Re: Looking into trying medication

[Patte Rosebank]

Meds won’t do it all for you, but they sure do help you make the necessary behavioural changes to minimize the bad stuff about ADHD, and maximize the good stuff. They’re just a medical device. Kind of like prescription eyeglasses or custom orthotics.

Now, on to your questions. First, the bad news…

Walk-in clinics definitely won’t be able to diagnose ADHD, or prescribe anything for it. It takes a fair bit of testing, or at the very least, long-term familiarity with a patient, for a doctor to put his/her reputation—and license to practice—on the line by diagnosing something so serious.

Also, most of the meds for ADHD are potent stimulants (similar to Meth in both composition and effects), which makes them rather desirable street drugs, and, therefore, highly controlled substances. In fact, the info sheets that pharmacies give you when you fill your prescription for them state that it is against the law to give or share them with anyone else. Because of this, no walk-in clinic is going to prescribe them for someone they’ve just met, who says, “I think I have ADHD. Can you prescribe something for it?”

So, what can you do? Plenty!

Do you live in Toronto permanently, or are you just here for university? If you’re here for university, there should be a campus medical clinic or student services office that can advise you further.

If you’re here permanently, you need to get yourself a family doctor here. Go to http://www.cpso.on.ca/docsearch/ and search for one who’s accepting new patients. Your timing is great. Every July, the Ontario College of Physicians & Surgeons releases its new graduates, and those new doctors will be looking for patients. But it only takes a few months for those new doctors to be full-up too. So look for one NOW. When you do get a new family doctor, you’ll need to request that your old doctor send copies of all your records to him/her, to acquaint him/her with your full medical history.

Now, for the issue of paying for this…

There are very few psychiatrists specializing in Adult ADHD. Some charge quite a lot above what OHIP covers, and not all medical insurance plans will cover this difference. Since you only have about a month, ACT NOW.

1. Call the specialists on this list: http://www.adrn.org/html/adult_adhd.html (note: Dr. Atilla Turgay passed away a few months ago, but there may be other specialists at his Toronto ADHD Clinic). Explain your situation, and ask how long it takes to get in to see them. Ask if they can see you any sooner, before your medical coverage runs out.

2. Ask your mom to find out if her medical plan covers psychological/psychiatric testing for you. If it does, call your family doctor, explain the situation, and ask if he/she can send a referral, ASAP, to the specialist who can see you soonest.

On to the cost of meds…

When your coverage runs out, you’ll have to pay for prescriptions on your own, and ADHD drugs (except for Ritalin) can be expensive. If you’re on a low income, register NOW for the Trillium Drug Plan. The information is here: http://www.health.gov.on.ca/english/public/pub/drugs/trillium.html and you can fill in the form online, print it off, and submit it with supporting documentation. When you are accepted to the Plan, it will cover most of the cost of your prescriptions. However, if a generic version of a drug exists, Trillium will only pay for that generic version. If you want the branded version, you’ll either have to pay the difference, or, in some cases (like Strattera), Trillium won’t cover it at all.

The trouble is, there is a BIG difference between the generic and the branded forms of ADHD drugs. Concerta is the most dramatic example.

But Janssen (which makes Concerta), has responded by setting up its own patient assistance program, which pays the difference between what Trillium covers and what you’d have to pay yourself if you wanted branded Concerta. Result: You get authentic Concerta, and it doesn’t cost you a cent. You have to ask your pharmacist about this program, but it just takes a few minutes to register for it, and it kicks in immediately. I think Concerta is the only ADHD drug that has a patient assistance program.

One more thing: In Ontario, if you want the branded version of a drug, your doctor must HAND-WRITE “no substitutions” on the prescription. If “no substitutions” is put there by any mechanical means (pre-printed, rubber-stamped, printed on the computer), pharmacists can, and will, ignore it and give you the generic form of the drug instead. For more info about this, check out Rick’s Rants on Generics—in the Videos section of this website.

Whew! I think that covers it all.

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