Jumping Through the Doctor's Office Hoops

Working with a doctor's office when you have ADHD can sometimes involve a crazy dance where a patient must jump through a million hoops before they are treated.

A post commenter recently posted about an ADHD doctor not wanting to be told what to prescribe.  Many doctors are a bit touchy when it comes to prescribing stimulants.  There have been doctors who have been taken to jail for prescribing drugs that were later sold on the street or abused.  I work in an Emergency Department where I see tons of patients who are drug seeking.  They come in with tooth pain and want only Percocet for instance.  Doctors are usually on the look out for signs of patient abuse and asking for a specific drug, even if you know that this is the only thing that works for you, is sometimes seen, by physicians, as a 'red flag'.  

Psychiatrists are a little different as they work with stimulants a lot more.  I believe that once you are seen by a psychiatrist things improve for patients with ADHD.  Unfortunately, many ADHD patients are treated by their primary care physicians and prescribing stimulants today is a major, health care worker, pain in the butt. Prescriptions must be hand written monthly. Patients lose them, wet them, and tamper with them so that they need to be re-written, etc. I am not defending physicians who are rude or impatient regarding prescription refills but I WILL tell you that for any health care worker it is far easier to have a patient on Stratterra, a non-stimulant, than it is to have them on Adderall.  Kaiser often will try patients on Statterra first and only if this treatment fails does the patient get switched to a stimulant.

We know that Stratterra does not work for everyone but I can see why Kaiser would like it to work for as many patients as possible. There are now stimulants, like Vivanse (a dex-amphetamine) that are less likely to be abused. They enter the system slowly over a 12 hour period and cannot be snorted or used recreationally.  With the advent of these non-abusable drugs, maybe doctors will be more willing to give patients the medicines that work for them.

No comments:

Post a Comment

Note: Only a member of this blog may post a comment.