Home Delivery of Prescribed Stimulant Medications

home delivery schedule II stimulantsHome delivery of stimulant medications?  That’s legal?  Yes, it is, in most of 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.

[advertising; not endorsement] [advertising; not endorsement]

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



FDA approves Vyvanse generics

Vyvanse Generics On the Way

  As the U.S. patent for Vyvanse expired August 2023, the FDA cleared 14  manufacturers to produce Vyvanse generics.  It might take several months for a significant number of consumers to access these Vyvanse generics.

Read More »

93 thoughts on “Home Delivery of Prescribed Stimulant Medications”

  1. Getting stimulants by mail is often even worse than locally. Many states have regulations limiting the ability to get more than 30 days’ worth. Because schedule ii drugs are not allowed to have refills, a new prescription is required for each month. Most mail order pharmacies take a few days to process a new prescription, but can’t start early enough to be able to fill and have it arrive before you run out of your medication. Worse yet, you can’t have mor than one active prescroption, even if you haven’t filled it yet, so if where it was submitted is out of stock and can’t tell you when or can’t get it, you have to work with your provider to send a new script elsewhere. The only way to prevent that is to talk to the pharmacy directly, in advance to ask about what they have in stock. Some pharmacies won’t do that, generally not buy policy but folks not wanting to bother. When you throw in the shortage of these medications, it’s all way worse.

    1. Hi Nah,

      Thanks for your comment.

      let’s see, though….. given my many years experience and hearing stories from 100s of others…..

      — I know of only one state that limits home-delivery stimulants to 30 or even 0 (New Jersey, last I checked).

      — A new prescription every 90 days is far easier than a new one every 30 days.

      — Ask the soonest that you can send in the prescription, to ensure a continuous supply. I’ve done it for 15 years, and have had no problem.

      — I’ve never heard of the home-delivery being out of stock, requiring the prescription to go elsewhere. It might happen, but it is by far the rarity, compared with storefront pharmacies. There it is almost a ubiquitous problem.

      — People who have been using home-delivery pharmacies have had much better luck coping with the shortages.


  2. I am also new to the site, and I thank you so much for directing me to this article in response to my first post.

    I’ve already verified that this is available through my insurance, and have begun working on implementing it. This may or may not be able to resolve the current issue of shortages, but it is absolutely the method I will use going forward regardless.

    1. HI Mary,

      You’re most welcome!

      I don’t like steering business away from local stores contributing taxes to localities. But it can be such a nightmare chasing down stimulant prescriptions.
      good luck!

  3. This is a really informative article. I guess the only question I couldn’t confirm was regarding when one should request a new Rx for the 90 days. It took over a week for my Rx to be delivered, so should I request a new script from a doctor a week prior? Or when should one do that to avoid gaps?

    1. Great question, Vince.

      This really depends on a few factors….mail transit time and the pharmacy policy.

      Here’s what I would do: Call the pharmacy and ask EXACTLY when is the SOONEST your prescriber can write/send the next script.

      Typically, it’s about 1 week before. I don’t like to cut it close. So I ask for the earliest possible date.

      If the delivery is late, you should be able to ask for an interim quantity to be filled locally.

      I hope this helps.

  4. CVS Caremark Mail-order filled my Amphetamine Salt Immediate Release 90-day supply but informed me the Extended Release medication was unavailable. I’m currently on hold to determine if it is just this particular strength and/or whether Vyvanse is available but I’m about to give up. (This is a Kentucky bound RX fwiw.)

  5. Jason Marshall

    Just finished a chat with Express Scripts asking what I needed to start home delivery for my generic Adderall. The agent totally ignored my question and instead gave a canned response that started “I understand your inquiry about your recent order (I haven’t made an order yet, ever with them.). Because manufacturer hasn’t provided us with availability dates we are unable to update you with an estimated delivery date.”, when I pointed out that wasn’t what I asked and have never made an order she said ‘It is covered for home delivery by your plan, but we are not mailing orders for that medication at this time.’

    So I think you might want to update the article to reflect that Express Scripts is no longer doing home delivery for these medications, after confirming with a rep if you have a contact still.

    I horrified the pharmacist yesterday after she told me they didn’t have any in stock and I asked if they still carried smoking cessation gum, they did. Its not a replacement or even a solution, but nicotine does help a little. BronkAid and Ephedra(the plant, to make tea) are also other OTC stimulant’s that have been helping.

    1. Hi Jason,

      This post is about home-delivery prescriptions. It’s an “evergreen” topic.

      What’s happening right now with Adderall is new, current and, one hopes, limited. It might also be that your pharmacy benefit isn’t working for you now but it is for others.

      In other words, just because Express Scripts isn’t filling your Adderall prescription, that doesn’t mean that it’s not fulling other prescriptions for stimulants.

      That’s one thing most folks don’t understand. They assume that’s what’s happening for them is happening for everyone with the same pharmacy fulfillment or even insurance company. But these things can vary, according to where you live, the terms of your policy, etc..

      Moreover, have you tried to get any other Schedule II medication? A stimulant? There are tons of choices beyond Adderall. Have you checked the pharmacy formulary? I would certainly consider those before possibly developing a nicotine addition, etc..

      good luck,

  6. Kevin williams

    My doctor gives my pharmacy 3 months at a time. The pharmacy has been out of Adderall for 2 months now. I have had to call 40+ pharmacies to get my script for the last 2 months. This month even calling 40+ pharmacies didn’t help. I have been out of meds for 2 weeks. I have been on Adderall for 25 years. And ritalin for 20 years before that. I can’t spend 10+ hours on the phone every month trying to locate my meds. I have bcbs. What can I do ?

    1. Hi Kevin,

      In this post, I touch upon why the widespread shortage of stimulants.


      You ask what you can do?

      I wrote this post where you’re commenting, on Home Delivery, to save readers the hassle of calling around local pharmacies month to month. If you have this type of 90-day home delivery, I encourage you to investigate if it would work for you.

      Meanwhile, maybe ask your prescriber to cancel one of those Adderall scripts and consider a trial of Mydayis. Like Adderall, it is mixed-amphetamine salts, but in an extended-release formulation.

      good luck,

  7. BlueCross Anthem supports Express Scripts, but my Concerta ER27mg will not be covered if I go that route.
    On the other hand, if going locally, I’m recently unable to get the full quantity – for example, today they only have 10 on-hand and can only dispense this, then I have to make a new appointment with my psychiatrist to get another RX issued for the remaining 20 – then on the day it is due, I have to call Costco Pharmacy, see if they have any on hand (usually not) and keep calling every day.

    It’s such a hassle, and extremely time consuming… at this point it makes more sense to just pay for it out of pocket and have the 90-count delivered by ExpressScripts (California)

    1. I keep trying to use ExpressScripts but it won’t let me register because I don’t have tri-care. Has anyone else experienced this?

    2. I’m in the EXACT same boat Kevin. I am looking into this mail to home as we speak. THIS IS UNFAIR. What did you end up doing?

  8. 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. 🙂


      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.


      good luck!

  9. 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.


    2. I’m so confused. Why did the author respond to you saying that she wasn’t aware of non-insurance pharmacy delivery benefits? That’s exactly what I’m looking for, cannot find, and don’t see where you mentioned this in your post. You specifically said that you use AllianceRx through your health insurance. What am I missing?? I need a delivery option that I can pay for out of pocket. I don’t understand why this is so difficult. I want to pay!

    3. Hi Sarah,

      Do you mean me as the “author”? You ask why I responded to another question saying I wasn’t aware of non-insurance pharmacy delivery benefits.

      I responded that way because I don’t know of any. 🙂

      I did attempt to find one but nothing came up. The website for ExpressScripts says it will offer its services to those without insurance in the future but…not yet.

      These huge warehouses and systems are set up to work with insurance. They are part of integrated systems.

      I did find this, for low-income patients without insurance. But perhaps you don’t qualify as low-income/

      I encourage you to search online, though….maybe you’ll find one.

      good luck!


  10. 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!

  11. Thom Maslowski


    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.

    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!


  12. 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.


      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.

    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.


    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.


    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?


    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.


    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:


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

  13. 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.


  14. 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.


    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.

  15. I enjoyed this post, thank you.

    A few notes.

    First, the federal laws and regulations are implemented by the states, each of them potentially differently.

    Second, doctors and pharmacies feel free to misrepresent the laws and regulations to you either because they dont know, or because they changed, or because they dont want to be bothered so they say it is the law to get you to go away.

    Third, so far as I can tell, they do not have a reliable way to diagnose ADHD nor a way to set the proper dosage of medications other than the touchy-feely, let’s try this, let’s try that.

    Fourth, even if you find a treatment that works for you and lets you live your life, you have no rights to get this medication, no one is required to help you, and they wont if its not convenient for them.

    Fifth, the system is fragile and breaks regularly and when it does you are expected to do without the medication even if it damages or destroys your career and your life.

    Sixth, if you ever in any way protest this state of affairs, they will just get rid of you, they don’t want to be bothered.

    Seventh, whenever you find a system that works, it is my experience that you should expect that at any time the system that was reliable may fail. A doctor retires, a pharmacist changes. Too bad.

    Eighth, the anxiety and disruption this causes you and the trauma that you may experience (and I have experienced a lot) is way beyond their capability to fix. They don’t care, it’s not their problem.

    Ninth, in general, if you have this disease and you find this treatment useful, as I have, then you should expect to be dealing with this is a disruptive and time consuming manner for the rest of your life or until you find another country that handles it better. I am working on that.

    I realize that many of these comments are off topic to the specific mail order stimulant question but I hope they may be helpful.


    1. Dear Michael,

      Thank you for delineating all the de-stabilizing mess. It’s just unconscionable. But, as you say, it’s the reality. Best be prepared for it.

      I will add, I think some of the professionals in question care, but they maybe aren’t clever or confident enough to navigate workarounds, make that extra push, etc..

      thanks for your comment,

  16. I’m new to the site and it’s been very helpful. Thank you for that. I have looked into quite a few home delivery pharmacies and every one of them says they can not or don’t fill schedule II prescriptions. My doctor is more than willing to write me a 90 day script so I can have the convenience of mail order but without a pharmacy willing and able to send me my ADD medication, I’m stuck with having to go through the tiresome act of getting my prescription filled once a month. My insurance company’s mail order pharmacy doesn’t carry any controlled substances so I’m out of luck there too. I’m wondering if the laws for mail order for schedule II changed since you wrote this article, is that possible? Thanks so much for your input.

    1. Hi John,

      I’m sorry that you’re having trouble.

      It’s almost impossible to get definitive answers on anything related to health insurance coverage. Plans are so variable, even within the same company. High-deductible. Low-deductible. High co-pay. Low co-pay.

      I did my best to see what type of laws might apply. The best I could get was from the ExpressScripts spokesperson, who said this (as quoted in the post):

      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.

      It might be that your plan has lesser-than-average benefits.

      That seems bizarre to me. It’s not an illegal substance. Stimulants are the first-line medication for ADHD — taken by millions of Americans.

      Good luck!

    2. Nancy E Lustgarten

      Hi John, stuck in New York state and now having to renew my son’s ConcertaER prescription monthly. To add insult to injury my insurance deductible is higher than the cost of the medications for a year (just), and they don’t cover methylphenidate ER anymore (which used to be our cheaper way of getting the prescriptions). I called my NY State Legislature’s office to find out if they could reverse the new law limiting three month prescriptions of Concerta ER / and similar generics but of course this comes with the perception of being soft on drug abuse so I can’t imagine the law ever getting repealed. Sorry to go on and on…I’m just so damned tired of drug companies, insurance companies, elected officials making my life harder and harder. Best to you!

      Nancy Lustgarten

    3. Hi Nancy,

      I appreciate your frustration.

      If it is any consolation, the situation is MUCH worse for many people with ADHD in single-payer NHS countries. I hear the stories every day. Extremely limited medication choices — and often the most problematic ones (e.g. Dexedrine). Waiting two years to even get an evaluation>

      In fact, we are very lucky here in the U.S. to have a range of choices and various discount programs (in the case of newer medications).

      The important thing is to be focused on the relevant facts and be precise with terms. For example:

      When you say “they don’t cover methylphenidate ER anymore (which used to be our cheaper way of getting the prescriptions)”, do you mean the authorized generic for Concerta?

      Because there are many new (inferior) generics for Concerta and they are also called methylphenidate ER.

      I wrote this post to help people gain access to the authorized-generic (which is the brand sold as a generic). So, you might want to try the tips I write.

      I’m not sure what your being in NY state has to do with it. You mean you cannot get 90-day prescriptions at your local drugstore or via any home-delivery pharmacy benefit you might have?

      From what I can read, you can get a 90-day prescription, but the diagnosis code must be written on the prescription: https://www.health.ny.gov/professionals/narcotic/newsletters/2006-12.htm

      I hope this helps.


  17. The last set of comments really hit home for me.

    You’re obviously much more educated in this subject than I, but could Laura be suffering from ADD rather than ADHD?

    I had never heard of ADD until I spoke to my oldest son’s high-school guidance counselor about 10 years ago. Symptoms were similar to those Laura described, i.e., difficulty concentrating, low motivation (discouraged), procrastination, feeling overwhelmed, etc…

    I took him in to his pediatrician for testing and sure enough, he diagnosed ADD. I truly believe ADD is under-diagnosed due to lack of hyperactivity symptom. Once my oldest son was diagnosed, we quickly recognized it in my younger son (even more severe) and in myself! I was told by the doctor it tends to run in families. In any event, we’re all on medication now – sons take Concerta and I take Adderall. What an improvement!

    1. Hi Jan,

      I congratulate you on following that clue — and helping your children and yourself. Kudos!

      Many people are confused about the terminology. They assume (or have been told) that ADD is ADHD without the hyperactive component.

      Trouble is, that is not true.

      There is no condition called ADD.

      The official term for ADHD is ADHD, but there are three “presentations”:

      1. Primarily hyperactive
      2. Primarily inattentive
      3. Combined

      Most adults with ADHD are not physically hyperactive; they have the combined presentation. A minority have the inattentive sub-type.

      Many people assumed that if a person with ADHD is not physically hyperactive, that person has the inattentive presentation. Also: not true.

      Years ago, as you point out, it was thought that ADHD was only physical hyperactivity. That’s because that behavior was the most obvious.

      Now we know more about the complexity that is ADHD neurobiology — and no longer base it on how someone “looks” (that is, hyperactive).

      Our challenge now is educating the public, teachers, mental-health professionals, etc. 🙂

      thanks for your comment.

    2. You are just a creative. And because that is not valued in our ultra capitalistic and type-a society and school system, you get put on narcotics. Yes, they are narcotics. Look up the definition. It will alter your brain chemistry forever. It has been proven. The reason why adderall is not made anywhere outside the USA is because of how insane it is and every other country has made it illegal. It destroyed my childhood and my understanding of who I was and took away my creative potential and also caused massive anxiety, sucked my thumb too much and altered my face permanently because of that … the list goes on. It is a societal ill that we have here in the USA. We want everyone to fall in line and if not, there is a pill for that.

      It should not be mandatory that children attend school until 16. I assure you if they had these drugs and they were popular in the 70s and early 80s, we would not have many of our famous actors that we do today.

      Having said all of that, when you are put on it even for one day, you usually rely on it for life. So I still take it and I get 3 months supply at at time. I have my psychiatrist send it to my parents home in the USA and then my Mom sends it to me as I am an expat. It is crazy to think that when you get put on these meds and then you rely on them that you pretty much confined to life in the USA, and if you want to live outside of the USA as an expat or join any government agency, you are going to jump thru A LOT of hurdles. None of it is consistent, lol. SMH

    3. Hi Philip,

      Thanks for your comment.

      It seems that you, like so many, were treated poorly in childhood. I wish I could say that the situation is vastly improved, including for adults. Yet, every day, I hear “bad prescribing” stories.”

      That doesn’t mean, though, that ADHD treatment does not help millions of people to live their best lives.

      The reason people with ADHD can get amphetamine-class stimulants in the U.S. is because the U.S. is the most advanced country when it comes to ADHD treatment. The others still labor under superstitions and fear-mongering (and single-payer bean-counters, it must be said).

      Except for Australia. You can get Dexedrine there. In fact, that seems to be the first-line medication. Trouble is, it’s really not a great choice for many people with ADHD, especially the immediate-release version.

      It’s funny….you start off castigating the U.S. for making amphetamine prescriptions available and glorifying all other countries for not having it available. But you, living in a foreign country, are able to get your medication only because your parents get it for you and ship it from the U.S.. (Pretty sure that’s illegal, so an abundance of caution is advised.)

      If you are “relying on it for life,” perhaps that’s because it gives you benefit. It helps you to focus, to self-regulate.

      I hope you continue to learn more about ADHD and feel less compelled to add more unnecessary stigma to an already poorly misunderstood condition.

      “You are just a creative.” Yes, that’s an old saw. But there is no evidence for it and much against it.

      e.g. This post from “a creative” with late-diagnosis ADHD whose husband also has late-diagnosis ADHD



      In my senior Business of Art course, our professor gave the women in the room some frank advice: keep your name when you get married. Artists are difficult to live with, he said. If we built an art career — very much about name recognition — only to have our marriages fail, we didn’t want to sabotage that career by reverting to a previous and unfamiliar name. We didn’t want to start from zero with networking and with search engine optimization because our names were our business.

      And having a marriage fall apart was, he warned, going to be more likely for us than for regular folk.

      Why? That singular dedication and drive, that chaos, that unwillingness or even inability to prioritize our spouses and our practical responsibilities over our work, which we might get wrapped up in for days or weeks. We may not come to bed until 3:00 a.m. We may not pay the bills on time or remember to pick up the dry cleaning before a formal gala. We may appear not to care about anything or anyone when we are working.

      Having a marriage fall apart was, our professor warned, going to be more likely for us artists than for regular folk.

      That sounds an awful lot like ADHD, which affects a great deal of intense creative thinkers. In fact, my husband — a computer programmer, which is a cousin to artist — fits this description exactly.

      When I read this book, I gave it to him immediately, saying, “this is a book about us.” He now credits Stopping the Roller Coaster with changing his entire perspective on life.


  18. Thank you. I have a scheduled consultation with the Kaiser folks to be screened after talking with one of their triage psychologists -it’s free, so I figured why not. If that fails, I’ll try and find an outside provider and go out of pocket.

    Do you have any advice about talking to psychiatrists about this – Bay area ones in particular? Kaiser’s maybe not the best litmus test, but no amount of prescription history or medical records from my psychiatrist seemed to matter to them. It also seems like there are more doctors devoted to treating addiction and stimulant abuse as well as marketing suspicious looking “holistic methods” than where I’m originally from. I don’t want to appear drug seeking or doctor shop – but on paper, I’m part of legions of educated sci-tech workers moving to the area “looking to get ahead”. Doctors are understandably spooked about prescribing stimulants, but I could be taking one pill of Adderall versus five pills of antidepressants/related meds.

    Thanks again.

    1. Hi Laura,

      Logic and science have nothing to do with it. And it’s hardly “holistic,” because that means taking care of the whole person — including sometimes medication, diet, physical health, etc.

      The word that fits better is “alternative.” And too often, that means….cannabis.

      In fact, I sometimes call the entire “left coast” the Third World of ADHD Treatment.

      Few believe me until they come up against it.

      My best advice is to learn all you can before you select a professional; that way you’ll be able to evaluate the professional. 🙂

      My book authoritatively covers how the evaluation should go, how medication should be selected and monitored, etc. https://amzn.to/2ZRGcpL

      I seem to recall some of my local group attendees referring to Evelyn Miccio, PsD, at KP in SF.

      You might want to join us next month. https://groups.yahoo.com/neo/groups/SiliconValleyCHADD/info

      My best advice is to learn all you can before you select a professional; that way you’ll be able to evaluate the professional. 🙂

      I have another idea but I will e-mail it to you.


  19. Hi Gina,

    Thank you for your reply. As to your questions – am I sure that I don’t have ADHD/ADD? No, but my symptoms are in that uncomfortable middle ground which skews either way depending on how you read it. I struggle with ability to concentrate or adhere to deadlines, and do things last minute frequently despite my best efforts. This turns into/is combined with motivational issues and anxiety, which is where the depression diagnosis came in. It’s kind of a chicken-or-egg issue.

    However, this didn’t cause problems in my childhood (a big benchmark for ADHD diagnosis), not because I didn’t procrastinate or have concentration issues, but that I could get away with it since the curriculum wasn’t challenging. On top of that, I didn’t have the behavioral issues (hyperactivity, acting out, sexual stuff sometimes attributed to girls, etc). Since my grades were great and I didn’t act out, I never interacted with mental health providers until my late twenties when stuff really started to hit the fan. This is in contrast to my partner, who’s been on some ADHD treatment since he was 10.

    I’m going to try and jump through Kaiser’s testing hoops but have a feeling I’m too high functioning. I’ll likely change to the more expensive Blue Cross/Shield insurance when I get a chance, so at least I can try to find a sympathetic psych.

    1. Hi Laura,

      I know this topic very well. In fact, I am considered an expert. 🙂

      From what you write here, I see many vigorously waving red flags for ADHD.

      Perhaps your past mental-healthcare providers, ill-versed in ADHD, have convinced you that what you are dealing with depression. Or perhaps you are getting information from websites that claim ADHD expertise but have it maybe half-right.

      In other words, there is a very good chance that, while you might also have neurogenetic depression, you have ADHD.

      Living with ADHD can be “depressing.” Once a person with undiagnosed ADHD gets diagnosed and starts medication treatment, the “depression” often lifts. But, again, there is a chance that brain-based depression co-exists with ADHD.

      Many of your assumptions for ruling out ADHD merit revisiting. For example, while childhood symptoms are helpful in determining the diagnosis, they must also be viewed with an astute and contextual eye. As you say yourself, you remember procrastinating and concentrating being challenges in childhood. Your “getting away with it” perhaps simply means you were smart and didn’t have to put in the effort that other kids did.

      Many people with ADHD do well in school, with the full ADHD fallout happening only later in life, when their capacity to manage multiple “adult domains of life” is stretched.

      What I typically recommend when encountering the KP roadblock is paying a prescriber outside the system for an evaluation, get titrated on a medication, and then bring that into KP.

      Good luck!

    2. Nancy E Lustgarten

      One cheaper way to go might be to try to find a gp who also specializes in ADHD. We just found out by coincidence that my son’s doctor in NY has that speciality… I don’t know if you can skip the expensive testing money pit (a short test and long conversation will typically uncover the same thing to a truly discerning eye), but it might be worth some investigating. Good luck to you. I absolutely sympathize with what you’re going through. a quick google search for AdHD testing led me to this site in California.
      Looks promising but I’m sure they too want to make money.

  20. Your previous reply about Bay Area residents having to fight for prescriptions hits home for me. I have a related question, but slightly different than others: I recently moved to the Bay area, and have a prescription for Adderall (or equivalent generic.) Problem is, it’s not for ADHD – it’s for treatment resistant depression. I’ve been on the merry-go-round of trying antidepressants and my psychiatrist in my home state prescribed it to me with no issue. I’ve been on it for a couple years with no problems, and it helps a ton. However, I have Kaiser insurance now and their internal policy is not to ever prescribe unless the patient is ADHD. Even then, my ADHD partner was treated like a drug addict when he had to jump through their hoops to be re-prescribed with a new doctor. I straight up got sneered at when I asked about my case and was told to start taking SSRIs again.

    Is there any way that my previous physician could write a prescription to a mail order pharmacy and I have it mailed to me? California law is worded in such a way that everywhere I’ve looked the answer is no, at least at a physical pharmacy. I’m more than willing to pay out of pocket at this point, but not to the point of asking family to pick it up and mail it to me (which may or may not be illegal). I also can’t really afford to go around to other out of network psychiatrists asking for a prescription and likely being told no.

    1. Hi Laura,

      I appreciate your predicament, especially with Kaiser. It has a bad reputation vis a vis ADHD in specific but mental healthcare in general—and have been fined many millions of dollars for the latter.

      There are pockets of helpfulness but they are hard to find.

      First, though, I hate to ask but are you SURE you don’t have ADHD?

      Many times, “treatment-resistant” depression IS ADHD. Mis-diagnosed ADHD.

      In fact, a famous study years ago examined a group of about 90 subjects with “treatment-resistant depression.” They screened for ADHD and ended up treating something like half that number with a stimulant, to which they DID respond.

      If you actually do have ADHD, it will be a lot easier if you are evaluated with and treated for that.

      Otherwise, I would ask your previous physician about prescribing across state lines. My hunch is that, since it’s a Schedule II substance, that won’t happen. But that’s just a hunch. I am not qualified to provide a definitive answer.

      This seems like a legitimate online pharmacy but I cannot attest to it. You might want to call and ask: https://www.healthwarehouse.com/catalog/pharmacy/new/

      Best of luck,

      This article on telepsychiatry touches upon the evolving laws: https://www.techhealthperspectives.com/2018/01/22/new-state-laws-allow-telehealth-prescriptions-for-controlled-substances-yet-regulatory-obstacles-still-remain/

  21. Gina,
    I have been through the entire routine of educating pharmacists and doctors about the authorized generic for Concerta for five years now. After five years and twelve different pharmacies, we are now out of options.

    Walgreens, our previous pharmacy, flat-out told us that the pharmacy benefits manager had taken the authorized generic off of their list and they were now substituting Amneal.

    Before that was CVS, Rite-Aid, Costco, Target, Ralph’s, several independent pharmacies, etc. I just got off of a long phone call with our current pharmacist at Walmart, and she does not have any answers for us.

    She has been ordering the authorized generic for us (using the NDC code that I gave her six months ago); and although we’ve been left in the lurch several times (three weeks back-ordered, two weeks back-ordered, short ten pills on one order, etc., we have ultimately been able to get the medication until now.

    Now, (according to my pharmacist) McKesson keeps telling Walmart that they do not have it in stock and they keep substituting the junk generic from Lannett. the pharmacist assures me that she is ordering it with the NDC number, as always, but does not receive the medication. This has been going on for two months.

    Independent pharmacies can get it, but won’t take our insurance; and we can’t afford $500.00 a month. I have a call in to our insurance to see if they offer mail delivery–perhaps a bigger supply that way?

    My son is supposed to start college next week and he has been out of medication for three weeks. Any suggestions? Los Angeles is a big place, but I have literally tried at least forty pharmacies by phone (and yes, many act like I’m a drug addict and many won’t talk at all on the phone); and fifteen in person; to no avail.

    It’s easy to tell me not to panic, but I have tried everything I can think of, I have a very ill husband, and am in dire financial straits, so this is the last thing we need right now. Please let me know if you have any other helpful ideas that I haven’t tried. Btw, I also have to drive (45 minutes) to pick up the paper scrip each month and then drive an hour to fill it; and then usually another trip to pick up the order. I am at my wit’s end and my son will likely have to delay college and work this semester so that he can make enough money to pay for his medication.
    Thank you,

    1. Hi Veronica,

      You didn’t mention any of that in your previous message—at least regarding during the transition from Teva to Patrio as the distributor—so you can understand why I suggested to keep looking after seemingly trying one store.

      If I assumed these things were “easy,” I would not spend days researching information to share freely on my blog in order to help.

      Obviously, I sympathize and have done my best here.

      It might be that your insurance is not the best.

      But it might also be that you were looking for the authorized-generic during the transition time—before Patriot got its act together (if it does at this point) and made its presence known.

      I had to dig for the information then. Nobody seemed to know anything, including Patriot when I contacted the company.

      It might be that the supply lines are settling into place now, as evidenced by other readers having success.

      So, you might want to re-try the Walgreen’s you used before, where you have a history.

      If you can’t get it, by all means, try another methylphenidate formulation. There are plenty of them, and some trying to gain market share offer discount cards.

      If you know that Wal-Mart uses McKesson, then you might not want to waste time on Wal-Mart.

      Yes, as I mentioned in the post — and in every post on this topic for about 5 years — it might be easier to get through the home-delivery benefit if you have it. It also involves jumping through some hoops — checking first if they can get it, asking for specifics as to how the prescription should be written, etc. But it can reduce hassles and cost.

      Good luck,

  22. I am fed up with my mail carriers. I have reported one a couple of years ago to the Post Master and after a few days of having a temporary carrier, he was back and he would actually knock to get the required signatures. But now, I have a new carrier. I know when I am expecting my Adderal delivery and I work from home. The front porch and mailbox are right below my window at my desk and I can hear the mail carrier and their scanner every day. I heard the carrier so I get up and go to the front door and open the door as he is putting the package on my mailbox, I believe I surprised him. He never knocked. He hands me the package and I say I need to sign and point to the label. He mumbles something which sounded like “I did” and then says ‘It won’t upload” and rushes off my porch. Checking the deliver confirmation it shows it was delivered a minute before I opened the door. Just love the ‘Smart’ world and its data. I H
    have requested the signature image from USPS and I would bet a hefty amount the signature is forged once again. Besides going to the Post Master again, are there any other things that can be done? This is forgery which is a felony and it is a Schedule II drug. If the package were to go missing from my mailbox I would have a difficult time getting a replacement, especially since it was released with a ‘signature’. Plus he lied to my face.

    1. Hi Liz,

      Typically, I hear the opposite: People frustrated that their USPS mail carrier will NOT leave the package without a signature.

      I’m not sure what suggestions to offer.

      I know that postal carriers are increasingly pressured to get more done in less time. Trump has been trying to “reform” the USPS by privatizing it. In other words, another profiteer move against a government institution.

      Perhaps you could aim higher up the food chain and support the USPS in its quest for survival and continued service.


  23. Thanks so much for suggesting this route! I just got off the phone with my insurance company and it looks like this will work–they use Caremark (CVS) so we’ll see if I actually get the Teva.

    1. Kris — I had lots of trouble with Caremark (we just this month moved to Aetna; previously, Blue Shield was great).

      Here’s what I recommend: Call the pharmacy rep and ask EXACTLY HOW the script should be written so as to receive the authorized generic (Actavis/Teva).

      With Aetna, the pharmacist said to specify on the prescription “Actavis/Teva authorized generic.” Maybe it will be the same.

      For many years with Blue Shield, I asked the doctor to specify “OROS only”. That meant the authorized generic. The OROS technology is what makes Concerta Concerta. It’s an osmotic pump.

      But with CVS, that resulted in receiving the Trigen.

      I called a pharmacy manager…what the heck?

      He said, “Trigen DOES have OROS.”

      Me: “WHAT? Who told you that?”

      Pharmacist: Trigen. :-0

      He’d confused Trigen’s osmotic delivery system with the patented OROS osmotic pump delivery system.

      Gotta watch these folks every minute….

      good luck!

  24. I’ve been struggling with home delivery issues for years! I even changed doctors because my first one required me to come in for a new prescription every month, saying, “that’s the law,” and there’s nothing he can do about it. When I finally did some research and pushed back, saying he had discretion over how often I came in (NYS law does not require monthly visits) and he could write 3-month prescriptions for home delivery, his answer was, “maybe you should find another doctor.” My GP, a friend of many years, wouldn’t even consider writing a prescription for Vyvanse to cover the period between leaving that doctor and finding another.

    I do understand that doctors and pharmacists are under a lot of scrutiny for schedule II prescriptions.

    After several failed attempts, I was finally able to order a 90-day supply of Vyvanse from OptumRx. Unfortunately it has taken so long that I’ll have a gap of about a week between when I run out and when the mail order arrives. OptumRx and United HealthCare were great about it and–after only one transfer to another customer service agent!!–gave me an override to get a prescription (up to 30-days) filled locally.

    Now, my (new) doctor says he can’t legally write another prescription because it is too soon. I’m 99% sure that, once again, the law gives him discretion to do whatever he thinks is appropriate. But his prescriptions do get scrutinized, and he’s scared of getting a reprimand. Worst case, I know he can orally provide an emergency prescription to my pharmacy for up to a five-day supply.

    So my experience is that the agencies, while probably thwarting some bad actors, have scared the rest of the doctors and pharmacists to the point of not being able to serve their customers.

    I’m waiting to hear my doctor’s solution. He might write a short prescription or one for another dosage.

    What do you think is the right solution?



    1. Hi Doug,

      First of all, congratulations on doing an excellent job of plowing through unnecessary obstacles!

      I do not know NYS law. But in general, the “system” is on the watch for stimulant abuse. (Too bad they weren’t as vigilant with opiods, eh? Then thousands of people wouldn’t be dying or developing addictions as I write.)

      Red flags come up when there is an overlap resulting in double-supply. And MDs don’t have a lot of wiggle room on this. Especially in over-riding insurance companies and pharmacies.

      If I am understanding correctly, you have a 90-day supply on the way. And, you have in hand a 30-day supply. So that’s a four-month supply.

      Obviously, I’m misunderstanding something if that’s the case.

      Generally, the physician can date the prescription to the first date the mail-order pharmacy will fulfill the prescription. You can send it in a few days earlier. But not too many, in my experience. They’ll just send it back!

      So you want to calculate when your current supply runs out, and double-check with the mail-order company….”When should I send in my next order and how should it be dated?” Because really, all that matters is their rules.

      As for the bad actors, I’ve had it up to here with prescribers STILL — after my 20 years of doing this work —— sending lives off the rails with carelessly prescribed Adderall.

      The DEA controls the amount of raw materials for stimulants. That’s why we often run out of supply by the end of the years. The quota has been met, and you’ll just have to wait until next year for more!


  25. Thank you for mentioning how you should consult with your insurance company to see if you qualify for home delivery medication. It is important to remember that taking the time to do some research and read online reviews can help you find the best way to get your medicine delivered. We are looking for ways to help our mom get the medication she needs to be delivered to her house, so I’m glad I found your post.

  26. I have medicaid and it doesn’t cover my Vyvanse prescription, so even with a Vyvanse coupon it costs me over $200 a month. I looked at the site you mentioned and it’s only for those insured through that group. I’ve seared for other sites for home delivery and cheaper price to no avail. Do you have any suggestions? Any ideas would be greatly appreciated.

    1. Hi Kelly,

      I’m not sure how to advise you. Have you contacted Shire’s program (“Shire Cares”)? You can call or e-mail:

      Contact Us
      For information about Shire Cares benefits and eligibility, please call 1-888-CARES-55 (1-888-227-3755), or email ShireCares@shire.com.

      Shire Cares is available from Monday through Friday from 8 AM to 8 PM Eastern Time, except holidays.

      If that proves fruitless, I wonder if you have tried other stimulants? Though I’m usually not a fan of generics, it might be that a generic Ritalin or Adderall would be a lot cheaper and might work almost as well (after you’ve tweaked the dosage and timing).


  27. I have a question. I have an ongoing prescription for ritalin. I have taken it for 4 years. Is it safe for me to order from on online pharmacy? I don’t want to get into trouble.


    1. Hi Den,

      I’ve steered clear of online pharmacies. They seem too fraught with problems. There is a chance of getting inferior or counterfeit medications, I understand.

      I think it’s best to stick with legitimate drugstores or mail-order pharmacies associated with health insurance.

      Good luck!


  28. Pingback: Consumer Q&A on Concerta Generics - ADHD Roller Coaster with Gina Pera

  29. Pingback: A Pharmacist Explains Generics and More - ADHD Roller Coaster with Gina Pera

  30. I really had no idea that home-delivery was an option for pharmaceuticals, but I guess since you have been using one for 15 years it must not be a far-fetched idea. I imagine a pharmacy supply company would have information on what sorts of services like that are available in your area. My dad is getting older and it’s hard for him to get out to the pharmacy, I’ll have to suggest that he look into this option.

    1. Hi Luke,

      Yes, definitely! It’s so much more convenient. Especially when it comes to stimulant medications, for the reasons I detailed.


    2. Hi Luke,
      My mail order pharmacy is a benefit through my health insurance. You might want to start there.
      Good Luck!

  31. First, I just have to say I love your site. So relieved to have found reliable information from someone who actually gets it. You’re a godsend.

    Second, I just wanted to share a few observations and tips from my own medication refill experiences with Adderall in NYC over the last 10 years:

    1. Electronic “E-Scripts” have been a game changer for me. As of 2016, my doctor was able to submit my prescription electronically to my pharmacy each month, saving me the hassle of emailing, picking up and dropping it off each month. Prior to 2016, I was told schedule II class drugs could not be sent electronically (I didn’t fact check this so I don’t know if that’s accurate). But apparently something changed as of this year as my doctor’s office is now able to and have heard the same thing from others in the city who see different doctors.

    2. Doctors still are not allowed to call these prescriptions in over the phone however, which I’m sure we all assumed but just making a note.

    3. I have yet to find a doctor in NYC that is willing to prescribe more than a 30 day supply at one time, so I still have to submit a new refill request each month to my doctor and schedule an in-person visit with him every 4 months. Both of which can still be a huge pain.

    4. Avoid chain drug stores in NYC — Over the past 10 years I’ve tried them all (CVS, RiteAid, Walgreens, Duane Reade) and my experience with each has always been consistently awful, especially at their larger midtown locations. If you go to any of these chains with an Adderall prescription you will more than likely get treated like a drug addict and be told to come back in 2-3 days for pickup as its on backorder. You can’t get your order delivered. Many of the chains won’t even fill your prescription until the day AFTER your previous prescription expired and have even void a few of my past prescriptions because I wasn’t able to pick them up within 24 hours (in both instances they told me I would have to give them a NEW prescription note from my doctor to get it filled, rudely I might add). I’ve heard dozens of similar accounts from others who’ve had the same or worse experiences filling their ADHD prescriptions in the city at one of these chains. So again, my personal advice is to try and avoid these chains all together.

    5. Better Alternative — Small, Family Owned Local NYC Pharmacies: SO MUCH BETTER. My experiences with this these smaller mom and pop pharmacies in the city has been the exact opposite of what I just described. Of course I can’t speak to every one of these establishments but based on the three different businesses I’ve been a pharmacy customer at thus far — I’ve been treated warmly and respectfully, been able to arrange for my prescriptions to be delivered to my home (often for free) with my insurance and credit card information kept on file, never had issues getting my Electronic E-Script filled and the one time they didn’t have my medication on hand, it was only a 1-day turnaround to back order and was delivered directly to my office the next day without hassle. Basically they treat you like a human.

    1. Hi JC — Thanks for the report from the front lines!

      I agree about independently owned pharmacies.

      I have to say, CVS was the worst with the Concerta debacle, continuing to foist the downgraded generics on customers. Walgreen’s did a MUCH better job.

      I’m glad you found a workable solution.


    2. My Dr in Indiana is being a complete rude jerk and threatened to take me off my Adderall!! I need an e script I am so sick of dealing with Drs and just want my Adderall. Any suggestions how to get a Dr online to e script me one?

    3. HI Aubrey,

      No, sorry. I do not recommend these “online doctors.”

      Perhaps it’s time to try something other than Adderall.

      good luck,

    4. 100% agree on the local NYC pharmacy. I lived in NYC for 8 years and got my Adderall filled at a great small pharmacy on 2nd between 42nd and 43rd. They always had it and were super nice.

    5. Thanks, KBW. Do you know the pharmacy carries Adderall now, though?

      There is a system-wide shortage, due to several factors.


  32. Pingback: A Recap: Consumer's Guide to Generic Concerta - ADHD Roller Coaster with Gina Pera

  33. Our insurance has a mail order pharmacy and the cost savings are small. However, the convenience is HUGE. If I could only get my ADHD partner to do it…..he’s still running to Walgreens at the last minute every month. 🙁

    1. Hi Deb,

      If I hadn’t set up the system, my husband would probably still be scrambling every month.

      I take care of it, as a favor to him—and to me! 🙂


  34. Well, our HMO here in Washington State will NOT let him get his stimulant by mail although they have a big mail order pharmacy. Since this HMO just joined hands with Kaiser Permamente, against the wishes of many of the HMO members, we are considering changing insurance carriers during open season. I’d probably be looking at Blue Cross.

    But, one question. DH is on medicare/medicaid. If we get his prescription filled through our current HMO pharmacy, he has to pay a co-pay of about $35 per scrip. If he walks into the pharmacy at our grocery store, he pays $1.25.

    Do you know if you can get medicare/medicaid prices and still get mail order meds with Blue Cross? I think you mentioned that was who you had. And, yes, I know, my mileage may vary.

    We will be looking closely this year at changing health carriers after about 30 years at the HMO that I *was* happy with for the most part. 🙁

    1. Hi Penny,

      You asked:

      But, one question. DH is on medicare/medicaid. If we get his prescription filled through our current HMO pharmacy, he has to pay a co-pay of about $35 per scrip. If he walks into the pharmacy at our grocery store, he pays $1.25.

      I am assuming that he does not use any kind of insurance card or medicare card at the grocery store pharmacy, right?

      Here’s the thing most people don’t understand (I should write a blog post): Insurance companies and pharmacies sometimes MAKE MONEY from co-pays on generic drugs. Some generics are very cheap. Which is why Wal-Mart and Costco and other “Big Box” stores sell them cheap to people without insurance.

      That’s why I advise that people shop around, compare the cost of the generic among pharmacies AND with/without using insurance or Medicare.

      Sorry, but I know nothing about Medicare/aid might dovetail with Blue Cross. I thought it was one or the other, not both. Except in the case of supplemental policies to Medicare.

      Who knows. You might like Kaiser. Many people do. For Adult ADHD, though, here in the Bay Area, people have to claw their way to getting treated. It’s gotten a bit better, with some locations being more pro-active than others. Still, it can be an uphill climb at others.


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