Pharmacy Shame and Adult ADHD16 Dec

Robert Wilford, Ph.D. and Sarah Ferman, Psy.D., L.M.F.T.

At first, the pharmacy tech was all smiles when she took my prescription and went to check if they had the medication on hand.  Then it started, “Oh really, it says here twice a day – I think that is too much.” “Oh yes, I will have to do some checking. Oh no, No- I don’t think that is o.k.” “This is for you?” she said surprisingly, with a scrunched face of disbelief on her forehead. “We will need to call and speak to the doctor, to make sure he knows about this dose for sure.”  “We can not fill this for you, without first consulting the doctor. You will have to come back tomorrow.”   I told her that I had just been to my psychiatrist, a 30 year Specialist in ADHD, and Yes, he did prescribe 1-2 capsules per day, and yes I was a high metabolizer, and yes that dose was what my licensed psychiatrist believed was required to provide relief from my ADHD symptoms.

“Still no, no, I will have to speak with him.  After all  this ADHD is still so very new she proclaimed, there are some companies who have age cut offs for it or if they will treat your ADHD, and some will only pay for once a day.”  Was this really happening to me a licensed psychologist running one of the most esteemed ADHD centers in California? The answer was YES.  I was being given a giant dose of pharmacy shame. That feeling I get in my gut when I know someone just thinks ADHD is something for kids, and it is just a disorder de jour.  It was then that I realized that while I am surrounded by insightful and informed colleagues all day, there is still much of the world, including the insurance companies, and apparently pharmacy technicians who still believe that Adult ADHD is not a real disorder.

Then the punch line came, “after all, I think that the world today demands too much from our kids, they were meant to be in fields, that is what our kids need today.”  Now understand that I acknowledge that my fellow ADHDers may have been better hunters than they were farmers, as far as our ability to climb the evolutionary ladder.  Hartmann’s Hunter-Gatherer theory suggests that the hyperfocus and ability to take in many sources of stimuli were essential in our evolution as nomadic hunters. He suggest that as society has moved to a more farmer linear model, the previously helpful attributes are now considered a disorder. Yet, there I was after work on a Tuesday at CVS in Van Nuys, having to defend the validity of my psychiatric diagnosis to a pharmacy technician.

The take away point for me is that Adult ADHD has come a long way in being recognized as a legitimate disorder in the medical community, and still in the everyday world, there are those that are quick to discount this disorder as something that is less than valid, that I should have grown out of, or could be cured if I were not in a world as demanding as ours. Well, the reality is I do live a demanding world. I do have commitments and deadlines, and yes, I do lots of leisurely things to relax including exercise and eating well.  But I don’t have another 1000 years to evolve into a person with less ADHD. I have adult ADHD that deserves to be treated with the sufficient respect and dignity of other disorders that cause as much difficulty as does my ADHD.   Adult ADHD like most things in life, in that it looks unique for every person, and is measured along a spectrum from mild to severe. For many adults living with ADHD, medication is a lifeline to capability and thriving in the world. The stigma about adult ADHD is not gone, and so I say to my fellow ADHD’ers fight back and stand strong. My fellow ADHDers we have come a long way, and the battle for equity in treatment is still upon us. Adult ADHD is real, and life I guess is just hard enough without having to deal with an unwanted dose of “pharmacy shame”.

I would like to hear your thoughts and experiences with pharmacies and /or ADHD skeptics.  Leave your comments…

3 Responses to “Pharmacy Shame and Adult ADHD”

  1. Gina Pera

    Hi Robert,

    It’s amazing that pharmacist made it through pharmacy school with such hidebound attitudes. Fortunately, in my ten years of guiding adults and their partners through the ADHD maze (evaluation, treatment, etc.), I’ve never heard such an egregious pharmacy-related report. Lucky you. :-)

    It’s ironic, though, that you defend Hartmann’s hypothesis, in so much as they encourage such baseless perceptions.

    The geneticists I know say the case is completely without merit. Moreover, I find that such fanciful tales have indeed contributed to the very prejudice you encountered when picking up your prescription medication, especially when it comes to children. Tragically, this too often means that proper ADHD treatment strategies are delayed often well into adulthood, when the emotional baggage has accumulated and the door for reaching certain developmental milestones has long shut.

    Even on the face of it, Hartmann’s hypothesis makes little sense. With all the distractions, multi-tasking requirements, etc. of our modern world, how on earth can anyone call our lives “linear”? And if hunters of yore were so easily distracted from their goal as some adults with untreated ADHD are — by every little sidetracking stimulation in the environment — they wouldn’t have eaten for long. More like, been eaten.

    Genetic mutations happen. There isn’t always an advance-the-evolution case to be made for them. As long as the mutation doesn’t cause death before an opportunity for pro-creation, it remains in the gene pool. This is especially true when that mutation is associated with sexual precociousness, pregnancy at an earlier age, and multiple sex partners (as ADHD is associated). Thus, mutations can proliferate widely in the gene pool, perhaps more quickly than mutations that are associated with more caution and reserve.

    Gina Pera, author
    Is It You, Me, or Adult A.D.D.?

  2. Scarlett Martin

    Tonight I went to a walk in clinic to get a refill of my Vyvanse. I am from out of town and CA pharmacies will not fill prescriptions from out of state. My insurance won’t let me fill more than 30 days at a time, so if I am in CA when my 28 -30 days are up (you can refill 2 days early) then I have to go to a doctor to get a prescription. I went to the same walk in clinic where I went last year and the doctor there not only refused to refill my Vyvanse prescription he actually compared me to a methodone user!!! He said I am not comfortable refilling this and I won’t do it. Then he added something along the lines of “Do you think you should be able to just come in and tell me you want a refill on your methodone prescription?” You need to go to your primary care doctor. If he’d been paying attention he’d realize that my primary care doctor is in another state. I was SO INSULTED by his treatment of me I am still furious over an hour later. I didn’t move here, I just happen to be here now because my son is an actor. He really treated me like a drug seeking addict like you’d see on ER lying about their symptoms so they can get more oxycodone. I am livid.

  3. Robert Wilford, Ph.D.

    Thank you Scarlett for sharing your experience. It is unfortunate that people still rely on shame and not on science when it comes to dealing with ADHD. If you were diabetic, I would doubt that you would have had such a shameful response.

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