The primary reason that I haven’t touched ADD meds with a 10 foot pole its because its just asking for me to get the bad-parent-patrol firebombing my site for me implying that only about 25% of the cases of ADD are diagnosed correctly; and the remainder are just parents who don’t want to deal with kids being kids. Since I just dug my own grave right there, lets continue.
TAP, I’m surprised you haven’t done a rant on ADD meds. When is that
coming – or do you restrain yourself because you have the condition
yourself? The media says it affects 3 to 5% of children (and adults, as
you don’t outgrow it but rather learn to compensate) but around here, I’d
say it’s more like 30 to 50%, and I have heard about school districts (not
mine) who are pushing, consciously or not, to get 100% of their students on
some kind of ADD medication. I’m quite aware that many parents (okay,
single moms) who face being kicked off welfare are coaching their kids to
misbehave in school, or act like they are retarded, so they can get SSI
payments for them. This, IMHO, is not what SSI was intended for, nor was
it meant for drug addicts but that’s another story.
I dont touch this issue (and also abortion) because it tends to piss off a lot of people. Yes, even I have my limits, and I tend to not piss off /all/ of my userbase, just /some/. Everyone can take jokes aimed at their profession, or their jobs, or what they call themselves; however talk about their kids and their ‘parenting skill’ and suddenly my biggest fan is calling my internet provider claiming I touched her daughter where she pees.
I will say that I do see children who need it. They usually sit in the store vibrating as their parents scream at them to not explode and rip stuff off of my shelves as their younger (and sometimes older) brother/sister sit there patiently. You can just see it in their eyes that its not the usual high-energy that a kid has, but something obviously wrong. They will take the store check stamp (you know, you stamp the back of a check when you put it in the register) and STAMP-STAMP-STAMP-STAMP-STAMP all over the counter. In almost all cases this patient has a brother and/or sister who is not on medication and acts perfectly normal. The patient goes to a child neurologist and is on not only some sort of Adderall/Ritalin but also Tenex or Clonidine. They will not be on the medication all year round, but only during the school year. The parents have been patients of ours for years and years and never once asked for an early fill, plans trips around when their refills are due, and are those patients that you really do bend over backwards to help when something hits the fan (you retail folk know what I’m talking about).
Then I see a family of 4, all the children are on Adderall. They zombily waltz in as their mother is chatting some drama up on her cell phone using terms that rival ‘baby-daddy’. She plunks down her imitation Gucci purse on the counter as she throws a handful of Rx’s at the clerk as all the kids slunk down into the waiting chairs on the verge of passing out. She talks loudly on the cell-phone looking at all of the hair products as she bitches about when the Rx’s are going to be done. All of the Rx’s are written by some out-of-town doctor that only seems to dump out ADD-C2’s like they are going out of style. One of the children politely asks for a drink of water and the mother just jumps down her throat and tells her to go sit back down. The mother buys about $40 worth of hair products and fake earrings. I sigh as I get the warning that two out of the 4 children’s Adderall were filled by another pharmacy 15 days ago. She gives me some two-bit smart-assed smoke-up-ass story about being stolen/lost/eaten/whatever (I never pay attention). She’s pissed off that her State Program doesn’t pay for early refills and decides to take her stupidity out on me instead of herself.
Now these are two extreme cases with obvious room for gray in the middle, but I tend to go with the extremes for illustration purposes.
In addition, I have never heard of a child being evaluated for it who
wasn’t diagnosed, usually by the first practitioner who saw them, 10
minutes after they walked into the door.That is, with one exception. I
once worked for a pharmacist who thought his B-student daughters could be
turned into A students by taking meds, and took them to 10 or 15 doctors
until he found one who would write prescriptions, no questions asked. I
told him what I thought, which probably contributed to my being fired a few
months later but it was a temp job anyway. I later learned that this man
has a long history of walking out on jobs without giving notice, and
signing up to do relief work and not showing up and being unreachable.
Lesson anyone in the pharmacy biz learns early in life: If you think you have it, some doctor out there will agree with you. You can be sitting at home watching TV and suddenly feel like you have agoraphobia after a paxil commercial. Sure as shit some doc out there will fill out the SSI paperwork and off you go to a life of no-work and a check every month. Parents will think that all of the doctors in town on crazy for thinking that their kid is perfectly normal except for that one quack out there who churns out C2’s by the truckloads. All it takes is a little time and a good sob story to get that Rx written for Adderall for your 3 screaming toddlers (from 3 different fathers, go figure) and off we go reinforcing the stereotype that ADD does not exist. Its sad, I see it all the time, however proving something as subjective and wishy-washy as ADD is like scooping a turd out of the ocean.
So there is no takehome rule from this ATAP episode, I figure I’m going to get the ghetto-parent-patrol jumping down my throat just for posting this.
- Paying the PBM’s to service them.
- Im dreaming of a Crackhead Christmas.
- SOMABOTS, TRANSFORM!
- A pharmacist example for non-pharmacists.
- Trying to not kill your patients.
- An open letter to my patients.
- The FDA obviously hates the public and needs to lay off the crack pipe.
- How to make your pharmacy career less painful.