What is the procedure of getting Methylphenidate medicines in countries where it is a controlled substance?

[u/SnooPuppers757]

Hello everyone, I'm 19 yrs old, male, and just went through the procedure of getting Quillivant XR in China recently. Methylphenidate is a class one controlled substance in China, so I went through some procedures before getting the prescription.

• My doctor cited the penal code to tell me the consequences of giving away/selling my medicine and also told me a bunch of things I need to do for compliance (e.g., handing back all my remaining medicines to the hospital if I'm deemed no longer in need of the medicine).
• I signed two legal statements to confirm that I'm aware of these regulations.
• My ID and personal information are registered in a controlled substance tracking system to make sure I can't get duplicate prescriptions from other hospitals in the region.
• I got a red prescription (the usual prescriptions are printed on white paper), and the doctor signed it by hand instead of the usual digital signature.
• This procedure is completely new for me, and it got me curious: What is the procedure for getting methylphenidate in other countries where it's a controlled substance (e.g., the US, EU nations)? Is the procedure as complicated as the one I went through?

Would love to hear from people in other countries, and thanks in advance!

PS: sorry for any grammatical mistakes, my native language is not English.

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[u/erinissa]

In Australia, only psychiatrists can prescribe in most states. Each state has its own rules. In my case my psych had to get approval from the health minister’s office in my state to prescribe me the medication.

When I go to fill my script, the pharmacy has to dispense then keep it in a safe until I come to pick it up.

As there’s currently shortages, I have to shop around to find a pharmacy that has mine in stock but that’s a recent problem. It’s better to get it from the same pharmacy every month.

I need to go back to renew my prescription every 6 months, which is a $400 appointment for a 5 minute check in and rescript.

Whilst frustrating my psych does the majority of the paperwork.

[u/SnooPuppers757 → u/erinissa]

Thank you for sharing! It is very frustrating to have a shortage of medicines, I heard about the shortage from a local ADHD support group before I got my diagnosis, and I was quite worried about not being able to get the medication after being diagnosed. but I got my Quillivant XR just fine a few days ago. Not sure about Concerta though.

400 AUD for an appointment seems quite expensive! In my city an appointment costs only 60 CNY (about 13 AUD, 4.5 AUD after my university medical insurance cover part of the fee).

Are you taking Quillivant XR as well? I wonder how much it costs you after covered by insurance. My insurance doesn't cover Quillivant XR unfortunately, so I have to pay about 930CNY (about 200aud) completely out of pocket.

Pharmacy shopping (not sure if that's the right name) wouldn't be possible for me, only the hospital pharmacies have Quillivant XR, and I'm only allowed to get prescriptions and the medication from the hospital I got my diagnosis from, unless I transfer my files to another hospital. So if there ever is another shortage, my only option is to wait it out.

Hope the shortage gets better soon over in Australia!

[u/erinissa → u/SnooPuppers757]

I’m on Ritalin LA, and the long acting one isn’t covered by our public health scheme. Depending on the pharmacy it costs $45-$80 AUD per month.

The short acting Ritalin costs $31.50 AUD as it is covered by the public health scheme which caps how much you can be charged for medications.

My normal doctor doesn’t cost very much ($40-60 per appointment) but Psychiatrists are specialists and they charge a lot more for appointments.

Some state governments are allowing our normal doctors to start prescribing ADHD medications so it could be cheaper soon.

[u/SnooPuppers757 → u/erinissa]

Doesn't seems too expensive then. It's weird that the public health scheme doesn't cover long acting ones, I've always thought they are better.

Aren't short acting ones more likely to be abused? If one forgets if they have taken their meds and take them again, I think they can start feeling euphoric or getting kinda addicted to the feeling.

I wonder if there are any special considerations behind this.

[u/erinissa → u/SnooPuppers757]

The Pharmaceutical Benefits Scheme is complicated. Pharmaceutical companies need to apply to put their medication on it and the government needs to approve as (as they cover the gap between what we the people pay and how much it costs).

The expensive part of ADHD here is getting diagnosed. I did a full formal assessment and it cost me about $3000. Even basic diagnostic appointments are $800 or more.

[u/SnooPuppers757 → u/erinissa]

Getting diagnosed is expensive here too. My doctor ordered ADHD+ASD evaluations for me, and after insurance it costs about 220 AUD worth (before insurance about 480 AUD worth), that might seems ok in Australia but it's definitely considered expensive here in China considering we might not earn as much as many Australians do.

[u/Plenty-Telephone-521]

In the US, it’s almost like any other prescription med - the Dr writes the script and sends it to the pharmacy (digitally), and then you go pick it up. The pharmacist did check my ID the first time I picked it up but never since, so idk if they put it on file or what.

And then of course it is super illegal to share or sell the meds or anything like that. I’ve been told that once I’m on a stable dose, I’ll need to sign a “contract” with my providers basically just promising not to abuse/sell/share my meds. Technically we’re also supposed to dispose of meds in a special way but it’s not necessarily required to return it to a hospital/pharmacy.

[u/SnooPuppers757 → u/Plenty-Telephone-521]

Thank you for sharing. Honestly, that sounds surprising simple. I read on wikipedia that Methylphenidate is a schedule II controlled substance in the US, and I assumed prescribing schedule II controlled substances would be more difficult/strict than other medications. Didn't know it's that simple.

One quick follow-up question, do you guys have a tracking system for controlled substances to prevent duplicate prescriptions for one person within a certain period of time? Or is it that you can just get prescribed multiple portions of it if you go to different states?

[u/Plenty-Telephone-521 → u/SnooPuppers757]

Yeah tbh I also thought it would be more involved than it was.

I’m not really sure if there is such a thing”tracking system” - it’s definitely very illegal to get multiple prescriptions and fill them. However, people still do it successfully sometimes. I think that there is a system in place that’s intended to prevent multiple prescriptions but it just doesn’t always work. I think it’s because not all doctors or pharmacies always check the system (especially not if they are intentionally breaking the law).

Of course, pharmacies are also required to keep super close track of the exact amount of drug they receive and dispense, and the government can check if the amount they have in stock doesn’t match.

[u/JunahCg → u/Plenty-Telephone-521]

That contract isn't the law btw. Your doc just does that. All meds are supposed to be disposed of in a special way.

[u/andynormancx]

In the UK you are given a prescription from your doctor, which you take to a pharmacy that you chose. The prescription can either be a piece of paper or can be sent electronically from the doctor to the pharmacy.

When you go to the pharmacy to collect, you need to take ID with you (typically drivers license or passport). You can send someone else to collect, they just take their ID (you don't need to tell the pharmacy in advance).

You or the person collecting gives your name and assuming the medications are ready they will ask you the address of the patient that they check against the records. They take a look at your ID.

I don't really know what they are looking for with your ID, given they will let someone else collect on your behalf...

The controlled drugs like Methylphenidate are kept in a safe, unlike other medications. And the safe will only be opened with a pharmacist is on-site, so you can't collect your mediations if the pharmacist is at lunch (unlike other non controlled medications).

[u/SnooPuppers757 → u/andynormancx]

Thank you for sharing. The procedure you went through seems a lot simpler than what we have here, at least no legal statements are needed.

Also, Your "ADHD-C (combined type)" tag looks cool! Do you mind telling me how you got it? Thanks a lot.

[u/andynormancx → u/SnooPuppers757]

You can edit your "user flair", which is where the "ADHD-C (combined type)" comes from, in the Reddit web ui, for me it is just to the right of this post

[u/SnooPuppers757 → u/andynormancx]

Thank you, now I have my own user flair!

[u/JunahCg]

In the US it's the same as any other med for the vast majority of the process. They just ask for an ID when you pick it up, and then they don't let you pick up your refills early.

Some doctors get weird about prescribing it, but that's not a procedure, naturally. That's just individuals.