Home Delivery of Prescribed Stimulant Medications

Home Delivery Prescribed Stimulant MedicationsHome delivery of stimulant medications?  That’s legal?  Yes, it is, in the U.S. at least.

Imagine: Instead of playing “drug store roulette” every 30 days, some folks get a 60 or 90-day stimulant prescription delivered.   Yes, stimulants, the first-line medication treatment for Attention-Deficit Hyperactivity Disorder (ADHD). Delivered to your home. If you have this benefit but never tried it, maybe it’s time to investigate.

“But Gina, you can’t get stimulant medication delivered to your home. That’s a controlled substance! There are laws!”

Yes, people say that every time I suggest it. They’ve said it for the entire 20 years that we’ve used a home-delivery pharmacy for my husband’s Concerta. But, it’s simply not true.

It is LEGAL.  It is often so much more convenient. The home-delivery pharmacies also tend to have more choices of generics and greater supply than storefront pharmacies.

Is home-delivery available on your insurance plan? That depends on the terms of your coverage.  Is it a workable option for you? That depends on other factors, discussed below.

Update: New “Digital” Pharmacies Add Confusion

Readers report using a new kind of “home delivery” pharmacy. Examples include Capsule and Alto.  These are venture-capital-funded “digital pharmacies”—new kids on the block.

They are not like the  big national “warehouse”-type home-delivery pharmacies—the ones I refer to in this post (e.g. ExpressScripts and Alliance Rx).  These new outfits do “home delivery”, but it’s by private courier. Also, you can’t get a 60- or 90-day supply. So, a different type of thing entirely.

I’ve heard about these companies mainly in the context of readers not being able to get what they  need from them, such as the Concerta authorized-generic or Adderall.  So, buyer beware.

Home Delivery of Prescribed Stimulant Medications for ADHD

Home Delivery: Who Benefits, Who Might Not?

Home delivery of prescribed stimulant medications might not be a great option for certain situations — or types of patients.

For example:

—College Students Living On  Campus: Maybe Not

Think twice about having a 90-day supply of stimulant medication hanging around the dorm room. Then again, think of the time-and-hassle savings.

—Patients New to ADHD Medication: Wait a While

Home-delivery is not a good option for people who are just getting started with ADHD+ medication treatment. Until you settle into a workable regimen, early days can mean lots of trial and error.

You likely don’t want to pay for large quantities of a medication (typically 60-90 days) that you’ll end up not using.

—Difficulty Finding A Pharmacy with Stimulants in Stock: Definitely!

Most storefront pharmacies won’t tell you over the phone if they have X stimulant in stock. I’ve heard it’s a fear-of-robbery thing.

Moreover, there typically is a day or two gap between one prescription ending and the next beginning. Who has time for this scramble? Especially 12 times a year!

Gives me palpitations to even think about.

—Everyone Else: Worth Considering!

In general, home-delivery works best for people who have settled on a medication and dosage and expect to be taking it for the indefinite future. Or at least 90 days.

In that case, home-delivery might save you huge amounts of time, money, and stress.

First, let’s examine the benefits and then learn about guidelines.

Benefits of Stimulant-Medication Home-Delivery: The Four Cs

I count at least four categories of potential benefits:

  1. Convenience
  2. Consistency
  3. Continuity
  4. Cost-savings

Convenience of Home delivery Stimulant Medications

1. Convenience:

Has this happened to you? You realize that you have one pill left. You leave work early and scramble to your doctor’s office. If you’re lucky, you can pick up the script. Then, where to fill it?

  1. Nothing says stress like having to run around to pharmacies, seeking one that has your medication in stock.
  2. Local pharmacies are often out of the stimulant medications, such as Ritalin, Vyvanse, and Concerta. In such case, you might receive 10 pills and are told to come back next week for the remaining 20.
  3. I’ve heard stories about pharmacist giving customers the hairy eyeball, as if they abusing the stimulant medication. (Catch 22: The more you get rightfully perturbed, the more suspicious you look to these ill-informed pharmacists!)

The mail-order pharmacies are huge, with inventories far beyond a local pharmacy’s capacity. They have greater access to distributors (such as the new distributor for Concerta’s authorized/branded generic:  Authorized Generic Concerta Medication Update

Think about it. You could reduce the hassle of getting a prescription filled from 12 times annually to only 4 or 6 times (with a 90- or 60-day supply). Without driving anywhere. Or waiting. Or hairy eyeballs.

When I describe the process I use for my husband’s medication (yes, that is my gift to him—and me!), folks look at me in wonder. But I don’t have time to waste—nor do we need more fodder for conflict. Who does?

You Still Need a New  Script Each Time

Unlike non-Schedule II medications, stimulant medication cannot be prescribed with refills. You need a new script each time.

With monthly prescriptions, that means physically procuring a script each month from your physician. Some physicians will give you several scripts for coming months, all at once. But some won’t and for good reason. 

With 60- or 90-day prescriptions, you need fewer paper scripts from your physician.  Or, the prescriber can send the script electronically (see below).

For some home-delivery pharmacies, you can send in the prescription two weeks ahead of time (that is, the time when the current supply is due to run out). Be sure to ask your pharmacy for clear instructions. Sometimes there is a narrow legal window.

Caveat: Someone Has To Sign For Delivery

You typically have to sign for the delivery (USPS or UPS).

Someone must be home to sign for it.  COVID work-at-home trends made this more practical.  You might have to make other arrangements (delivery to office, your doctor’s office if that is convenient, etc.  Ask for the rules).

New-ish:  Electronic Prescribing

A quick word about electronic prescribing.  Of your healthcare plan’s pharmacy and your physician’s office are set up for it, this is a great innovation. No more lost paper scripts!

 

Consistency is a benefit with Home Delivery of Prescribed Stimulant Medications

2. Consistency

Let’s say there are three manufacturers of the generic medication you take.  (For example, there seem to be dozens of generic version of Concerta now, but only one is the authorized-generic, from Patriot.)

By trial and error, you’ve learned that one of those generics works best for you—and the others work poorly.  They cause intolerable side effects or simply don’t work as well.

Local pharmacies often change vendors, in order to get the best price.  It’s a crapshoot each and every time.

In my experience, these large home-delivery pharmacies have more reliable supplies of specific generics. Some will even note your preference in your record — if your prescriber specifies it. Sometimes this requires pre-authorization.

Home Delivery of Prescribed Stimulant Medications

3.  Continuity

Perhaps you’ve noticed one particular problem with 30-day supplies of medication you need to take every day: Some months have 31 days.

So, even if you’re super organized and plan diligently each month to procure your script from the doctor and take it to the pharmacy, there are gaps.

What if you’re not…ahem… super-organized and planning diligently? Those gaps can be huge. It’s within those gaps that life can spin out of control. You might not even realize what is the problem. In fact, weeks might go by while you keep asking yourself…why have things gotten so hard?

 

cost savings with Home Delivery of Prescribed Stimulant Medications

4.  Cost-savings

Again, much will depend on the parameters of your health insurance plan. Employer-provided policies are decided by the employer. So, it’s not as if, for example, all Blue Cross policies are alike; there are huge variations.

On average, though, copayments are 29% lower through home delivery than at retail pharmacies, according to ExpressScripts spokesperson Jennifer Leone Luddy.

Update:  90-day supply at local pharmacies?

A reader sends this note:

For those of you dealing with CVS Caremark and long-term mail order prescriptions – my plan now allows the same mail-order price for purchasing a 90 day supply directly from our CVS pharmacy at Target. (I assume a stand-alone CVS would be the same, but we don’t have any near here.)

This was not in any of my plan’s documentation – I heard about it from my pediatrician who had others who were able to do this. The first time the pharmacy couldn’t confirm anything about pricing until after they processed the full prescription, so I just kept my fingers crossed.

This has been a huge improvement for us. The mail-order was a huge stress, especially as we also had substitutions and ridiculous mess due to tiny misses on the scripts. (In NY State they can only fill 30 days for a stimulant unless Code B is written on the script. That was my favorite, esp since they charged the full 90-day price. After getting the med for a couple years, I’d think they would know it was a “long-term” Rx, which is what the code means, and do a better follow-up with the doctor.)

It is worth checking with your local Target, Walgreen’s, or CVS to see if they’ve been able to provide long-term fills for others. I’ve found our local Target pharmacy to be very helpful. It’s easy to tell their hands are tied in some areas, but they do what they can.

Q&A: Stimulant Prescription Home Delivery

Below, ExpressScripts spokesperson Luddy answered my questions on this topic:

Question 1:

This access to a mail-order pharmacy: Is that a benefit with all health insurance plans or does it vary by plan?

It varies by plan. But many health insurance providers offer a mail-order pharmacy, or as we call it, home delivery pharmacy, option.

Many other pharmacy benefit organizations offer mail-order as an option, too. [Gina notes:  We’ve used Express Scripts in the past; our current plan uses PrimeMail. Both have worked similarly.]

Question 2:

When you have a local pharmacy fill the prescription, that’s typically a 30-day supply. With a home-delivery pharmacy, some insurance plans allow for 60-day or 90-day home-delivery supply. Is this variation due to the health plan or state law?

Both.  Some controlled substances have quantity limits that vary by state law, and sometimes a plan may limit the quantity available.

For patients who are prescribed a controlled substance, they should call their plan to learn more about any limitation surrounding the dispensing of the medication, and any additional paperwork required by the plan for coverage of that medication.

Question 3:

Regarding Schedule II substances—specifically, the neurostimulants such as Adderall, Ritalin, Concerta, Vyvanse, etc.   Does the ability to have these scripts filled via home delivery vary by state?  And, is that determined by the state the consumer lives in or the location of the pharmacy?

We are not aware of any limitations by either state law or plan design to prohibit these medications to be filled by home delivery pharmacies.

Question 4:

Do you have data on how many stimulant prescriptions Express Scripts filled last year via home delivery?

I do not have this data available at this time.  However, our latest report showed that use of ADHD medications among Americans rose 35.5% from 2008 to 2012, increasing the number of privately insured individuals on these drug therapies to more than 4.8 million in 2012.

____________

 I welcome your experiences, good or bad, with home delivery of prescription stimulants for ADHD.  Your tips can help others!

Please note: I have no business relationship with  Express Scripts or any pharmacy—or any entity.  This information is strictly a reader service.
—Gina Pera

73 thoughts on “Home Delivery of Prescribed Stimulant Medications”

  1. I have been getting my Adderall prescription until September delivered through Alto Pharmacy but they like so many others have stopped delivery of it.

    I do not know any other delivery service in the Santa Ana area that can deliver and I am not very mobile.

    1. Hi Robert,

      By home-delivery pharmacy, I didn’t mean a Silicon Valley startup that has a spotty record and is more of a local drug store with delivery service. 🙂

      https://www.yelp.com/biz/alto-pharmacy-san-francisco

      I meant Express Scripts, PrimeMail, and whatever else exists.

      It might be that you’ll have an easier time with those big warehouse pharmacies than this local delivery outfit.

      But it might also be that the legal limit of Adderall’s raw material has been reached for the years already. Thanks to COVID pushing diagnoses.

      I checked the FDA drug shortages page. The only reference to mixed amphetamine salts (generic name for Adderall) was resolved in May.

      https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Amphetamine%20Aspartate;%20Amphetamine%20Sulfate;%20Dextroamphetamine%20Saccharate;%20Dextroamphetamine%20Sulfate%20Tablets&st=r

      good luck!
      Gina

  2. I just switched to home delivery in WA because my local pharmacy had 40 minute pick up lines plus a 10 minute time release safe for my meds. I could not transfer my RX but had no problems when my doctor sent in a new prescription. 90 day supply straight to my house and no signature required. I have to use the home delivery option covered by my health insurance which is AllianceRx Walgreens. I previously tried other home delivery options (Amazon) which would not ship Adderall so I think it’s important to start with your insurance company first. I also have to follow up virtually with my dr every three months for a new rx, but that’s manageable. Such a relief!

    1. Thanks for your comment, Molly.

      I’m glad it’s working out for you.

      I didn’t realize there are non-insurance pharmacy benefit delivery services.

      g

  3. Hi Gina, I have a cvs Caremark and do have option for home delivery in California. My question is after I setup for home delivery do I call them to ask for authorized generic Concerta only?

    1. Hi Ravi,

      Your prescriber needs to specify, on the prescription (paper or electronic): Patriot only

      To be sure, check with the pharmacy first — if they have it, and exactly how your prescriber needs to specify.

      I know….this is a lot of work. Beats the alternative, though, if the brand/authorized-generic works best for you.

      good luck!
      g

  4. Hi,

    I read your article and that sounds great, but my google searches keep coming up that ‘adderall cannot be shipped by mail.’ Can you provide a link to a pharmacy that will mail a script? I do not have insurance that covers my medication, but do have a prescription from a doctor. My doctor would write a 90 day supply without a problem.
    Thanks
    Thom

    1. Hi Thom,

      I can’t explain whatever you find in your Google searches. I imagine that information pertains to “online pharmacies” — that are not legitimate pharmacies.

      The home delivery pharmacies are part of healthcare insurance benefit, for prescription medication. So, if you don’t have insurance that covers your medication, that won’t be possible, unfortunately.

      Some local pharmacies are now able to offer 60 and 90-day supplies of stimulants. But I suspect that, too, is part of an insurance benefit.

      Check out this letter from the DEA. It explains COVID-related eased restrictions around Schedule II substances. Maybe take to your prescriber to see if it’s helpful to you.

      Depending on your browser settings, the PDF should download immediately.

      ·

    2. https://www.deadiversion.usdoj.gov/GDP/(DEA-DC-017)(DEA065)%20Early%20RX%20Refill%20-%20OMB%203-20-20%202200%20DAA%20approved.pdf
    3. Good luck!

      Gina

  5. I just tried to get a 90 day supply of vyvanse for the second time unsuccessfully. I was hopeful to avoid the pharmacy due to covid and I’m in a transitional period. My Doc gave me the green light and I had the prescription mailed to NJ via Express scripts. As soon as it was sent electronically the insurance company rejected it and only filled 30 capsules stating NJ does not allow for C-2 meds to be mailed in 90 day quantities with a max of 30. My insurance company keeps playing the blame game and giving me the run around saying at first yes of course we can do that for you Mr. New Customer only to be disappointed after I request them to execute on it. It seems like every time they have a new story and give me false hope . Do health insurance customer service reps lie to people a lot(Cigna and Xpress Scripts)? I had 3 customer service reps say before the doc sent it in that it would work. I gave them every piece of detail they needed to know before hand.

    FL and NY are also mail options for me. Again the customer service people are saying it can’t be done in NJ but can be done in FL and NY. However, the customer service rep told me it could be possible if the doctor mails a handwritten prescription only and cannot be done electronically(makes no sense and is more dangerous than a secured electronic transaction but okay!) they also stated the doc needs to fill out a “special form”.

    Does anyone know if it is possible to get script for 90 in those states? If not by mail then just 90 at a time?

    I’m tired of going to the pharmacy 12 times a year for 10 years dealing with unexpected delays cranky & paranoid pharmacist. My doctor is also in NY and I do-not want to lose him.

    What state are you in that allows for a 90 days mail ins of vyvanse/concerta?What insurance carrier do you have? Is your doc in a different state? Where is the actual statues/laws that I can read myself instead of someone being paid $10 an hour to tell me over the telephone. How are you doing this???? Can I fight Cigna/Xpress Scripts on this.

    1. Hi Paul,

      I understand your frustration. I can’t say if the representatives are lying. But it seems more likely that the rules are very unclear.

      Still, the rep who told you it could be possible if the doctor mails a handwritten prescription seems to be correct. (Electronic prescriptions are still not that common with Schedule II substances.)

      I found these guidelines, on page 32.

      https://www.njconsumeraffairs.gov/regulations/Chapter-45H-Controlled-Dangerous-Substances.pdf

      In particular:

      All prescriptions for controlled substances shall be dated as of, and signed on, the day when
      issued and shall bear the full name and address of the patient, the drug name, strength,
      dosage form, quantity prescribed, directions for use and the full name, address, proper
      academic degree or other definitive identification of the professional practice for which he or
      she is licensed, and registration number of the practitioner. All prescriptions for controlled
      substances, regardless of schedules, shall be presented to the pharmacist for filling within
      30 days after the date when issued, except as provided in (a)1 below. A practitioner may
      sign a prescription in the same manner as he or she would sign a check or legal document
      (for example, J.H. Smith or John H. Smith). Where an oral order is not permitted,
      prescriptions shall be written in ink or indelible pencil or typewriter or printed on a computer
      printer and shall be manually signed by the practitioner. A computer-generated prescription
      that is printed out or faxed by the practitioner must be manually signed. The prescription
      may be prepared by a secretary or agent of the practitioner for the signature of the
      practitioner, but the prescribing practitioner is responsible in case the prescription does not
      conform in all essential respects to the law or rules. A corresponding liability rests upon the
      pharmacist who fills a prescription not prepared in the form prescribed by this section.

      I hope this helps.
      g

    2. Gina,

      Thanks for that helpful information. It’s good to know that NJ does not offer more than 30 days regardless of if it is an electronic prescription or hand written. It’s ridiculous that ADD medication is a C-2 drug and drugs like Xanax and Ativan are C-4 makes zero sense.

      I hope this helps someone avoid the hassle in NJ. As far as FL and NY go do you have any information there? I want to be equipped with the knowledge I need before I make my Doc jump through more hoops to get me my medication in a 90 day quantity. The customer service people at Express Scripts/Cigna are unreliable. They still filled the NJ prescription (only 30 days) from an electronic prescription so it seems like they are not following the law either.

    3. Hi again, Paul,

      Again, as I said elsewhere, it might be that COVID-induced relaxation of certain policies can account for why you received the prescription.

      Sorry, I’m not a legal expert, either. 🙂 But you can do a Google search for those states.

      g

    4. Also, I found out recently from an ex- customer service rep at a large insurance company that it is common for many reps to overpromise because people can get very hostile/irate on the telephone when it comes to medication. The reps are afraid of backlash so they will say anything to make you happy and get you off the call (likely they will never speak to you again). Anyone reading this should be suspect of the rep and what they are telling you! They are not learned in the state laws and they are trying to read and interpret laws themselves which may be written in confusing language. Insurance companies/Express Scripts need to get better at training these people and should be interpreting the law for them succinctly. They expect a customer service rep with no legal training to interpret the exact text from statues correctly? That is ridiculous.

    5. Hi Paul,

      I understand your frustration.

      I would expect that reps cannot be legal experts, but they should be provided with clarity on what the company can/can’t deliver where.

      My frustration lies with states such as New Jersey. These punitive laws probably only give the appearance they are protecting citizens. Meanwhile, they create havoc for consumers, prescribers, and pharmacies.

      During COVID, some laws/statues changed regarding ADHD. To make treatment easier. Things are in flux.

      g

    6. I live in California and I have been on Vyvanse for years and I also get home delivery. I get a 90 day supply. I see my doctor every 60 days then he mails the fax or mail the scripts in. Then the pharmacy still have a month to get my medication to me. Like most insurance companies they make it harder and harder to get your medication. They make the doctor send them a form every 6 months stating why you need the medication. Even though you have been on it for over 10 years. And sometimes you will be waiting for your medication not knowing the letter has expired and they need a new one. And because of this they just sit on the scripts and wait tell you have nothing then you call and ask them then if you needed this why didn’t you reply to me or my doctor. And they play stupid. So my advice to anyone that are having any problems with getting your medication call the state pharmacy board and explain to them what is going on. Then tell them you want to file a complaint against that pharmacy that is holding your medication. Then you will see how fast they get off there ass to get you your medication. And if enough people file the pharmacy board will step in and fine them and look into a lot more of there complaint. Because they can end up taking there licenses. So please fight back. This is the only way to get the help

    7. Hi Helen,

      Great idea!

      I also live in California but none of the home-delivery pharmacies we’ve had over the years are based here.

      So, I don’t know how that works. Does the state pharmacy board have purview over an out-of-state pharmacy if it’s serving CA residents?

      t
      g

    8. Hi Paul,
      This is actually in response to your 5/1/21 comment re: Schedule 2 vs. Schedule 4 meds, but I didn’t see a REPLY link for that comment.

      Anyway, I totally agree with your frustration over ADHD meds being classified as a Controlled Substance, which wasn’t always the case. I saw an April 2022 ADDitude webinar with Dr. William Dodson on the problem of medication non-compliance, which was very helpful. (If you try to watch the replay, not sure this part is included, as it was during the Q&A at the end, which may not be included in the recording.) He
      agrees that the Sched. 2 designation is ridiculously unnecessary, and prevents some of those who already struggle with organization, planning, perseverance, etc. from being able to obtain the very meds that can help them with such issues (Catch-22, anyone?)

      Apparently, when stimulant meds first came out in 1958, they were Schedule 4. Dr. Dodson said that didn’t change until 1978, when the FDA over-reacted to the cocaine and meth crisis at that time, and decided to re-label the stimulants as Schedule 2 (Controlled Substance.)

      If they are so worried about people getting addicted or misusing these substances, I think a more appropriate solution is better / more careful diagnosis of ADHD, and therefore more accurate prescribing. Those who TRULY have ADHD, do NOT get high by taking the meds. That only happens to “neurotypicals” who already have enough natural dopamine and are the ones who are abusing the meds. Sure wish the FDA consulted experts like Dr. Dodson (and other ADHD specialists) who could explain this to them! Until then, we are unfortunately stuck with the current (mis)classification of these meds, and all the hassles that entails.

    9. Hi Ann,

      Thanks for your comment.

      Actually, this is a complex issue, with no easy statements in any direction. Anyone who claims it’s simple….is not being honest. Or responsible. [I don’t mean you. I mean the online sources that have led you to believe this.]

      I know it’s popular to say, “Only neurotypicals get high” from the stimulants. But that is simply not the case. Absolutely not the case.

      People who promote this idea typically have an agenda, and it usually involves a pharma who is paying them to dance to its tune.

      Absolutely, people with ADHD can get “high” from amphetamine stimulants. No question. Absolutely people with ADHD prescribed stimulants can abuse them. Same for people with bipolar disorders. Sure, “neurotypicals” (another term that’s thrown around online without accurate meaning) can abuse drugs, too. With most diseases of addiction, however, there is an underlying vulnerability.

      Shire denied the rampant Adderall abuse and addicrtion until it came time to introduced its new patented drug, Vyvanse, a “non-abuseable” amphetamine, it claimed. Yes, the delivery system can be said to minimize abuse. But where there’s a will there’s a way, and addicts have plenty of will, it seems. Even some people with ADHD use Vyvanse as a “performance” drug the way some people with ADHD do the same with Adderall.

      But if Adderall wasn’t a problem, why the big splash on “non-abuseable”?

      There will always be “drug seekers”, especially with amphetamines. This is human nature. It’s humans who are stimulation-seekers, not just people with ADHD (another marketing line).

      But even people prescribed amphetamine stimulants often experience highly problematic results. It’s rarely acknowledged, but it’s true.

      Most prescribers believe the one-pharma’s-PR that “amphetamines are best for adults with ADHD” — despite there being only twisted, contorted data to support that.

      The result is that many people with ADHD who would benefit from long-term treatment get burned out and exhausted from the way they are prescribed amphetamines.

      Not everything is as it seems on commercial ADHD-themed sites.

      I’m glad you found my blog.

      Best
      Gina

    10. Hi Gina,
      I’m trying to reply to your Aug. 10 response to me, but the only REPLY link I could find was under Paul’s 4/29/21 comment. Maybe someday I’ll figure out how this works!
      Thanks for your response to my not totally accurate comment.

      Admittedly, I have limited knowledge of ADHD’ers using prescribed stimulant meds to get high. All the ones I know (granted, a relatively small pool of people, including my son) take their legally prescribed meds seeking only the “calming of the mind” that they desperately need in order to function. (Doesn’t mean they don’t ALSO like to get high at times, but generally use marijuana for that. )

      I noticed you only mentioned the amphetamine class of ADHD meds in terms of abuse, which brings up a question I’ve had for awhile. Is methylphenidate (in general) considered “less abusable” than amphetamines? Obviously, most types of generic or brand Ritalin tablets could be crushed up and snorted. But is there something specifically in the different chemical compositions of AMP vs. MPH that makes the former easier or more likely to be abused?

      You also mentioned the myth that the Amphetamine class is better/more effective for adults than is Methylphenidate. I recently experienced this inaccurate belief from a top ADHD expert in the country (won’t mention name, but he’s an MD based in Maryland and affiliated with Johns Hopkins School of Medicine, who’s written numerous articles and given many interviews over the years.)

      We specifically sought him out for his expertise, and paid the exorbitant Evaluation Fee out of pocket (son unfortunately has Kaiser insurance) only for him to prescribe Adderall, when my son had previously done very well on Methylphenidate for many years. (had been off all meds for a couple years, with predictably disastrous results in all domains of his life.)

      Anyway, this Dr. was rather dismissive when I asked “Why re-invent the wheel, when we know Concerta works well for him?” Not to mention the fact, that I’ve read your MADDERALL posts, and so was actually rather fearful of my son trying that class of meds. Long story short, we wasted 4 months on the Adderall, seeing little to no improvement in core ADHD symptoms, but a noticeable increase in anger and aggression, before the Dr. FINALLY switched him back to Concerta.

      Thanks so much for your hard work Gina, and for sharing your wisdom with us. I have found your writings to be much more accurate and helpful than the advice from most of the many doctors we have worked with over the years. SO grateful for you!
      – Ann W.

    11. Hi Ann W,

      I’m sorry it’s not more obvious, the reply thing here. Out of my control!

      I’m going to answer your question first. Yes, the amphetamine class is the “stronger” class of stimulant. That’s because it has extra mechanisms of action. Methylphenidate is simpler. Some people need the “extra” but for others extra is too extra! 🙂

      The basic rule of thumb is: If the dose of MPH is too high, expect a “zombie” effect. If the dose of AMP is too high, expect anger/irritability.

      Clearly, that MD was mistaken. He did not have a leg to stand on. Arrogance and over-confidence should not always win the day. Not with MEDICINE and a child’s FUTURE.

      My perspective is: It’s sometimes best to avoid the “names”. Instead, self-educate (including with my first book, with the best explanation of how medication trials should go…anywhere) and self-advocate. Find a compassionate prescriber willing to work with you.

      Especially because you knew Concerta worked well for him, you could have bypassed this misery and gone to a prescriber in your plan. (Though not, admittedly, with Kaiser….it’s a problem everywhere….though sometimes if you can identify the rare staff physician knowledgeable in ADHD).

      Adderall definitely is abused, and nitwit prescribers who literally do “pass it out like candy” — absolutely mindless to the potential consequences — are why we continually have blockbacks against the very diagnosis. I warned about this 20 years ago, and i really hate to see I’ve been right.

      I don’t recommend viewing Netflix’s “Take Your Pills” but you might be interested in reading my review of it:

      https://adhdrollercoaster.org/adhd-news-and-research/take-your-pills-pseudo-documentary-dont-take-the-bait/

      take care, Ann W.! good luck to your son!
      g

  6. It’s April and I’m still getting Christmas cards that were mailed in December, but trust the post office to deliver the drugs that make me able to live my life? There’s no way in heck I’m going to do that. Even if they managed to deliver it, then the porch pirate get a hold of it and now I’m left hanging for 90 days without my prescription because I can’t get anymore. Oh, you want me to wait around for the delivery, why get the drugs at all if I’m not going to be able to work? What a load of malarky this entire post is.

    1. Sorry you feel that way, Jay.

      Many people get home delivery with no problem.

      I’ve always found excellent service through the USPS, even during COVID.

      The post includes several caveats.

      Maybe it’s not for you but it’s not malarkey.

      g

  7. First off, going to Europe is NOT the answer. The doctor will tell you to your face that you are, and I am quoting here, “just another over medicated American”. I have been without my ADHD medication for 3 years (the length of time I have been working in Europe, incidentally) because I have been unable to get a prescription from any doctor in the 5 countries where I have tried to get one. This is despite being able to show years of medical records and prescriptions for both Ritalin, Ritalin XR, and Vyvanse.

    Now that I am back in the land of good, if expensive, medical care, I am looking to restart my medication. With all of the COVID insanity, I was hoping to find a telemedicine doctor who would be willing to write it. I can still have empty pill bottles to prove that I have been on Vyvanse.

    1. Dear Lisa,

      Thank you for echoing my perspective: It’s NOT better anywhere. It’s worse!

      Europe is fantastic compared to Asian countries such as Japan and China. Russia? Out of the question.

      The single-payer systems are the worst. Wait several years in the UK just for an evaluation. Then, if you’re very lucky, get your choice of extremely limited stimulant choices or, more likely, an antidepressant (NOT an ADHD treatment). In Australia, the NHS routinely provides Dex — and that’s it. Canada is a bit better but only because they have a strong professional community who lobbies the government. (Several ADHD pioneers were Canadians.) But there, too, access to professionals is extremely spotty.

      France’s NHS is recognized as one of the best systems. But oh boy….not the place to have ADHD. Unless you want to have a slew of anxiety and antidepressant medications thrown at you — or be psychoanalyzed. Germany is also a recognized best system. The problem there, however, is that the public is so little educated about (or accepting of) ADHD.

      It’s so painful receiving e-mails from folks in these countries.

      And then to hear Americans who’ve been brainwashed by a demagogue who knows nothing about healthcare policy….ready to ditch our entire system…

      No system is perfect. All healthcare systems have their plusses and minuses. But using ADHD as the litmus test for scientific rigor and access to care, I’ll take ours ANY DAY over any other. There is more of an onus on the consumer to identify competence (and avoid the incompetents) but at least it is there and decisions are not made by government beancounters.

      I wish you luck in re-starting your Rx. I know of no telemedicine docs who can prescribe out of state, though, so you might want to look in-state. Or not rely entirely on tele-medicine.

      g

    2. Richard Tilghman Wendel

      Virtual doctors are not permitted to write Rx’s for Schedule II drugs, which include Vyvanse.

    3. There are membership options available. I use an outfit called PeakMed and though based in CO does support tele-appointments. For this I pay a little over $79 there about a week or week and a half out for initial appointments. I hope this helps.

Leave a Comment

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Stay in Touch!
Ride the ADHD Roller Coaster
Without Getting Whiplash!
Receive Gina Pera's award-winning blog posts and news of webinars and workshops.
P.S. Your time and privacy—Respected.
No e-mail bombardment—Promised.
No Thanks!
close-link