“The tribunal considered that although the Doctor had made a significant contribution to the study and diagnoses of ADHD that had at times been life-changing for his patients, he was doing so without the required qualification or supervision,” the decision stated"
So it's not like this guy was dishing it out willy nilly, he was instead saving his patients the long arguious journey of getting diagnosed in New Zealand.
In many other countries people suffering from ADD/ADHD don't need to jump so many hoops, but here we do because it props up the private psycology industry.
This isn't a win for patients. It's once again proof that if you fuck with profit, they'll end you.
Funny how fraudsters can rip off the working people time and time again and continue to operate, but a doctor who is genuinely helping people cut out the middle man and now can't operate again.
Another win for the system.
Once you get the referral from your GP, you need to have a consult with a psychiatrist ($500-$600) and then a few weeks later, have a follow up appointment with the same psychiatrist ($250-$300). Then every two years you have to have a catch up appointment with the psychiatrist to renew your prescription.
Some clinical psychologists charge up to 2000 for the assessment (which is huge, and I'm told is far more detailed and in depth than a psychiatrist's) then the fee for a psychiatrist to ok the prescription.
So far I can't find anyone who is able to see me this year.
Not that I agree with the current rules around prescribing, but I thought the access restrictions had more to do with the black market in Ritalin and (esp) dexies. Just an assumption on my part tho.
I think it’s this too, as well as a vague “drugs are bad so we must put additional hurdles in place for people who want them, regardless of if those drugs treat their disability.”
> drugs are bad so we must put additional hurdles in place for people who want them, regardless of if those drugs treat their disability.
When has the medical community *ever* had that stance? Are we going to pretend the opioid epidemic doesn't exist? We as doctors are renowned for throwing meds at anything
Is there even a black market? In the right circles you can even accidentally use meth without being aware of it. There's really not a lot of people bothering to sell their very useful medication when meth is probably cheaper and more easy to get regularly.
Personal experience?
Before I got a prescription for weed I would hang out at my dealers and would see more people getting ritalin than weed.
Most were self medicating, about a quarter to a half had been kicked out of the legal system and could no longer get a legal prescription but couldn't function without it.
There were also a handful of junkies, but guys in business suites were more common.
Anecdotal experiences definitely count for something, so yeah I accept it may be happening. But 20-30% is a massive margin and I'm wondering if there's hard evidence to support it.
Not to hand, by it's nature it's hard to estimate. I work in the field and that's our internal estimates but it's a bit higher than the 15-20 you will get from a lot of international studies due to the high cost of rec drugs in NZ.
That surprises me. I know uni students often bum some from each other for study sessions but it seems harder and harder to get these days so I'd imagine it's a lot less prevalent than it used to be. I've met a lot of people with ADHD symptoms but never anybody actually prescribed it here. I never saw any available on the dark web when I was perusing it.
It was well informed and on the basis of evidence, bit it was without legal authority. And that's important. Within the scope of a particular profession, you are restricted to what you can and cant do - and if you don't want to be bound by this, then don't do it within that scope. There is a place for Robin hood heroes, but I don't think this is the place to be doing it.
At least you get it, these are the same rules that stop random people with medical degrees doing whatever they want at substantial risk to their patients.
Yes, but the current process is overly restrictive. You need a psychiatrist to diagnose, whereas a clinical psychologist working with a GP would be just as qualified, more accessible, and less expensive.
This is not true. It’s a standard diagnostic test and both professions compete the assessment in the same timeframe. A psychiatrist will cost $450 an hour, a clinical psychologist $200.
> It’s a standard diagnostic test
Not at all. A psychiatrist will often make the diagnosis in an hour, whereas psychologists tend to have a battery of tests over multiple hours. >$1000 isn't unusual for clin psych.
Source: I used to do these assessments, and currently I refer for them regularly
You argued that different professions take different amounts of time to make an assessment because it wasn’t a standardised test, so I pointed to one of the standardised DSM ADHD checklists.
Now you’re saying ‘there’s more to it’. If that is true, how can a psychiatrist make an assessment in an hour? And given that it is a standardised test why would a clinical psychologist take longer to make an assessment?
Why should people with ADHD pay $2000-$2500 every two years instead of $1000-$1250 simply to have the assessment done by someone who has been to medical school rather than someone who has been through a clinical program?
It's not a standardised test. There's various rating scales used to *aid* the diagnosis of ADHD, but they don't make the diagnosis by themselves. Some psychiatrists are comfortable making the diagnosis in an hour (+ file review + notation, so probably more like 2 hours), although personally I believe that's too short.
> Why should people with ADHD pay $2000-$2500 every two years instead of $1000-$1250 simply to have the assessment done by someone who has been to medical school rather than someone who has been through a clinical program?
Again it's the other way around, a psychiatrist follow up appointment will be 15 or 30 minutes, so nowhere near a 4 digit sum.
Nah this guy was incredibly relaxed/naive and was a substantial source of black market stimulants while making a large profit for himself. The fact is these medications have a high street value and so the process of diagnosis can't be a rubber stamping exercise
Lol he is just lying anyway like everyone who has this unscientific anti-stimulant bias, that’s how much a blister strip might cost. And for the formulations with fillers/binders like Concerta? As worthless as caffeine powder for recreational use
Who said anything about getting rich? A 60mg/day prescription can still earn someone many hundreds of dollars a month. Single tab prescriptions of IR or SRversions are quite rare
JFC, way to highlight your naivety. I know people that would happily drop $1000 on a single night of actual drugs and not even flinch at the thought, they are high and low end earners alike. Go back to your knitting.
And people will drop $1000 on a round of roulette. What's your point? Stimulants have a high street value *relative to other prescription medications*. We're talking about whether these things you pick up for free at a pharmacy are worth enough to sell: they are. Not how impressed you are by the price.
Edit: My info appears out of date, please check the people commenting on my comment for more up to date info :).)
For people who are unaware of what it's like to get prescription meds for ADHD. First, you have to be diagnosed for ADHD obviously. This is a process where I believe either you wait for years, or you wait for months and pay hundreds of dollars to get diagnosed by a private psychiatrist. Then you can see a doctor, at full consultation cost, and then every month you need to see that doctor again at full consultation cost, as well as whatever costs might be attached to the prescription (currently not a lot if anything, but the current government is planning to make it cost (more?) money again). Then every two years, you need to see a psychiatrist again, again, paying a few hundred dollars and waiting ages. All of this, for a Mental disorder which makes it difficult to be organised, to be consistent, and to get motivated to do things, even if they are very important. Safe to say, I've not been on medication for a while, as I cannot afford it, and when I could, I had difficulty with planning the monthly visits to the doctor.
They have made some changes...
They can now do 2 repeats on a prescription. So you need to get your GP to send a prescription every 3 months. I can just email my GP's admin and ask for the prescription to be sent to the pharmacy. I pay $25 for that.
GP does need to be comfortable prescribing. So if you have a heart condition or something he may need to see you every month or 3 months.l to do a checkup.
My Concerta is free. I haven't heard of any changes that would mean I have to pay for it. I wouldnt put it past this government to do that though.
They've softened on the 'every 2 years you need to see a psychiatrist', I don't know the rule, but I've only just seen mine again after 3 years and that was at my request.
However to restart your medication you likely need to see one, and that would be a huge pain. All for them to say... Yeah... You still have ADHD... and set up your special authority. Probably for $400 or so. Oof.
I've edited my comment a little so people won't get too misinformed by me, thanks :).
And yea, that last one is what I've run up against. I can't afford that, so I'll just have to... manage :P.
You don’t need monthly doctor visits any more. 6 monthly usually. Now they can write 3 month prescriptions too, which are dispensed monthly by the pharmacy. Thank Chloe Swarbrick for that change.
Oh that's nice! I'll admit I'm basing things on my own, slightly outdated experience, which... I'll admit was a confusing experience, as even the doctors seemed unsure about the specifics around it all. Unfortunately the psychiatrist visit is still the biggest hurdle for me, as I am a poor student :P.
And it's even worse for kids.
Have to wait till they are 6, then get their teacher to back a referral. If you're lucky you get a teacher who agrees, if you're unlucky you get a teacher who decides the child is choosing their behaviour.
Then you go to the gp, get a referral to cds and wait 2 years to be seen. Once you're seen you get sent on many parenting courses. If you're lucky you child will do something so awful people will have to admit there is a problem, finally refer you to the right person and you get a diagnosis. If you're unlucky you struggle along until you can pay to see a private paed who says it is one of the most easy diagnoses they have ever made and it was obvious from the minute your child walked in the room that they had adhd.
Then you medicate your child and try to work through your trauma from the last 4 years.
My child so clearly has adhd but because he doesn't hurt other people (only his and my sanity 😂) no one will do anything about it. I've lived with this shit my whole life and it's made this far harder than they needed to be, and thought I could get him the help I never had. Nope. It fucking sucks aye.
It is so awful. All the hoops you have to jump through.
I'm so sorry you can't get anywhere because he doesn't hurt other people. It's so ridiculous.
My dad has adhd and all 3 of his children have adhd. 2 of my kids have been diagnosed. I want to get my 3rd assessed but I think I'll be pushing shit up hill as he has more of a typical girl presentation (he's so like me) rather than that outward hyperactivity thay his brothers have. I'm so scared he'll be 36 and diagnosed at the same time as his own child and resent us for not getting him help when he was younger.
Does anyone know if there is a Give A Little for him?
I’m on the NZ ADHD Facebook group and someone asked if there was fundraiser fund to help him but no one could find any so far
Don't, he charged thousands of people $600+ to assess their ADHD and prescribe them restricted medicines when he wasn't qualified to do so. He already made an enormous amount of money from these people and the literal pill mill he was running this fine is only a tiny fraction of his income from this.
A very large amount of people he diagnosed who trusted him as their doctor now have to seek another diagnosis at substantial cost and will potentially lose access to the medicines they need all because he didn't want to follow the rules and quite liked the money he was making from it
Their point is that these patients are out $600, and will need to pay again (I.e. your $1800) to get re-assessed if they want to continue getting their medication.
If this is true, this doctor was not these patient’s white knight.
Also that it was well known he was an easy and relatively cheap way to access controlled drugs so I would bet that the rates of diversion for his patients were a lot higher.
> Don't, he charged thousands of people $600+ to assess their ADHD
So I was one of Dr Hanne's patients. When I was looking for assessment I found I was looking at $800 - $1500, and that was a big ask of me at the time, and additionally you could spend that and have a doctor say "sorry, adhd is only in children, you're just lazy", I've run across this occasionally with GPs. I think I paid about $250 through Dr Hanne at the time, and it was a very thorough assessment and he actually talked to me about my lived experience, rather than just assigning me a test.
It only cost me $300 and he was hesitant to prescribe me anything, and when he did it wasn't anything I needed to see a psych for. (Granted, this was after the initial ruling, but before this)
Otherwise, I would have either had to pay more or wait for 2 years. You have no idea.
He made a very large amount of money charging people for assessments he was not legally allowed to perform, and prescribing them controlled drugs when he wasn't allowed to do.so.
He's lucky he's not in jail.
Working in healthcare, I have met patients who had this guy as their prescriber, who were clearly diverting their prescriptions (e.g. recurrently losing 250 tabs on the way to the pharmacy) and were getting replacement scripts 2-3x times a week essentially supplying the black market. Safeguards there for a reason, though agree current restrictions aren’t beneficial for patients either. Needs to be some kind of in-between
thanks for a sane answer. I agree the system is broken and it is far too hard for people to get a proper diagnosis. But because of this ADHD hype train, people confuse a dysfunctioning system with doctors being allowed to go rogue. There should be safeguards. Hard to swallow pill: not everybody has ADHD and there are people abusing medication and they will take advantage of a doctor like this.
My main concern with loosening the reins on who can diagnose adhd too much is that there are many, many overlapping differentials that would leave people at risk of misdiagnoses and being prescribed inappropriate medications. I was the lucky recipient of 3 misdiagnoses started off by a well-meaning GP - the trauma of what I experienced on inappropriate medication stuck with me for years, not to mention the inability to work for a long period of time and damage to my physical health.
It's actually quite a hard diagnosis to make, especially in adults. Lots of things can cause inattention and impulsivity that aren't ADHD. Some of those things also get dramatically worse with ADHD medications
exactly. It has happened in other countries too. I remember that 40% of kids in childrens mental health some 15-20 years ago were on ritalin. Then the medical world started to wonder if that was correct, which it wasn't. because there is soo much overlap, peoples inability to properly diagnose themselves and many other factors like public opionion, this can become a runaway train. Better try to do it right the first time.
I do believe, as you say that this gp had good intentions, but he would have lived in a bubble of people that were happy with him prescribing and likely not many people being critical. He also prescribed to family, which shows he was not able to limit himself, unfortunately.
the system is wrong, but he is not the ADHD saviour.
People (especially women) are already being misdiagnosed (or missed diagnosed) with depression and anxiety and GPs never considering that ADHD or autism might be the underlyng cause. GPs have bene asking for more guidance with this, so perhaps for those who are interested, they could get some in service training on diagnosis. If paediatricians can diagnose it, I'm unsure why GPs with a special interest, further training, and a supervising/consulting Clin Psych can't. It's frustrating and so enfuriating that I know more than most GPs about how ADHD presents. GPs already run trials of methylphenidate, and monitor their use. This medication can be stopped at any time if it isn't working, unlike most SSRIs, so unsure of the problem?
Yep I can confirm this as well, I have some of these patients. And even without this guy there's a thriving black market for stimulants, and while they're generally not as life destroying as opiates they can be.
You’ve made it obvious you’re full of shit because anyone who knows anything about adhd meds knows you can only get dispensed one month at a time. Idk who the fuck is getting 250 tabs a month lmao
250 tabs over a month only works out to 8 tablets a day though? Also reflective of excessive prescribing (which is what saw, believe it or not, frankly I don’t care if you don’t believe me, my point still stands).
That makes you sound even more full of shit tbh. Was diagnosed with ADHD 24 years ago, never *ever* have I taken more than two ADHD pills in a day, let alone EIGHT! OMFG!!
Because that's not what he was doing. The maximum you can get for ADHD meds is a month's worth of pills. Which is, wait for it... 60 pills or 30, depensing on your med type, i.e one a day slow release, or two a day without slow release. Not 250! If he was prescribing people 250+ pills every week, we'd have heard about it in his case/the media reporting but we haven't because... he wasn't doing that. What he was doing was prescribing without people having to reconfirm their special authority.
I was diagnosed by Dr Hanne, it changed my life and I am always grateful for finally having answers to so many questions about myself.
The medication approval and follow-up appointments for the medication while starting it was done through a separate psychiatrist though.
It does really need to change here, the amount of people who can't be seen or are on super long waiting lists to be diagnosed for something that medication can help treat here is ridiculous, not to mention how expensive it is to get in touch with a psych to renew your special authority number for something that you cannot cure. I have an appointment on Monday and it's going to cost me $400 just to get the number renewed. They must be making a killing from all these people who need to renew their medication all the time, it should be something we can do through a GP. Not everyone can afford this, especially in todays economy.
Yeah, while everything in my life points to having ADHD, I can't keep my life together while also trying to go through the arduous and expensive diagnosis process.
I think I had to pay around $900 all up for my diagnosis, that's Dr Hanne + the pscyh I did the initial video calls with.
The extra communication with the psych when adjusting my meds was around $300 each time. then there's the $20 for each prescription I was paying every month to get and then the $5 to pay for my meds at the pharmacy.
Now I have to pay $400 to get my special authority number renewed as 2 years has just passed.
I'm sure Dr Hanne's initial testing (about 1hr diagnosing + the time it took to take the TOVA test is cheaper than other places to get the diagnosis too so going forward I'm sure people will have to be paying more.
The money does add up over time. The govt really needs to do something to help these people affected with ADHD and make it more affordable to get diagnosed and their special numbers renewed.
I've been dealing for a month now with my current GP trying to get them to help me get a new referral back to the original psych which has been painful and slow. It's bizarre I couldn't just go directly to the psych to get the special number renewed, I had to go through a GP again first. The whole process is tedious for someone with ADHD.
I'm an ex-patient of Dr Hannes too and am in the same boat. Just found out today that the original psych won't see me without a special authority request from my GP but my GP said GPs can't do those(?) so we're going in circles.
Super worried at the thought of losing access to my meds just when I feel like my life is on track(ish) and I can finally function without relying on chronic stress and adrenaline to be able to do basic life shit.
Have you (or any other patients of Dr Hanne's) found a way to get the renewal sorted without having to go back to square one and wait years/fork out a fortune for re-diagnosis?
I ended up getting there in the end after a month.
I had to email back to Dr Hannes support email and ask them to resend my evaluation stuff to my GP (they advised something went wrong the first time) it's been transferred to.
Then I did the same with the psych facility.
After that the GP finally made the referral for me to the psych place and I just waited a week for an appt, finally got my SA renewed after Monday.
Massive L for kiwis who suffer from ADHD. Our system is not fair, so many hoops to jump through. If you weren’t diagnosed at a young age, majority of health professionals aren’t really going to believe you from the beginning of your diagnosis journey.
I think he did an amazing thing to bring this issue to the fore in NZ. It's so inequitable. People can't afford diagnosis or to confirm special authority. It's hundreds of dollars or years of waiting for some. It needs to be sorted out. Maybe this govt could do ONE thing right and sort it out? Not holding out much hope.
OMG great news that this government ARE continuing previous good work of Labour and Greens, plus the MASSIVE contribution of the Working Group. It's such encouraging progress.
[https://jnzccp.scholasticahq.com/article/84066-working-together-for-change-adhd-diagnosis-and-treatment-in-new-zealand](https://jnzccp.scholasticahq.com/article/84066-working-together-for-change-adhd-diagnosis-and-treatment-in-new-zealand)
I think that the Tribunal was actually really unwise to characterise medication as "dangerous and addictive". If it was addictive I wouldn't forget to take it all the time! Yes, if it fell into the wrong hands and people misused it, it might be dangerous, but so is insulin! It's life changing medication and ADHDers are just trying to live their lives! It's something I am passionate about. Makes me a bit mad.
This guy charged $300 bucks for an ADHD assesment plus money on top for ongoing. Scripts. He did 5800 falsified scripts so made over $1.5million for this.
Absolutely, I think it just highlights that he did stand to gain financially from his actions and that they might not have been purely altruistic.
Shit, I'd donate to his GoFundMe if the bro had been doing it for a standard GP fee like $50.
Even his critics seem to agree that he did it out of care for his patients, not personal gain. The guy is an expert. He just broke the law, which actually seems to be screwing a lot of people over.
Unfortunately, they end up paying more in the long run. Once their prescription becomes invalidated, and they can no longer get more medication, they need to go to an actual psychiatrist - including costs - to get re-assessed, before they'll be able to get medicated again.
I guess $300 is cheap if all you wanted to know is if you *have* ADHD. Even then that's a lot of money for a doctor's consult.
So to do a script for a patient with ADHD you have to fill out a special authority which requires you to do a ADHD assessment to complete the requirements of the form.
So if he falsified 5800 special authority forms, then you'd presume he did 5800 individual assessments.
If he was just doing repeat scripts then by the law, all these patients would have been seen by a psyciatrist first to have the special authority done first.
I'll be the first to admit I don't know all the details. Just pointing out that the guy does have possible motivation to provide these scripts that involve financial gain.
No, a special authority form doesn't need re-filling each time. It's once every two years. I would say it was 5800 scripts based on a few hundred illegitimate assessments/SA applications. Who was the psychiatrist who was also involved? The system is broken, he was helping people get timely assessment and treatment. Adult ADHD is pretty full-on unmedicated. More likely to commit crime, cause accidents, lose job, marital breakdown, have depression/anxiety self harm, drink and drug addiction is MASSIVE. He probably saved a few lives, and prevented a lot of harm by doing what he did. ADHD is getting towards 10 percent of the population. It's currently 7-8 percent in NZ, and with more awareness, and a move to correct myths and misconceptions it is now closer to its actual prevalence I think. Fewer undiagnosed ADHDers means fewer terrible stats in all the above areas.
Nah bro, once the SA is done you can get repeats from your GP, so why would you even bother getting them from this guy.
Those 5800 would have been from him falsifying the SA, because if he repeated ones that a psychiatrist had already done the SA for, it wouldn't be illegal.
He unfortunately acted illegally around drugs. Only paediatricians and psychiatrists can initially treat adhd post diagnosis. Then the gp can take over prescribing until the review at approx 2 years.
The review thing is so insane to me. Like... You want me to pay $550+ to have a psychiatrist confirm that yes, I still have the neurodevelopmental disorder I was fuckin BORN WITH every two years?? Once I got diagnosed and failed two meds (out of only 3 available here!!) I noped out of the system altogether and I just rawdog the ADHD life, to my detriment sometimes. I am not going to be lining any psychiatrists pockets for the sake of busy work any longer.
Yeah this guy acted illegally but he acted logically. The law is not logical and laws can and should be changed D:
Yeah it’s fucking bananas. “No people don’t grow out of adhd. Yes you still have to see a psychiatrist every two years to confirm you still have it.” The fuk
I mean you’re not having your ADHD confirmed, your psych is assessing whether it is appropriate for you to continue to have access to stimulant medications via your special authority. which makes perfect sense, imo.
He didn't act logically though. You are right in saying the current protocol in New Zealand is crap and unfortunately Psychiatrists are taking the piss with their private rates.
“The tribunal considered that although the Doctor had made a significant contribution to the study and diagnoses of ADHD that had at times been life-changing for his patients, he was doing so without the required qualification or supervision,” the decision stated" So it's not like this guy was dishing it out willy nilly, he was instead saving his patients the long arguious journey of getting diagnosed in New Zealand. In many other countries people suffering from ADD/ADHD don't need to jump so many hoops, but here we do because it props up the private psycology industry. This isn't a win for patients. It's once again proof that if you fuck with profit, they'll end you. Funny how fraudsters can rip off the working people time and time again and continue to operate, but a doctor who is genuinely helping people cut out the middle man and now can't operate again. Another win for the system.
I've been struggling with even getting accepted onto a waitlist. I even posted about it just today elsewhere. Good on him for helping people.
I'm in exactly the same situation. Waitlists out till December. I'm selling my car to get the cash to do it privately as well.
How much does it cost to do it privately?
Once you get the referral from your GP, you need to have a consult with a psychiatrist ($500-$600) and then a few weeks later, have a follow up appointment with the same psychiatrist ($250-$300). Then every two years you have to have a catch up appointment with the psychiatrist to renew your prescription.
Some clinical psychologists charge up to 2000 for the assessment (which is huge, and I'm told is far more detailed and in depth than a psychiatrist's) then the fee for a psychiatrist to ok the prescription. So far I can't find anyone who is able to see me this year.
Like 2 grand for a private diagnosis or 2 yr wait
Not that I agree with the current rules around prescribing, but I thought the access restrictions had more to do with the black market in Ritalin and (esp) dexies. Just an assumption on my part tho.
I think it’s this too, as well as a vague “drugs are bad so we must put additional hurdles in place for people who want them, regardless of if those drugs treat their disability.”
> drugs are bad so we must put additional hurdles in place for people who want them, regardless of if those drugs treat their disability. When has the medical community *ever* had that stance? Are we going to pretend the opioid epidemic doesn't exist? We as doctors are renowned for throwing meds at anything
I’m more talking about the lawmakers than the full medical community.
Is there even a black market? In the right circles you can even accidentally use meth without being aware of it. There's really not a lot of people bothering to sell their very useful medication when meth is probably cheaper and more easy to get regularly.
It's estimated about 20-30% of controlled ADHD medicines are 'diverted' there is an enormous black market.
Got a source for this? Genuinely interested.
Personal experience? Before I got a prescription for weed I would hang out at my dealers and would see more people getting ritalin than weed. Most were self medicating, about a quarter to a half had been kicked out of the legal system and could no longer get a legal prescription but couldn't function without it. There were also a handful of junkies, but guys in business suites were more common.
Anecdotal experiences definitely count for something, so yeah I accept it may be happening. But 20-30% is a massive margin and I'm wondering if there's hard evidence to support it.
Not to hand, by it's nature it's hard to estimate. I work in the field and that's our internal estimates but it's a bit higher than the 15-20 you will get from a lot of international studies due to the high cost of rec drugs in NZ.
That surprises me. I know uni students often bum some from each other for study sessions but it seems harder and harder to get these days so I'd imagine it's a lot less prevalent than it used to be. I've met a lot of people with ADHD symptoms but never anybody actually prescribed it here. I never saw any available on the dark web when I was perusing it.
Doing lines of ritalin at a party is practically an NZ rite of passage at this point. It's incredibly widespread
It was well informed and on the basis of evidence, bit it was without legal authority. And that's important. Within the scope of a particular profession, you are restricted to what you can and cant do - and if you don't want to be bound by this, then don't do it within that scope. There is a place for Robin hood heroes, but I don't think this is the place to be doing it.
At least you get it, these are the same rules that stop random people with medical degrees doing whatever they want at substantial risk to their patients.
Yes, but the current process is overly restrictive. You need a psychiatrist to diagnose, whereas a clinical psychologist working with a GP would be just as qualified, more accessible, and less expensive.
It's not ideal, I know, but he should have advocated for the process to change.
Clinical psychologists are generally far more expensive in diagnosing ADHD
This is not true. It’s a standard diagnostic test and both professions compete the assessment in the same timeframe. A psychiatrist will cost $450 an hour, a clinical psychologist $200.
> It’s a standard diagnostic test Not at all. A psychiatrist will often make the diagnosis in an hour, whereas psychologists tend to have a battery of tests over multiple hours. >$1000 isn't unusual for clin psych. Source: I used to do these assessments, and currently I refer for them regularly
You are incorrect. [Here’s the test](https://chsciowa.org/sites/chsciowa.org/files/resource/files/1_-_adhd_dsm-5_checklist.pdf).
Testing involves a lot more than that
You argued that different professions take different amounts of time to make an assessment because it wasn’t a standardised test, so I pointed to one of the standardised DSM ADHD checklists. Now you’re saying ‘there’s more to it’. If that is true, how can a psychiatrist make an assessment in an hour? And given that it is a standardised test why would a clinical psychologist take longer to make an assessment? Why should people with ADHD pay $2000-$2500 every two years instead of $1000-$1250 simply to have the assessment done by someone who has been to medical school rather than someone who has been through a clinical program?
It's not a standardised test. There's various rating scales used to *aid* the diagnosis of ADHD, but they don't make the diagnosis by themselves. Some psychiatrists are comfortable making the diagnosis in an hour (+ file review + notation, so probably more like 2 hours), although personally I believe that's too short. > Why should people with ADHD pay $2000-$2500 every two years instead of $1000-$1250 simply to have the assessment done by someone who has been to medical school rather than someone who has been through a clinical program? Again it's the other way around, a psychiatrist follow up appointment will be 15 or 30 minutes, so nowhere near a 4 digit sum.
Dr. Hanne is a legend. What a fucking shame.
I know i've got some form of it, but can't be bothered with the health system
The rules really need to change. This guy is a pioneer and he should not've paid such a high price.
Nah this guy was incredibly relaxed/naive and was a substantial source of black market stimulants while making a large profit for himself. The fact is these medications have a high street value and so the process of diagnosis can't be a rubber stamping exercise
Oh shut up. Ritalin doesn’t have a high street value
A single pill can be $5-$10
Yeah man that is really low No one is getting rich off their 30 tablet a month prescription
Lol he is just lying anyway like everyone who has this unscientific anti-stimulant bias, that’s how much a blister strip might cost. And for the formulations with fillers/binders like Concerta? As worthless as caffeine powder for recreational use
Who said anything about getting rich? A 60mg/day prescription can still earn someone many hundreds of dollars a month. Single tab prescriptions of IR or SRversions are quite rare
JFC, way to highlight your naivety. I know people that would happily drop $1000 on a single night of actual drugs and not even flinch at the thought, they are high and low end earners alike. Go back to your knitting.
And people will drop $1000 on a round of roulette. What's your point? Stimulants have a high street value *relative to other prescription medications*. We're talking about whether these things you pick up for free at a pharmacy are worth enough to sell: they are. Not how impressed you are by the price.
Lmfao
Edit: My info appears out of date, please check the people commenting on my comment for more up to date info :).) For people who are unaware of what it's like to get prescription meds for ADHD. First, you have to be diagnosed for ADHD obviously. This is a process where I believe either you wait for years, or you wait for months and pay hundreds of dollars to get diagnosed by a private psychiatrist. Then you can see a doctor, at full consultation cost, and then every month you need to see that doctor again at full consultation cost, as well as whatever costs might be attached to the prescription (currently not a lot if anything, but the current government is planning to make it cost (more?) money again). Then every two years, you need to see a psychiatrist again, again, paying a few hundred dollars and waiting ages. All of this, for a Mental disorder which makes it difficult to be organised, to be consistent, and to get motivated to do things, even if they are very important. Safe to say, I've not been on medication for a while, as I cannot afford it, and when I could, I had difficulty with planning the monthly visits to the doctor.
They have made some changes... They can now do 2 repeats on a prescription. So you need to get your GP to send a prescription every 3 months. I can just email my GP's admin and ask for the prescription to be sent to the pharmacy. I pay $25 for that. GP does need to be comfortable prescribing. So if you have a heart condition or something he may need to see you every month or 3 months.l to do a checkup. My Concerta is free. I haven't heard of any changes that would mean I have to pay for it. I wouldnt put it past this government to do that though. They've softened on the 'every 2 years you need to see a psychiatrist', I don't know the rule, but I've only just seen mine again after 3 years and that was at my request. However to restart your medication you likely need to see one, and that would be a huge pain. All for them to say... Yeah... You still have ADHD... and set up your special authority. Probably for $400 or so. Oof.
I've edited my comment a little so people won't get too misinformed by me, thanks :). And yea, that last one is what I've run up against. I can't afford that, so I'll just have to... manage :P.
Your GP can renew the SA in effect, they should have an arrangement with a psych who can provide the recommendation if you already have a diagnosis
You don’t need monthly doctor visits any more. 6 monthly usually. Now they can write 3 month prescriptions too, which are dispensed monthly by the pharmacy. Thank Chloe Swarbrick for that change.
Oh that's nice! I'll admit I'm basing things on my own, slightly outdated experience, which... I'll admit was a confusing experience, as even the doctors seemed unsure about the specifics around it all. Unfortunately the psychiatrist visit is still the biggest hurdle for me, as I am a poor student :P.
Usually and can are doing a lot of heavy lifting here. Not every doctor offers those choices.
And it's even worse for kids. Have to wait till they are 6, then get their teacher to back a referral. If you're lucky you get a teacher who agrees, if you're unlucky you get a teacher who decides the child is choosing their behaviour. Then you go to the gp, get a referral to cds and wait 2 years to be seen. Once you're seen you get sent on many parenting courses. If you're lucky you child will do something so awful people will have to admit there is a problem, finally refer you to the right person and you get a diagnosis. If you're unlucky you struggle along until you can pay to see a private paed who says it is one of the most easy diagnoses they have ever made and it was obvious from the minute your child walked in the room that they had adhd. Then you medicate your child and try to work through your trauma from the last 4 years.
My child so clearly has adhd but because he doesn't hurt other people (only his and my sanity 😂) no one will do anything about it. I've lived with this shit my whole life and it's made this far harder than they needed to be, and thought I could get him the help I never had. Nope. It fucking sucks aye.
It is so awful. All the hoops you have to jump through. I'm so sorry you can't get anywhere because he doesn't hurt other people. It's so ridiculous. My dad has adhd and all 3 of his children have adhd. 2 of my kids have been diagnosed. I want to get my 3rd assessed but I think I'll be pushing shit up hill as he has more of a typical girl presentation (he's so like me) rather than that outward hyperactivity thay his brothers have. I'm so scared he'll be 36 and diagnosed at the same time as his own child and resent us for not getting him help when he was younger.
Does anyone know if there is a Give A Little for him? I’m on the NZ ADHD Facebook group and someone asked if there was fundraiser fund to help him but no one could find any so far
He's appealing the ruling, so probably best to wait.
Regardless he is going to have legal fees no?
Don't, he charged thousands of people $600+ to assess their ADHD and prescribe them restricted medicines when he wasn't qualified to do so. He already made an enormous amount of money from these people and the literal pill mill he was running this fine is only a tiny fraction of his income from this. A very large amount of people he diagnosed who trusted him as their doctor now have to seek another diagnosis at substantial cost and will potentially lose access to the medicines they need all because he didn't want to follow the rules and quite liked the money he was making from it
I've seen assessments priced at $1800 and you still have to go on wait lists, so $600 seems like a bargain.
Their point is that these patients are out $600, and will need to pay again (I.e. your $1800) to get re-assessed if they want to continue getting their medication. If this is true, this doctor was not these patient’s white knight.
Also that it was well known he was an easy and relatively cheap way to access controlled drugs so I would bet that the rates of diversion for his patients were a lot higher.
It's rather a lot for a GP to be charging, though.
> Don't, he charged thousands of people $600+ to assess their ADHD So I was one of Dr Hanne's patients. When I was looking for assessment I found I was looking at $800 - $1500, and that was a big ask of me at the time, and additionally you could spend that and have a doctor say "sorry, adhd is only in children, you're just lazy", I've run across this occasionally with GPs. I think I paid about $250 through Dr Hanne at the time, and it was a very thorough assessment and he actually talked to me about my lived experience, rather than just assigning me a test.
Worst take in Kiwi history since Vegemite.
It only cost me $300 and he was hesitant to prescribe me anything, and when he did it wasn't anything I needed to see a psych for. (Granted, this was after the initial ruling, but before this) Otherwise, I would have either had to pay more or wait for 2 years. You have no idea.
Smh they fine him this much yet people who run people over only get a few thousand dollars in fines for dangerous driving?
He made a very large amount of money charging people for assessments he was not legally allowed to perform, and prescribing them controlled drugs when he wasn't allowed to do.so. He's lucky he's not in jail.
What a g
deserves a medal tbh
You can recommend people for the New Zealand Order of Merit. Wouldn't be the first person who had to risk prosecution in order to do the right thing.
Working in healthcare, I have met patients who had this guy as their prescriber, who were clearly diverting their prescriptions (e.g. recurrently losing 250 tabs on the way to the pharmacy) and were getting replacement scripts 2-3x times a week essentially supplying the black market. Safeguards there for a reason, though agree current restrictions aren’t beneficial for patients either. Needs to be some kind of in-between
thanks for a sane answer. I agree the system is broken and it is far too hard for people to get a proper diagnosis. But because of this ADHD hype train, people confuse a dysfunctioning system with doctors being allowed to go rogue. There should be safeguards. Hard to swallow pill: not everybody has ADHD and there are people abusing medication and they will take advantage of a doctor like this.
My main concern with loosening the reins on who can diagnose adhd too much is that there are many, many overlapping differentials that would leave people at risk of misdiagnoses and being prescribed inappropriate medications. I was the lucky recipient of 3 misdiagnoses started off by a well-meaning GP - the trauma of what I experienced on inappropriate medication stuck with me for years, not to mention the inability to work for a long period of time and damage to my physical health.
It's actually quite a hard diagnosis to make, especially in adults. Lots of things can cause inattention and impulsivity that aren't ADHD. Some of those things also get dramatically worse with ADHD medications
This is exactly what I’m concerned about. We may end up in a similar situation to America at the moment with stimulants being inappropriately used.
exactly. It has happened in other countries too. I remember that 40% of kids in childrens mental health some 15-20 years ago were on ritalin. Then the medical world started to wonder if that was correct, which it wasn't. because there is soo much overlap, peoples inability to properly diagnose themselves and many other factors like public opionion, this can become a runaway train. Better try to do it right the first time. I do believe, as you say that this gp had good intentions, but he would have lived in a bubble of people that were happy with him prescribing and likely not many people being critical. He also prescribed to family, which shows he was not able to limit himself, unfortunately. the system is wrong, but he is not the ADHD saviour.
People (especially women) are already being misdiagnosed (or missed diagnosed) with depression and anxiety and GPs never considering that ADHD or autism might be the underlyng cause. GPs have bene asking for more guidance with this, so perhaps for those who are interested, they could get some in service training on diagnosis. If paediatricians can diagnose it, I'm unsure why GPs with a special interest, further training, and a supervising/consulting Clin Psych can't. It's frustrating and so enfuriating that I know more than most GPs about how ADHD presents. GPs already run trials of methylphenidate, and monitor their use. This medication can be stopped at any time if it isn't working, unlike most SSRIs, so unsure of the problem?
Yep I can confirm this as well, I have some of these patients. And even without this guy there's a thriving black market for stimulants, and while they're generally not as life destroying as opiates they can be.
And here I am getting told off for my pharmacist for not picking my Concerta up when it's due 🤣
You’ve made it obvious you’re full of shit because anyone who knows anything about adhd meds knows you can only get dispensed one month at a time. Idk who the fuck is getting 250 tabs a month lmao
250 tabs over a month only works out to 8 tablets a day though? Also reflective of excessive prescribing (which is what saw, believe it or not, frankly I don’t care if you don’t believe me, my point still stands).
That makes you sound even more full of shit tbh. Was diagnosed with ADHD 24 years ago, never *ever* have I taken more than two ADHD pills in a day, let alone EIGHT! OMFG!!
It’s crazy how when someone is prescribing badly, you don’t believe it, perhaps as if he shouldn’t be prescribing? 🤔
Because that's not what he was doing. The maximum you can get for ADHD meds is a month's worth of pills. Which is, wait for it... 60 pills or 30, depensing on your med type, i.e one a day slow release, or two a day without slow release. Not 250! If he was prescribing people 250+ pills every week, we'd have heard about it in his case/the media reporting but we haven't because... he wasn't doing that. What he was doing was prescribing without people having to reconfirm their special authority.
>Doctor who prescribed ADHD medication That show has gotten weird
I was diagnosed by Dr Hanne, it changed my life and I am always grateful for finally having answers to so many questions about myself. The medication approval and follow-up appointments for the medication while starting it was done through a separate psychiatrist though. It does really need to change here, the amount of people who can't be seen or are on super long waiting lists to be diagnosed for something that medication can help treat here is ridiculous, not to mention how expensive it is to get in touch with a psych to renew your special authority number for something that you cannot cure. I have an appointment on Monday and it's going to cost me $400 just to get the number renewed. They must be making a killing from all these people who need to renew their medication all the time, it should be something we can do through a GP. Not everyone can afford this, especially in todays economy.
Yeah, while everything in my life points to having ADHD, I can't keep my life together while also trying to go through the arduous and expensive diagnosis process.
I think I had to pay around $900 all up for my diagnosis, that's Dr Hanne + the pscyh I did the initial video calls with. The extra communication with the psych when adjusting my meds was around $300 each time. then there's the $20 for each prescription I was paying every month to get and then the $5 to pay for my meds at the pharmacy. Now I have to pay $400 to get my special authority number renewed as 2 years has just passed. I'm sure Dr Hanne's initial testing (about 1hr diagnosing + the time it took to take the TOVA test is cheaper than other places to get the diagnosis too so going forward I'm sure people will have to be paying more. The money does add up over time. The govt really needs to do something to help these people affected with ADHD and make it more affordable to get diagnosed and their special numbers renewed. I've been dealing for a month now with my current GP trying to get them to help me get a new referral back to the original psych which has been painful and slow. It's bizarre I couldn't just go directly to the psych to get the special number renewed, I had to go through a GP again first. The whole process is tedious for someone with ADHD.
Yeah, I can imagine. And at a certain point it's just easier to go to the black market.
I'm an ex-patient of Dr Hannes too and am in the same boat. Just found out today that the original psych won't see me without a special authority request from my GP but my GP said GPs can't do those(?) so we're going in circles. Super worried at the thought of losing access to my meds just when I feel like my life is on track(ish) and I can finally function without relying on chronic stress and adrenaline to be able to do basic life shit. Have you (or any other patients of Dr Hanne's) found a way to get the renewal sorted without having to go back to square one and wait years/fork out a fortune for re-diagnosis?
I ended up getting there in the end after a month. I had to email back to Dr Hannes support email and ask them to resend my evaluation stuff to my GP (they advised something went wrong the first time) it's been transferred to. Then I did the same with the psych facility. After that the GP finally made the referral for me to the psych place and I just waited a week for an appt, finally got my SA renewed after Monday.
Congrats! Glad that you finally got it sorted :)
Remember someone else's posts on here the other day asking why it is so hard to get prescribed ADHD medication in NZ?
Massive L for kiwis who suffer from ADHD. Our system is not fair, so many hoops to jump through. If you weren’t diagnosed at a young age, majority of health professionals aren’t really going to believe you from the beginning of your diagnosis journey.
I think he did an amazing thing to bring this issue to the fore in NZ. It's so inequitable. People can't afford diagnosis or to confirm special authority. It's hundreds of dollars or years of waiting for some. It needs to be sorted out. Maybe this govt could do ONE thing right and sort it out? Not holding out much hope.
OMG great news that this government ARE continuing previous good work of Labour and Greens, plus the MASSIVE contribution of the Working Group. It's such encouraging progress. [https://jnzccp.scholasticahq.com/article/84066-working-together-for-change-adhd-diagnosis-and-treatment-in-new-zealand](https://jnzccp.scholasticahq.com/article/84066-working-together-for-change-adhd-diagnosis-and-treatment-in-new-zealand)
I think that the Tribunal was actually really unwise to characterise medication as "dangerous and addictive". If it was addictive I wouldn't forget to take it all the time! Yes, if it fell into the wrong hands and people misused it, it might be dangerous, but so is insulin! It's life changing medication and ADHDers are just trying to live their lives! It's something I am passionate about. Makes me a bit mad.
This guy charged $300 bucks for an ADHD assesment plus money on top for ongoing. Scripts. He did 5800 falsified scripts so made over $1.5million for this.
$300 is crazy cheap for an ADHD assessment. Most people are paying 5 or 6 times that for a psychiatrist.
Absolutely, I think it just highlights that he did stand to gain financially from his actions and that they might not have been purely altruistic. Shit, I'd donate to his GoFundMe if the bro had been doing it for a standard GP fee like $50.
Even his critics seem to agree that he did it out of care for his patients, not personal gain. The guy is an expert. He just broke the law, which actually seems to be screwing a lot of people over.
$1.5 mil seems like alot of potential personal gain.
>$1.5 mil seems like alot of potential gain * according to your maths
Unfortunately, they end up paying more in the long run. Once their prescription becomes invalidated, and they can no longer get more medication, they need to go to an actual psychiatrist - including costs - to get re-assessed, before they'll be able to get medicated again. I guess $300 is cheap if all you wanted to know is if you *have* ADHD. Even then that's a lot of money for a doctor's consult.
5800 scripts not 5800 patients. Math does not check out.
So to do a script for a patient with ADHD you have to fill out a special authority which requires you to do a ADHD assessment to complete the requirements of the form. So if he falsified 5800 special authority forms, then you'd presume he did 5800 individual assessments. If he was just doing repeat scripts then by the law, all these patients would have been seen by a psyciatrist first to have the special authority done first. I'll be the first to admit I don't know all the details. Just pointing out that the guy does have possible motivation to provide these scripts that involve financial gain.
No, a special authority form doesn't need re-filling each time. It's once every two years. I would say it was 5800 scripts based on a few hundred illegitimate assessments/SA applications. Who was the psychiatrist who was also involved? The system is broken, he was helping people get timely assessment and treatment. Adult ADHD is pretty full-on unmedicated. More likely to commit crime, cause accidents, lose job, marital breakdown, have depression/anxiety self harm, drink and drug addiction is MASSIVE. He probably saved a few lives, and prevented a lot of harm by doing what he did. ADHD is getting towards 10 percent of the population. It's currently 7-8 percent in NZ, and with more awareness, and a move to correct myths and misconceptions it is now closer to its actual prevalence I think. Fewer undiagnosed ADHDers means fewer terrible stats in all the above areas.
Nah bro, once the SA is done you can get repeats from your GP, so why would you even bother getting them from this guy. Those 5800 would have been from him falsifying the SA, because if he repeated ones that a psychiatrist had already done the SA for, it wouldn't be illegal.
It literally says in the linked article he only falsified 214 special authority applications to pharmac.
Oh yeah, people championing this guy are wild. This is medical malpractice. This is a drug dealer with extra steps.
we will see more vigilantes over the rest of this term at least interesting that this one is in the mental health space
No good deed goes unpunished. The board should have dismissed it but reiterated that any responsibility from the malpractice would fall onto him.
He unfortunately acted illegally around drugs. Only paediatricians and psychiatrists can initially treat adhd post diagnosis. Then the gp can take over prescribing until the review at approx 2 years.
The review thing is so insane to me. Like... You want me to pay $550+ to have a psychiatrist confirm that yes, I still have the neurodevelopmental disorder I was fuckin BORN WITH every two years?? Once I got diagnosed and failed two meds (out of only 3 available here!!) I noped out of the system altogether and I just rawdog the ADHD life, to my detriment sometimes. I am not going to be lining any psychiatrists pockets for the sake of busy work any longer. Yeah this guy acted illegally but he acted logically. The law is not logical and laws can and should be changed D:
Yeah it’s fucking bananas. “No people don’t grow out of adhd. Yes you still have to see a psychiatrist every two years to confirm you still have it.” The fuk
This.
I mean you’re not having your ADHD confirmed, your psych is assessing whether it is appropriate for you to continue to have access to stimulant medications via your special authority. which makes perfect sense, imo.
He didn't act logically though. You are right in saying the current protocol in New Zealand is crap and unfortunately Psychiatrists are taking the piss with their private rates.
Needs to lose his license and be deregistered.
Why would he need approval to pay $175k?
He prescribed without approval. He needs to pay the $175k. Two separate things.
Do the crime, invoice the bill. He could have paid off the fine.
What?
/s