Post APCsau0Q6oT2UQDvm4 by Kirstie@mastodon.nz
(DIR) More posts by Kirstie@mastodon.nz
(DIR) Post #AP9ImXQlgkcI7puvGi by strypey@mastodon.nzoss.nz
2022-11-01T04:46:38Z
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In Aotearoa, people taking medication for #ADHD need their prescription reviewed by a specialist every 2 years:https://www.rnz.co.nz/news/national/457283/the-health-system-s-attention-deficit-when-it-comes-to-adhdA 2020 NZ Ministry of Health report estimates as many as 280,000 kiwis have #ADHD:https://www.adhd.org.nz/adhd-is-more-common-than-you-think.htmlIf half that number got diagnosed and started taking medication, then the country would need 35 specialists, working 40 hour weeks, 50 weeks a year, doing nothing but bi-annual ADHD assessment. Does anyone think this is a sensible health policy?
(DIR) Post #AP9J99nbiTvhUfNxVw by icedquinn@blob.cat
2022-11-01T04:52:13.686485Z
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@strypey i don't really know why people think the monopoly of force should be used on personal drug use :blobcatshrug2: i guess there could be concerns with people willing to take performance enhancing drugs edging everyone else out, but the war on drugs has racist origins more than protective ones.
(DIR) Post #AP9JE9M0na3JYqrIXY by rach@mastodon.nz
2022-11-01T04:52:50Z
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@strypey no but many of our health policies don’t make sense. The requirement to continuously see doctors for asthma medication is ridiculous, and only being able to get scripts for three months at a time is crazy. My asthma isn’t suddenly going to up and disappear.
(DIR) Post #AP9KG6NAxBuuqetiKm by mikeythenurse@mstdn.social
2022-11-01T05:04:11Z
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@strypey easier with kids and youth, usually funded and occasionally just requires the primary care provider to send a request through to the paediatrician/psychiatrist, but much trickier with adults.
(DIR) Post #AP9LBdjrZYVupxwhQ8 by strypey@mastodon.nzoss.nz
2022-11-01T05:13:31Z
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In case you want to check my numbers (probably wise), they assume a medication review takes 1 hour of specialist time (time with patient plus paperwork etc). Also that each specialist is working at full capacity every year (no illness etc). So this an extremely conservative estimate.35 specialists x 50 weeks= 1750 weeks x 40 reviews/week= 70,000 reviews x 2 years= 140,000 reviews x 2= 280,000 ADHD cases estimated by MoH
(DIR) Post #AP9LV4EfHYY2W9cIaW by strypey@mastodon.nzoss.nz
2022-11-01T05:16:49Z
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Remember these numbers are only for bi-annual medication reviews. They don't include the specialist time required for initial diagnostic assessments. Although these can be carried out by clinical psychologist too, they can't prescribe medication, and GPs can't prescribe it based on their diagnosis.
(DIR) Post #AP9eRawncIDlwUJmKW by CentralAndWesternGLAMProject@mastodon.social
2022-11-01T08:50:19Z
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@strypey Kia ora, knowing a whānau member who would sell his ADHD meds to get drinking money sadly, I would propose that some of this is to do with that scenario? I'm sure more than just they do this kind of thing. Even sadder is that they really needed it, but other things were more important. Tautoko tho on the time/cost of doing all this if that is not one prime driving factor for it.
(DIR) Post #AP9lbWSfqiP2bXuMfA by strypey@mastodon.nzoss.nz
2022-11-01T10:10:51Z
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@icedquinnI agree with all of this. In a country with no prohibition on personal use and a public health system, specialists and prescriptions would still be important for deciding whose drugs need to be subsidized so they can achieve basic health. Screening out those who choose to take drugs for fun or profit, and can pay full market prices for their own supply. But it makes no sense to design a system that's clearly unworkable if everyone seeks the treatment they need.
(DIR) Post #AP9lxLBQShXDzrFC7c by strypey@mastodon.nzoss.nz
2022-11-01T10:14:51Z
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@rachMine did after I got off the dairy products, but I was lucky. Anyway, I don't know why you ought to need a prescription for asthma meds at all, it's not like anyone takes them for fun. A proof of diagnosis ought to be all you need to buy them over the counter. Like a California med pot certificate.
(DIR) Post #AP9mCuyNgB53L8ZPu4 by mikeythenurse@mstdn.social
2022-11-01T05:04:58Z
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@strypey like I normally just send a quick email to the psychiatrist to renew the special authority
(DIR) Post #AP9mCvXTZh9Z5yzRbc by strypey@mastodon.nzoss.nz
2022-11-01T10:17:36Z
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@mikeythenurseIsn't that what that GP in Ak got in trouble for doing just recently? It's good that you've been able to do it like that, but it demonstrates that the whole process is fairly pointless hoop-jumping.
(DIR) Post #AP9ogpfYA9IjUE9cx6 by strypey@mastodon.nzoss.nz
2022-11-01T10:45:21Z
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@CentralAndWesternGLAMProjectHow long ago was that? Apparently even the cops are saying there's no longer much demand for Ritalin as a recreational stimulant, due to the easy availability of P.Edgy hot take: legalizing licensed sales of quality controlled MDMA would probably wipe out most of the demand for both, with a massive reduction in drug-trusted harm (see David Nutt et al).
(DIR) Post #APARKoUXkxtxfyUuLQ by mikeythenurse@mstdn.social
2022-11-01T17:58:10Z
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@strypey Nah that was the initial diagnosis. He'd see them, do the psychometrics, send a letter to a psychiatrist mate who'd authorise starting methylphenidate. We were working on a comparable model when he got in trouble for what he was doing ironically.
(DIR) Post #APArhqqvk3HGT2cBCS by CentralAndWesternGLAMProject@mastodon.social
2022-11-01T22:48:58Z
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@strypey Quite recently & I've heard that too, but I understand its still popular with the younger set. But yeah, way too much easy availability of P, esp here where its ruining our communities. It's known cause of much violent crime & robberies, terrible stuff.
(DIR) Post #APAwLHq3k4VVH0GcW8 by strypey@mastodon.nzoss.nz
2022-11-01T23:41:08Z
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@mikeythenurseOk. I guess my numbers are a bit overblown then. I did say in the first follow-up post that it was wise to check them ;) Let's posit that reading and replying to your email takes about 6 mins, so a specialist could do 10 per hour. That still adds up to the equivalent of 3.5 fulltime specialists doing nothing but that, all year round. I can think of better things we could have prescribing specialists doing with their work time :/
(DIR) Post #APAwZtueyoW5PdO5TM by strypey@mastodon.nzoss.nz
2022-11-01T23:47:13Z
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@CentralAndWesternGLAMProjectIt's probably worth pointing out that for all the unworkable obstacles the system puts between ADHD patients and our medication, it didn't stop your whānaunga getting the meds (because he needs them), nor selling then (because it can't). Ironically the impulsiveness that makes selling your meds to buy booze seem like a good idea is itself an ADHD symptom. A classic catch22. If he'd been diagnosed earlier, and supported better, it might have helped him avoid this.
(DIR) Post #APAyX7SsL0AQTyC1eC by mikeythenurse@mstdn.social
2022-11-02T00:03:00Z
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@strypey yeah 100%! Such a waste of resources.
(DIR) Post #APAz1EojZ7zTyPmLQG by CentralAndWesternGLAMProject@mastodon.social
2022-11-02T00:13:47Z
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@strypey Tautoko all of this. It probably did neither of us any good (I am also ADHD but manage it differently), that we were born & bought up in a so-called "christian" cult, which was anything but, and which is currently before the RCI for abuse of children & adherents. It breaks my heart what so many went through, including whānau, some of whom I have been unable to help as they don't realize they need it. 😭
(DIR) Post #APB9zdmWsOoeJeBkES by strypey@mastodon.nzoss.nz
2022-11-02T02:15:46Z
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@CentralAndWesternGLAMProject I'm so sorry to hear this. It's hard enough living with ADHD in a neurotypical-dominated society, without adding all of that mamae into the mix. Kia kaha ki te whānau katoa!
(DIR) Post #APBYA2IuxIHIANpNT6 by strypey@mastodon.nzoss.nz
2022-11-02T06:09:50Z
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@CentralAndWesternGLAMProjectBTW that was meant to be drug-*related* harm (damn autocucumber ;)
(DIR) Post #APCsau0Q6oT2UQDvm4 by Kirstie@mastodon.nz
2022-11-02T21:54:53Z
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@strypey thanks for the reminder I need to book in for my Med review!!!
(DIR) Post #APDoKVPDb9CGtzi0EC by strypey@mastodon.nzoss.nz
2022-11-03T08:59:28Z
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@KirstieDo you go in person or can you just send an email like @mikeythenurse ?
(DIR) Post #APEm6AWYQw5ZKn8Ub2 by Kirstie@mastodon.nz
2022-11-03T20:09:25Z
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@strypey I have no idea so I emailed the psych yesterday as to her process