when all is said and done. Kinda like security theatre to me, it's just dumb and punishes people that already have a hard time keeping up on appointments and paperwork due to their health.
hombre_fatal 1y ago
I was on a 90 day prescription for ten years (vyvanse) when I told my doctor I was traveling abroad. Insurance doesn’t cover 90 day bottles so it was $300/mo but worth it. Nowadays there’s generic Vyvanse which is much cheaper so it probably makes 90 day prescriptions financially viable? I just moved back to the US and had to find a new local doctor who gives me 30 day scripts so I haven’t asked about 90 day yet. I imagine these pill mills are pretty stingy. It takes a lot of time and calling around to find docs who don’t treat you like a fiend in some way. But we need to count our blessings. People on pain killers need to put up with crazy shit like getting randomly summoned to the office so they can count your remaining pills.
- 1659447091 1y ago
  > I just moved back to the US and had to find a new local doctor who gives me 30 day scripts You may have difficultly getting a 90 day, both the doc and pharmacist have to agree to do it - 3x30 day with 'fill on dates' is more likely. When I had a long out of town trip I was able to get a 60 day script. When I came back the doc sent 60 day script again but the pharmacist wouldn't fill it and only allowed it because what ever code/note the doc added about long term travel. That was self pay so I wasn't even a risk for selling it. Some states won't allow more than 3x30 day. I am surprised you got name brand vyvanse for $300/month, generic is ~$250/month without coupons/discount cards
  - nerdsniper 1y ago
    ExpressScripts pharmacy basically mandates 90-day Rx and will mail them to your home. Excellent for people who suffer from ADHD.
    - notfromhere 1y ago
      I don’t understand how this works when legally in many states they can only dispense a 30 day supply
  - hombre_fatal 1y ago
    Interesting. I got a 90-day bottle from a doc in my hometown until 2022. That's when I moved back to Texas but didn't want to drive all the way to my hometown anymore to see that doc. Now I go to some "psychiatrist" pill mill where they made me take a BS $200 computer test to diagnose me with ADHD (CYA even though I've been taking this drug for 16 years) and they ask me the same goofy questions every televisit (probably more CYA). Yeah, it was $1000-1200 for 90 pills of Vyvanse all that time. GoodRX only knocked it down $200 or so. And the website coupon only applies to 30-day. Now with insurance, Vyvanse is $100 for 30 while generic is $10.
0cf8612b2e1e 1y ago
Not to make light of your situation, but women taking birth control have been in this situation forever. It is only recently that over the counter birth control and/or three month allotments have been available.
- elzbardico 1y ago
  And the same people who fight against abortion were the same ones who fought tooth and nail to make birth control hard to access. Go figure!
  - aianus 1y ago
    Who, the AMA? Canada is super pro abortion and definitely didn't have OTC BC when I was in college.
- qingcharles 1y ago
  * In the USA
- aidenn0 1y ago
  You have to go into a doctor every month and get a new paper prescription for hormonal birth control? In the US? 20 years ago, my wife was able to do an electronic prescription, and it automatically refilled at the pharmacy every month. For stimulants, they can't do an electronic refill, so I literally had to go to my doctor, get a paper prescription, then drop it off at the pharmacy, then come back a few days later (because it's usually backordered) every 30 days. Some doctors would write 3 prescriptions with a "not before" date, but others were not willing to do so.
  - hilux 1y ago
    Definitely for Adderall, and possibly for birth control, the regulations vary greatly by state. Of course, it wouldn't surprise me if hormonal birth control were to be Federally banned before this White House is done.
dev1ycan 1y ago
This is why I stopped, when I was starting doing internship at my job I was earning "1000", to go to the psychiatrist to get a prescription it'd cost 250, and the 1 month of pills would cost another 250, half my salary in this bullshit... on top of having to go every month which on itself is a burden. Nice joke really, even after I started earning more after the internship period ended it was just too annoying so I stopped entirely, instead since it was work from home I literally spent 24/7 trying to finish my work so basically, "working" (if you have adhd you know that while you procrastinate, you aren't actually "relaxed" enough to go play games or whatever so it'd basically still being in work mode mentally) 16 hours a day.
justinator 1y ago
Are we talking Adderall? I would be amazed if it still works at all on you. It seems research is showing that stimulants work for ADHD, until it doesn't. If it is Adderall, do you cycle on and off, or what's your protocol? (curious is all)
- astrange 1y ago
  If it stops working, take magnesium supplements. (Glycinate or threonate, not oxide.)
- terminalshort 1y ago
  It's worked for me for 20 years
  - justinator 1y ago
    You never developed a tolerance?
    - terminalshort 1y ago
      Yes I did. It doesn't hit like it did when I first took it, but that decline quickly leveled off. I think it also helps that I don't take it on the weekends.
godelski 1y ago
Or how every month the brand changes or you get a slight variation or they give you half the pills but double the dosage, where all of these things requires a consultation with the pharmacist and it's always a 5 second conversation: "This again?" "yep. Any question?" "no" "Have a nice day" For the last few years I think the actual medication I take changes every month. Is it just amphetamine? Just dextroamphetamine? Both (like Adderall)? These aren't the same and effectiveness is at different dosages. And then I got to figure out how to adjust to the specific version and batch as the manufacturing tolerance is within sensitivity range. Not to mention food interactions. And most of this is a solvable problem!
insane_dreamer 1y ago
I'm pretty ignorant of how all this works, never having had to take medication, so I apologize in advance if this comes off the wrong way. But isn't the reticence of doctors a result of the over-prescription of opioids leading to the very serious opioid crisis? Not sure what the correct solution is, but on the one hand we don't want doctors to overprescribe, but on the other hand we want doctors to liberally prescribe without re-checks to make it easier for those who need it to get their meds. That would seem to put providers in a bind.

groby_b 1y ago

This doesn't even account for the perma-drama due to the artificial shortage generated by the DEA. Getting your prescription filled, if you manage to wrangle one, often requires hours of calling around which pharmacy can fill said prescription. And you get to do that every months. And you can't get a prescription earlier, you have to wait a full month. So, essentially: Right when you're forced off your medication that helps your executive function, you need to exercise large amounts of executive function. It's massively stupid.

totablebanjo 1y ago
The hoops I have to jump through for a prescription I’ve been on for multiple years is ridiculous. My insurance will wrongly think I’ve filled it at a CVS I sent the script to hoping they’d have it in stock and then I sometimes end up paying out of pocket because otherwise I am exhausted all day and have limited capacity to do tasks. The meds themselves have dramatically improved my life by being more capable of getting tasks and work done. Main downside is the drop off around 8/9pm when I become really tired and unfocused.
- baby_souffle 1y ago
  > Main downside is the drop off around 8/9pm when I become really tired and unfocused. Talk to your prescribing psych about this. More, but smaller, doses throughout the day may be a way around this. Diet and changing when I medicate helped me a ton. I got another few hours per day out of my meds just by splitting the medication up and administering every few hours, timed just before/after lunch. You do still need to acknowledge / accept that the medication can't be a 24x7/forever cure though; that crash back to sub-optimal levels of function and abundant distractability is inevitable :(.
- herbst 1y ago
  That's not what you want to hear I guess. But Adderall has a dirty crash, using pure Dextroamphetamine and not one of this mix pills makes the crash more bearable and less tiring
wombat-man 1y ago

diob 1y ago

Yeah, the journey to stimulants for me was long and painful, with a lot of procrastination on my part. And now even having them prescribed it is a pain dealing with the bureaucratic / expensive nightmare of USA health insurance.

arcfour 1y ago
What does the DEA have to do with US health insurance, exactly?
- gopher_space 1y ago
  They get to decide how many of each pill manufacturers may produce each year, and how they’re controlled.
  - arcfour 1y ago
    Right, so nothing to do with insurance or our system of it.
    - Uehreka 1y ago
      Insurance often refuses to cover ADHD meds, so a lot of us our paying the full price. Which is garbage, and is very much to do with insurance and our system of it.
      - arcfour 1y ago
        That has nothing to do with the DEA though. You're conflating different concerns.
        Uehreka 1y ago
        We’re mad and we have ADHD. We’re not interested in staying on topic.
- 1y ago

mithametacs 1y ago

I literally did the thing you’re not supposed to do. my psych kept giving me everything by Adderall. So I went to one of those online doctors and got Adderall through her. Then I just told my psychiatrist that I have Adderall prescription and she took it over. For the record, she’s actually really reasonable and I like her but very conservative about the stimulants. Which when I finally got them were a revelation. Medication that actually works.

llbbdd 1y ago
Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that.
- baby_souffle 1y ago
  > Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that. There are a few providers out there. The DEA is cracking down on them (they call them "pill mills") and that crackdown is - depending on who you ask - partially/fully responsible for the stimulant shortages the past few years. The /r/ADHD sub has some good discussion(s) from time to time on the latest action(s) taken by the DEA. --- When I was seeing medical help to confirm or refine my suspected/self-diagnosed ADHD, it was a _pain_ to jump through all the hoops. I was nervous getting my first Rx filled but oh my god was it a night and day difference. Within 45 min, it was _clear_ that the medication was working ... exactly how it's supposed to for people with ADHD. That "validation" was my prize for attempting to navigate the american health care system. If I could have replaced dozens of hours / 6+ months of phone-tag/paperwork/assessments for a monthly subscription and a 30 min video call, I'd have jumped at the chance.
  - skissane 1y ago
    > and that crackdown is - depending on who you ask - partially/fully responsible for the stimulant shortages the past few years. Australia has been experiencing psychostimulant shortages in recent years, but they haven’t been due to the DEA (or Australian equivalent thereof-most of the DEA’s functions are state government responsibilities in Australia), they’ve been explained as due to manufacturing issues and growing demand - https://www1.racgp.org.au/newsgp/clinical/further-adhd-medication-shortages https://www1.racgp.org.au/newsgp/clinical/further-adhd-medic... - while I totally believe the US is facing additional issues due to its own regulatory regime, if Australia is having supply issues independent of that factor, why wouldn’t the US too? Since controlled substances prescribing is a state issue in Australia, each state has its own policies - but I know my state (NSW) has been loosening regulation not tightening it - https://www1.racgp.org.au/newsgp/clinical/first-phase-of-gp-adhd-reforms-revealed https://www1.racgp.org.au/newsgp/clinical/first-phase-of-gp-...

hinkley 1y ago

I've heard it argued that ADHD diagnoses should come with a social worker. Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. Three day weekends are the worst. One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a drawer. You only ever withdraw when you've fucked up your re-order.

pesus 1y ago
I'm of course not recommending or condoning this, but with instant release it's definitely possible to also get a higher dosage than you actually need and cut the pills up to take the lower dosage you need, and stash the rest to build up a surplus. Or so I've heard.
- lazide 1y ago
  And yet, the exact same song and dance is required for extended release and prodrugs like Vyvanse.
- hinkley 1y ago
  The extended release means you only have to remember to take the medication once a day instead of twice. What we need is for these pills to be compounded the way they do opioids: the wax granules are arranged to attempt to keep you from getting a burst dose by crushing the pills. The same process that makes crushing work makes splitting not work. So if you make split pills still time release, no problem. But not for saving pills. Some people are exquisitely sensitive to these medications and you need 25mg per day but it only comes in multiples of 10 up to 50. So you’d like to split a 50 and take 1/2 pill per day. Also the 40mg often costs only 30-40% more than the 20.
  - impure-aqua 1y ago
    Vyvanse is biochemically rate-limited rather than mechanically, so it is ideal for this; there is not really an alteration to the absorption properties no matter what you do.

jackdoe 1y ago

> handle rejection poorly Off-topic but recently I found out about Sensitive Rejection Dysphoria, its not officially recognized as a thing but it is in active study now, and very related to ADHD, and tbh I wish I knew about it sooner

losthobbies 1y ago
Same as me. I think about it every day now. I’m 44 and It explains a lot of my behaviours. I found the adhd chatter podcast very helpful https://youtube.com/@adhd_chatter_podcast?si=Ne0isYQ2QCgIeqYI https://youtube.com/@adhd_chatter_podcast?si=Ne0isYQ2QCgIeqY...
- mthoms 1y ago
  It's nothing personal but I clicked your link enthusiastically and was greeted with nothing but clickbait thumbnails. "THIS COMMON MEDICATION IS DANGEROUS FOR ADHD WOMEN!" & "THIS STRANGE HABIT IN PREGNANCY INCREASES THE RISK OF ADHD!" are just two examples. I'm sure it's a good podcast but I find this practice distasteful at best and absolutely abhorrent when you're directly targeting mental health patients with poor impulse control and self-regulation issues. (I want to emphasize that I know you mean well :-) )
  - losthobbies 1y ago
    Yea that is very annoying. It's copying the Diary of a CEO format, sensationalizing the topic.
cardanome 1y ago
Yes, knowing about RSD was life changing for me. Before I had my ADHD diagnosis, I just assumed that I have social anxiety and tried to fix it myself by giving me exposure therapy. I would force myself to seek out any social interaction regardless on how I felt. The result was that I got worse, so much worse because I was basically trained myself to disregard my emotions. Turns out being undiagnosed with ADHD is traumatizing. I did not imagine that people hated me for being different, I never had any phobia. It wasn't "just in my head". The truth is that I am different and lots of people will instinctively hate me for being neurodivergent. I just needed to learn to deal with that. That is why a correct diagnosis is so important. I despise that people are given generic diagnosis like depression or anxiety instead of digging deeper and trying to find out what actually causes them.

wnevets 1y ago

> because doctors fear losing their license like so many did during the pain pill debacle. Which is understandable after the monumental pain and damage oxy caused to families everywhere.

dodobirdlord 1y ago
Only if you myopically assume all drugs have equal abuse potential, addiction potential, and negative consequences of abuse. The US federal drug schedule is a clown show.
- wnevets 1y ago
  I'm sure RFK Jr will have wellness farms that everyone can go to instead of using these drugs.

kanbara 1y ago

funnily, i had zero issue getting vyvanse after a nearly 20 year medication gap, and being hugely successful by most metrics. i went to a psych, did an eval, and got medication. i know there are issues, but it’s interesting how different people’s outcomes are

globnomulous 1y ago

> Welbutrin (which works poorly, if at all) This depends on the person. ADHD medication by itself doesn't work nearly as well for me as ADHD medication+Wellbutrin.

torben-friis 1y ago

Funnily enough, my journey here in Spain was almost the opposite. I didn’t know until my thirties that certain issues with executive dysfunction could be caused by adhd, as it is not a widely known disorder particularly for adults. After I contacted a professional however, and once the relevant testing and assessment was finished, my doctor strongly recommended trying medication as part of the therapy. The whole thing took about $200 for the assessments and medication is cheap. Absolute life changer btw.

aaroninsf 1y ago

This is exactly me. Exactly. I got gate-kept with a massive ten page plus questionaire to fill out. Got half way through the laborious free form text responses. Came back the next day and none of my work was saved. Gave up. Haven't ever gotten back. Because...

pcthrowaway 1y ago

Highly relevant reading, from a psychiatrist who prescribes ADHD meds: https://slatestarcodex.com/2017/12/28/adderall-risks-much-more-than-you-wanted-to-know/ https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo... TL;DR they believe the most responsible thing to do is to give everyone Adderall if they're seeking Adderall, with minimal gatekeeping, because the risk of not giving Adderall to someone who needs it far outweighs the concerns of giving Adderall to someone who doesn't need it.

kstrauser 1y ago

The analogy I've given is having an asthma clinic at the top of Mt. Everest. If I could freaking get there, I probably wouldn't need it. A friend referred me to a telehealth clinic where I could get in quickly instead of waiting for 6 months. They're dialed in to their patient care, too: I get a string of email and text reminders that I have an upcoming appointment. And contrary to some of the horror stories, my doc spent a couple of hours with me on the first appointment before coming up with a treatment plan. It wasn't a 5 minute visit where they through pills at me, but an actual genuine doctor's appointment with someone doing due diligence and customizing a care plan specific to me, with alternatives to try if my insurance didn't cover the first line of meds. I feel so lucky that I got connected with the right people, after a series of PCP visits and a psychiatrist referral who diagnosed me as having anxiety. Oh, you think? Yeah, I'm feeling pretty anxious that my boss is annoyed at me for having all the signs and symptoms of ADHD and how it affects my work. Life is easier now, I tell ya.

hilux 1y ago

There are non-stimulant ADHD meds as well. Most of us don't get a chance to try all of them. In fact, I was surprised to learn that Adderall is highly illegal in many countries, including Japan and South Korea(), both of which have a higher standard of healthcare, and a much longer life expectancy, than the US does. In other words, they're not anti-health. () In theory, you can bring Adderall into South Korea with your American prescription. In practice, not really.

kayodelycaon 1y ago
I’m using Wellbrutin, which is a NDRI (norepinephrine–dopamine reuptake inhibitor) antidepressant. The main reason for this is because I’m also bipolar. First-line stimulants for ADHD cause manic episodes.
- rjh29 1y ago
  Wellbrutin is not dispensed in the UK except for quitting tobacco. Annoying because it seems like a very useful antidepressant.
habinero 1y ago
They're kind of famous for having bad mental health care and high suicide rates. I can survive without ADHD meds, but life is a whole lot easier and a lot more enjoyable with them.

flir 1y ago

> People with ADHD are horrible at following through and handle rejection poorly The form my GP gave me (after telling me I probably wasn't) sat in my car for six months, untouched. Went private. No regrets.

cbsmith 1y ago

s/providers/insurers/

vovavili 1y ago

This is actually less of an issue for technically inclined folks, since we can get our initial fix from the darknet using cryptocurrency, and then getting more consistent at planning and sticking to routine becomes cognitively easier. This also has the advantage of the fact that researching darknet is actually quite fun and stimulating, sort of like a difficult video game with lots of little tricks and secrets. That's how I started my treatment, at least.

glennpratt 1y ago

I agree, except I've been much happier with Wellbutrin. After getting through the initial insomnia a few years ago and switching to normal release, not extended, I have good focus and don't have tremors or back pain like I did with stimulants.

veunes 1y ago

The system isn't built for people who need it to be a little easier

sanderjd 1y ago

Yeah, requiring a check in every month to keep getting a prescription always struck me as an ironic requirement when treating people with ADHD.

dimal 1y ago

Hmm. That hasn’t been my experience. Getting adderall or Ritalin was as easy as saying, “I’m having trouble concentrating.”

wordofx 1y ago

And most people who claim to have ADHD don’t have ADHD. But apparently thinking you have ADHD makes you feel better about doing things you don’t enjoy.

deleted 1y ago

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