ADHD medication was “life-changing” for many people, patient Adam Currie said.
Photo: 123RF
Adam Currie became one of the first people in the country to be prescribed ADHD medication by a GP at an 8.30am appointment on Monday.
He told RNZ he booked the first available doctor’s appointment for February after he heard about the upcoming changes “many months ago, hoping the doctor would prescribe it”.
Not every GP would choose to offer the service, with some lacking the capacity to offer 90-minute ADHD assessments and the required follow-up sessions and questionnaires, which did not fit into the usual 15-minute appointment slot.
However, Currie – who already had his diagnosis – said his Monday morning appointment was “really smooth”.
Under the previous process, following his assessment and diagnosis (which cost thousands of dollars), he would have needed another psychiatrist appointment to have the medication prescribed. That would have cost more money and involved waiting several months.
On Monday morning he simply provided a urine sample and the doctor was able to prescribe him the medication.
ADHD medication was “life-changing” for many people, making it easier to hold down jobs, maintain relationships, and focus on tasks, contributing to a “far better quality of life”, Currie said.
“I think it’s really exciting that people are able to get the support they need,” he said.
Lack of funding ‘discriminatory’- advocate
The rule change allowing GPs and some nurse practitioners to diagnose ADHD and prescribe stimulants has been widely welcomed by many in the sector as a way to remove some barriers in terms of cost and access.
However, it is unlikely that every practice will have the capacity to offer ADHD assessments – and those which do will have to charge patients for their time, which could run to hundreds of dollars.
Aroreretini Aotearoa convenor Kent Duston, who represented adults with ADHD, said his organisation had been working alongside Pharmac, the Ministry of Health and Medsafe for years to get policy changes.
Poor access to diagnosis and treatment was “a long-standing and persistent issue in New Zealand”, and the lack of funding to support the rule change was disappointing, he said.
Government agencies had made “very timid progress towards addressing these problems”.
“The Ministry of Health’s refusal to fund anything of any description for the ADHD community really is a pretty significant piece of discrimination. in that I can’t think of any other issue that would affect 5-7 percent of the population that has life-long implications that the Ministry of Health would say. ‘We’re not going to do anything about that and we’re not going to allocate a single dollar to it.’
“So we think that the health system as it’s configured at the moment for the ADHD community is highly discriminatory.”
He dismissed fears of “over-diagnosis” or “over-prescribing” as unfounded.
Between 250,000 and 350,000 New Zealanders were likely to have ADHD, based on international estimates, but only 60,000 people had been prescribed medication, Duston said.
Even taking into account that medication was not suitable for everyone and that some people did not want it, “that’s still hundreds of thousands of people who are not getting the help they need”.
Both the Ministry of Health and Health NZ have been approached for comment.
Health authorities have been criticised for not allocating extra funding for the new service.
Photo: RNZ / Angus Dreaver
Change brings ‘both opportunity and risk’ – psychiatrist
The College of Psychiatrists said allowing doctors and nurse practitioners to also prescribe ADHD medicines would help reduce barriers for some people.
ADHD spokesperson Dr David Chinn, a child and adolescent psychiatrist, told Nine to Noon the change brought “both opportunity and risk”.
Firstly, there were significant risks associated with undiagnosed and untreated ADHD, and having a wider range of clinicians able to do that would be hugely beneficial.
Many went undiagnosed, particularly Māori, Pacific, Asian and people from deprived communities, Chinn said.
“In terms of risks, we want to make sure that assessments continue to be of a good standard, that the right people are diagnosed with the right conditions and prescribed the right medication, whether that’s ADHD or otherwise,” he said.
Primary health providers were highly skilled at treating many mental health conditions, but it was important that they had sufficient time to carry out ADHD assessments and also access to “escalation pathways”, if patients required more complex interventions.
A thorough assessment typically took about two hours.
None of the features of ADHD – including attention problems, impulsivity, difficulties with emotional regulation – occurred only with ADHD, and it was important to rule out other problems, like mood disorders, anxiety, substance abuse problems etc.
“Stimulants can be life-changing for some people. Psychiatrists are quite supportive of these changes to ensure people aren’t encountering extra barriers in accessing them.”
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