Related:
Global Perspectives on ADHD: Social Dimensions of Diagnosis and Treatment in Sixteen Countries (2018)
Here in Switzerland, for example, adult ADHD was even started to be recognized only since 2011. No immediate release formulations are legal here, only extended release. Even though Novartis, a Swiss company, is the producer of Ritalin. You can't get Ritalin in Switzerland, as it is an immediate release drug.
In Russia, _all_ stimulant drugs are banned (and ADHD usually is not even recognized as a valid diagnosis). As is you can get to prison there if you take your Ritalin with you.
Bipolar medication on the other hand, many of my bipolar friends in Europe have difficulty getting proper medication, much less proper treatment. In the US, the only issue I had was finding a psychiatrist and therapist who was available.
The problem is cost. If I had ended up getting sent to inpatient treatment (nearly happened), the bill would have been huge.
It's hard to have a conversation when you talk about "europe", where there are a dozen different healthcare systems.
Here in the UK treatment (including medication) is easily available to anyone who needs it.
A slice of the challenges she faced:
- Few psychiatrists/doctors were willing to prescribe meds to an adult.
- You can't call to check on availability of Schedule II medications from pharmacies, you have to query in person, and many require a prescription before they'll answer.
- Insurance often requires pre-approval to pay for the meds - another hoop and another delay.
- You can only ever get one month prescription at a time (with no refills), and have to contact your doctor every month. Not too early, not too late.
Any one of these issues can be tough when you have an executive function disorder (poor short term memory, poor awareness of time, etc.), and especially if you run out of your meds and are fighting yourself just to do basic self care.
Never had an issue with this and I have frequently switched doctors. I'd suggest finding a prescribing nurse practitioner. It's hard to find a psychiatrist without waiting six months for the first appointment.
> You can't call to check on availability of Schedule II medications from pharmacies, you have to query in person, and many require a prescription before they'll answer.
I drop three prescriptions off at a time. Or it's called in and then I call for refills. If they don't have it in stock they can probably order it.
> You can only ever get one month prescription at a time (with no refills), and have to contact your doctor every month. Not too early, not too late.
I've had five or six psychiatrists. All of them prescribe 3 months in advance after the prescription is stabilized.
Go careful here. Ketamine infusion is a pretty heavy duty intervention and patients require careful monitoring while taking the infusion and for a short term afterwards.
In the UK we're looking at 1:1 nurse:patient ratios, delivered in ECT suites.
In the US the way increased access has been achieved is by dropping down the nurse:patient ratio and delivering it in wider settings. It's a more risky way to deliver the treatment.
We know that in the US there's already a problem of "doctor shopping" -- going around doctors until you find one willing to prescribe ketamine / eskatamine. This is normally associated with harmful prescribing, although it's too early to say if that's the case with these meds.
EDIT to add: There are cultural differences here. The US sees access to medication as being the same as access to treatment. The UK sees it as over-medication with at best ineffective treatment, and at worst treatment that causes harm.
I've been taking ketamine lozenges at home for 2+ years now. Ketamine is a very safe drug. It is used in pediatrics and on the WHO's list of essential medicines. It's hard to find any fatalities directly attributed ketamine in the literature.
The infusion therapy you speak of has been used to rob patients blind. Before I found a doctor that would prescribe I was on target to waste 10k a year. And that's not even considering the wasted time of appointments in the clinic.
> We know that in the US there's already a problem of "doctor shopping" -- going around doctors until you find one willing to prescribe ketamine / eskatamine. This is normally associated with harmful prescribing, although it's too early to say if that's the case with these meds.
Doctor shopping refers to going to different doctors to get more medication or to divert the prescription for profit. If one is depressed and seeks treatment from a researcher and doctor in another city or state it is not doctor shopping because of the underlying medical condition. Seeking help is not a crime.
Nevertheless, could you please post proof that there is a problem since you made that claim?
Not true.