Guilty Until Proven Innocent and Then Once Innocent, You Still Are Screwed.

He ran down his list of things he had to do before he went to the drug store to score.

1. Dress well so as to not arouse suspicion.
2. Talk Calmly and Nonchalantly so as to not appear to need the drug that he needs to function.
3. Make sure to fill out the prescription  neatly and without any errors and all the information available, to ensure there was no question of the validity of the prescription, in case they call the Doctor and the Doctor is NOT in. (This has happened before).

Any deviation from the above three may arouse suspicion and denial of drugs by simply being told they are out of stock. (see “Watch List” below)

4. Plan (see “Planning” below) that #1-3 will not work and ensure you have adequate reserves of your drugs. (see “Reserves” below) of your drugs.

This was the fifth pharmacy he went to over the last three days and he only has a couple pills left. Not panic, but nervousness has set in. He walked up to the counter, trying not to appear stressed and handed the prescription to the pharmacist. The pharmacist looked at him briefly and then said “I don’t know if we have enough of this, let me check” and then she came back a few minutes later and said “Sorry we don’t have enough, we can order some but it won’t be in for five days after the manager orders it.”  He noticed the partial answer and had been through enough to ask.

“When is the manager coming in?”
“She’ll be in on Monday.”
“So in three days, which means best case, this doesn’t come in for over a week.”
“Right,” she said with a half-shrug / half apology, but no more volunteered information or help came.
“And no one else other than the manager can order it, right?”

“Yes.” And she offered no more. One of the other pharmacists, where he was previously denied, gave a little more information. Every pharmacy can only carry a certain amount to limit the attractiveness of the store as a target for drug addicts and criminals. In addition, only certain people (like the Pharmacy manager) can order to make sure that the Pharmacy itself is not oversupplying these controlled substances. In addition, only certain people at each Pharmacy can inventory the drugs. Effectively this limits the supply of a drug that a certified, licensed, professional has determined is in his best interest.

“OK. Thanks.” He said as he turned around and left, mentally scratching off another drug store. He made sure to stay pleasant and nice, because in 30 days, this may be the store he needs as he shops around for his drugs. So far he had taken about 3 hours of time this month trying to get his fix. In a couple of days he would have nothing left, and nothing to do other than hope he hit the drug lottery sooner than later.  He knew better than to ask if they could call other pharmacies to see it they had it in stock. Depending on who he talked to, they tell him it was either against the law to provide that information over the phone or against company policy. This is in order to prevent Drug Break-Ins, Keep Drug Crime low, and to protect their employees in affluent suburbia. So he continued to play a modern-day version of Clue, where instead of finding the Room, Murderer and Weapon, he would find the Drug Store, Pharmacist and Fix by simply walking and driving around his neighborhood until he happened upon the trifecta. 0 for 6 so far. If his drug detective work aligned with the old Clue board, at worst, he only had three more stops. Only problem is, frustration set in 3 stores ago, aka yesterday.

Store 7

“I’m sorry, we only have 27 pills and the prescription is for 30. We can’t fill this.”
Trying not to sound desperate he says, “I’ll just take the 27. Or could I get the others later since these last for 27 days?”
“I’m sorry, no. Company Policy/State Law/Federal Law/Insurance Reason/Pick a Reason to make your life more difficult”
“Ok.” The Thanks is now dropped.

He finally gets the meds at Pharmacy 8, the following day. The pharmacist takes his driver’s license and enters his information. This includes an annotation that he has never filled at this pharmacy before and that his prescription dosage has changed three times and prescription drug twice in the last year. He got this one with one pill left. He tries to look casual and unconcerned, but by the very act of thinking about this, he feels he is not acting casual or unconcerned and worries that the pharmacy will notice him trying to act casual and unconcerned and become suspicious. This will repeat the next month for pretty much forever, unless the laws, insurance, and company policies change.  The drug is Adderall and the He is Me.  A couple of points in this Catch 22 combined with a Confederacy of Dunces in Health Care.

1. You cannot have refills OR have the Doctor call in the Prescription. In today’s Digital age of secure public keys, secure payments, and secure everything else, somehow the paper prescription is de rigueur. Every 30 days to make sure you don’t take too much or become a drug dealer.
2. You also have to physically see the Doctor every thirty days, to make sure you don’t become an addict (even though you are already treated like one.)
3. Watch List – Every time you fill a scrip for one of these controlled meth amphetamines (Adderall, Ritalin, etc.), the drug store, or insurance company enters your information in a database. If you try to fill your 30 day prescription too early often enough,they add you to this watch list. You are supposed to refill as close to the 30 day window as possible. If you have over a certain number of pills prescribed you, they may add you to the watch list. If you appear worried, needy, etc., they can put you on the watch list. If you appear to be pharmacy shopping (don’t go to the same pharmacy every time) they may add you to the Watch list. Doctors, Pharmacies AND Insurance companies can all share this data and watch list. Once you are on, many Pharmacies will refuse to fill even a valid prescription or will only do so after a significant more amount of work. Now remember, you are not able to find out the availability of the drug, orders can take over a week, and you cannot have refills or call-ins. In other words, often times, you HAVE to move pharmacies or do without. In addition, you are not told if you they are putting you on the list, nor are you typically told what actions caused them to put you on the list.
4. Planning – As someone with ADHD, this is likely a strong suit of yours – planning (heh-heh) And as someone who has a recognized medical need for this medicine that helps your Ability to function to include planning, it is rather counter intuitive to put road blocks up. If you somehow don’t plan perfectly for Doctor availability, your general life schedule and the ordering schedule of pharmacies that you are not allowed to know, it makes it difficult to Plan.
5. Reserves– One of the answers is to keep an emergency amount available. BUT then you are not taking it according to the Prescription, which if found that you are keeping pills, can put you on said watch list as you are abusing your medication dosage. The alternative is to do without, which again, helps planning.
6. Number of Pills. Insurance (and Pharmacy as well) limits the number of pills in a monthly dose. Note this is NOT the amount of medication. You cannot have, let’s say 90 10 mg Ritalin Pills for a month as that shows you are taking too much. BUT you CAN have 30 30mg Ritalin Pills (math test – 90 x 10 and 30 x 30) and no one will say anything. The logic (heh-heh again) is that individual pills cost more (which is true the way Pharma PRICES them and Insurance negotiates to pay for them) and that if you have individual pills you could take less and use the rest for abuse (see Reserves above or selling them on the market). In other words, nothing in this entire write-up assumes you are a responsible citizen seeking the very treatment prescribed by a licensed, trained, educated, insert additional qualifier here Doctor.
7. We’ve essentially made a series of roadblocks for treatments that help in planning and prioritization for portion of our population that needs help in planning and prioritization. As an adult with ADHD, you are minus the typical support systems a child with ADHD has, such as parents, government support and school programs. As adults we are given the assumption that we SHOULD be able to handle our own lives (believe me, I subscribe to that Should as well), and then make it harder for people to do so when there is already a struggle.

Something needs to change.

P.S. If I hear ONE more argument of equivalence from the “No Gun Laws other than maybe not allowing private citizens to own nuclear weapons” Nut-Case lobby that Outlawing Guns does NO good, because drugs are illegal and look at how well that works, I invite them to fill my prescription three months in a row at the same pharmacy and keep their cool when things don’t go their way. If that argument held water AT ALL, no one should care about making health access a little easier to those that need it, and making the lives easier for literally hundreds of thousands of people against the specter of a few more people who don’t care about the laws of drug abuse.  These drugs are often kept out of the hands of people who need them. And good luck travelling for somewhere outside of the 30 day period. I go through more paperwork, time, and suspicion, than anyone should have to. And so do the rest of us.

P.P.S. I understand that not everyone’s experience is this very experience. Due to caring pharmacists; different company rules, insurance plans, and state laws; and the support system one has, your mileage may vary. However, each and every one of these points exist somewhere in the United States and affects this group of people as a whole, you just may not experience it or understand the frustration.