How to get prescribed ADHD medication in the Netherlands, a guide based on real world success:

1) spend over a year repeatedly trying to tell the GP that it’s not going well and you need help. This will not cost you money, only your precious finite time on this earth. It helps if you have a husband to drag you to the doctor when you’re at your lowest and argue with them

2) finally get escalated to a psychologist who takes a few months to be sure there’s definitely something wrong. She will recommend the GP to prescribe ADHD medication

3) Your prescription mysteriously disappears into the system. After several attempts to follow up that take months, and several confused phone calls from your psychologist to the GP, it turns out the GP refuses to authorize it because *shrug* reasons. Maybe if a psychiatrist also signs off on it?

4) You attempt to get an appointment with a psychiatrist. Every psychiatrist in the Netherlands is booked until 2034.

5) Finally, after a dozen rounds of pleading and nagging, you get a mysterious phone call from an unknown number. They give you an address and tell you to be there at 7 in the evening.

6) You find yourself at the door of a historic art deco mansion in the most exclusive district of Amsterdam. There is absolutely no indication that this is a medical practice. You ring the doorbell. Nothing happens. You wait nervously, and try again.

7) The door creaks open. An elderly man wearing crocs stands before you. He silently bids you follow him up a winding staircase to a parlor filled with a thousand thick and aging books in every tongue of the earth and perhaps a few also of the angels. They concern prophecy, and music, and poetry, and the apocalypse.

8) In a thin whisper of a voice barely to be heard, he asks your name, and where you were born. He slowly, very slowly, so slowly that you think you have died and this is purgatory, types this into a computer. It is in his lap because his desk is covered with strange devices beyond identification.

9) He tells you the prescription will be ready for pickup tomorrow.

If your client cuts this off after the first few sentences, I guarantee the back half is more interesting than the first 😂
and then the final, crucial step is to come home to Odin 

amused by how many people are replying/quoting with, like "yeah it's the same here, it sucks" without commenting on the visitation from the angel attempting mortal guise

my fault for not opening with that I guess 😂

@0xabad1dea you're clearly assuming that heavenly visitation is a rare occurrence when in fact, in many smaller european nations, it is quite common

@halcy @0xabad1dea

Some vision of Wim Wender's Wings of Desire made me remember this...

https://www.youtube.com/watch?v=AiX4CIgKMEs

"The Trapeze Swinger" (Iron & Wine) - Gregory Alan Isakov, Fuel/Friends Chapel Session #34

YouTube
@0xabad1dea I suspect Odin is the one indispensable element here.
I too got my ADHD meds from a wizened old figure who somehow cuts through red tape like it's nothing. Less sure about the angel part, more just he stopped caring about the consequences :P
@0xabad1dea
@twodarek @0xabad1dea same. Mine forgot my name and mixed up patients and case details many times. He was a senile pill-dispenser and I despised him and the system he was a part of for their negligence and inhumanity. But he was useful.

@twodarek

You have to stop caring about the consequences to become an angel.

*dramatically smokes cigarette in a film noir fashion

@0xabad1dea

@0xabad1dea I just read through the experience.  

I'm glad the old croc wearing man was there for you.

@0xabad1dea No no, yeah, that bit happened to me too.
@0xabad1dea his snoot is so perfect, with just the right amount of tongue and nose and flappy jowls

A natural antidepressant!

@0xabad1dea

@0xabad1dea You win! Odin is wonderful.
@0xabad1dea hello my friend, happy to see you :) How's May in Amsterdam? Are you more a winter or summer newfie?
@0xabad1dea he could as well have told you god will fight you tomorrow and it might have made more sense
@0xabad1dea so what i'm getting from this is that ADHD meds are a bit like the potion in Death Becomes Her?

@0xabad1dea In the United States this process is much simpler, shorter, and quicker.

1. Doctor prescribes the medication, and 2. Insurance company denies it because it's not medically necessary.

@snow @0xabad1dea I miss the step where you pay 3555578865443126778 USD
@snow @0xabad1dea
3. your cousin who cooks ACTUAL meth hooks you up and takes cash. (This is something a few friends have done.)

@heathen_cat @snow @0xabad1dea

4. You OD because he mixed up his bottles

A legit concern.

There is such an overlap and when the legal doctors won't prescribe ...

@heathen_cat @snow

@snow @0xabad1dea Damn, I guess I had it easy here in Poland. First of all, psychiatric care here doesn't even require that you have health insurance, even the universal healthcare one. I walked into the center on June 6th last year, got my first evaluation/classification appointment on July 10th (first of maybe three, with psychologists). Then a series of appointments with the assigned psychiatrist. We did autism spectrum and ADHD diagnostic evaluation.
@snow @0xabad1dea Got spectrum diagnosis first. For ADHD we did DIVA test, where I scored just below the threshold, but the psychiatrist said that he's gonna test ADHD meds anyway. I got my first Concerta and Medikinet prescription May 5th this year. My visits are free of charge. I paid for a bottle of 30 Concerta 18mg pills about 10 Euros. My next visit is on June 30th.
@snow @0xabad1dea Also, every visit with a real person requires a randomly generated co-pay, every phone call ends up with four transfers each requiring you to repeat your name, birthday, home address, phone number, the 20 digit number on the front of your insurance card, the 36 digit number on the back of the card, your favorite pharmacy, your favorite member of the Three Stooges (Shemp, no really!) and THEN the insurance company denies it.
Shoulda went with Curly.

@0xabad1dea

thank you for not sharing the elderly man's pii - he must be protected at all costs

@0xabad1dea Oof that sounds rough :( most of my (Dutch) friends have similar stories of various bureaucratic reasons to block getting help faster. I hope this is behind you!
@0xabad1dea yes it really helps to turn up to your GP with two diagnostic labels in hand (gained in the UK at some emotional cost) and all you need is the rubber stamp from the local system. (It would have been nine months to wait for the specialist clinic, but I got a cancellation appointment after four…)
@0xabad1dea can’t wait for the next chapter
@0xabad1dea well at least it's not just the UK then.
@0xabad1dea I didn't even realise Sierra made a Medication Quest
@0xabad1dea Oh wow, you glitched into the William Gibson timeline. Can you grab me some RAM while you're there?

@0xabad1dea Good grief. Now, let's see if the Rx actually shows up.....

(Wrestling stuff out of Dutch GPs should be an Olympic-level endurance sport... )

@0xabad1dea

I feel a deep kinship with the eldritch cryptid that you met, and I hope his researches into the occult depths are fruitful.

@0xabad1dea You should somehow work this story into your VN
@mcgrew this honestly isn't too far off from the existing planned scene "Ravelin is captured by a very wise, scholarly god who would like to know what on EARTH she is doing blipping in and out of existence"
@0xabad1dea why did physicians become so callous 😡
@0xabad1dea Ah yes, I have the Belgian variation where the neurologist (I went directly to a specialist) believes this is just anxiety, prescribes the lowest dosage possible then immediately gives up medication when it doesn't work and sends their patient to an ADHD-specialized psychologist to just accept the condition (to be fair, acceptance is part of reducing ADHD-fueled anxiety).

@0xabad1dea In Germany my mom got my diagnosis as a child and somehow I only needed to go to a neuro psychiatrist, fill out a form, get an EKG and then I got my meds. I have no idea how hard or easy it is to get that if you haven't been diagnosed yet.

Now my biggest hurdle is to get a new prescription because i have to go in person and the doctor is only there at very inconvenient times. And because it is classified as a narcotic I HAVE TO do it myself.

@0xabad1dea I have a different story and I'm stuck elsewhere in the timeline.
1) Go to GP, GP refers you to the own practice's mental health support employee (GGZ ondersteuner)
2) Filling in an online survey
3) Said support employee saying "you only have a score of 5 out of 6 for ADHD on the preliminary screening, I don't see a point in referring you for a formal diagnosis, you'll wait for ages and I don't believe in medication anyway"
@0xabad1dea that’s fantastic news, I know exactly how much this must mean to you having been through my own ADHD diagnosis and then prescribing battles with the NHS in the UK about 15 years ago.
@0xabad1dea we have this problem in the UK too where GPs serve no purpose except to deny medical care. It's a mystery to me what society thinks we need them for.
@whimsy I finally got a fantastic one. Except he's a GP, so he can't change my ADHD med doses or prescribe any of the 'hard' psych meds I probably actually need.
He is exceedingly kind and proactive about it tho!
@0xabad1dea
@whimsy @0xabad1dea in the US we have the problem where medical providers just dont respond or tell you to wait months and then it costs way too much money

@0xabad1dea

Step 2 should have been "Find a new GP who takes you seriously."

@0xabad1dea Psychologist at step 2? The profession that _does not diagnose nor prescribes medicine_?

Go to Poland to get diagnosed. Ask for the diagnosis in English. Use it to skip to the end of the process in the Netherlands.

Will probably end up saving money that way.

@0xabad1dea

Reads like a story from Borges

@0xabad1dea does a Grue appear at any point?
@0xabad1dea epic. And you got meds at the end. Bravo for persistence.
@0xabad1dea That's very similar to how it works in Australia. Except instead of the prescription apparently getting lost in the system because the doctor refuses to prescribe, the doctor can't find you in the database because you've never been prescribed anything that requires government approval, so they prescribe you two valium for which you don't need approval, but gets your name in the system because it's dangerous, so then they can prescribe what you're actually approved for.
@0xabad1dea Same in Norway.
@tuvix @0xabad1dea i had the same type of experience as @ThePolishDispatch in Norway 🤷
@0xabad1dea I thought 7.5) was going to be "you have to roll two 20-sided dice and pray for primes"

@0xabad1dea I am so sorry this is what you have to go through.

It's a similar tale over here in the U.S., but to varying degrees in some pain points than others.

@0xabad1dea meanwhile my doctor in California offered me some ADHD meds to see if it will help with fatigue 😅😬
@0xabad1dea As beautifully portrayed as it is, this seems somehow unrealistic.
An encounter with the Dutch medical system that doesn't feature being fobbed off with paracetomol?
@KatS that happened a dozen times in phase one
@0xabad1dea I was lucky enough to be able to make use of my italian prescription here and convince my GP to prescribe me the same medication in the netherlands. however, switching to lisdex from medikinet was months and months of constant appointments which included a lot of pointless ones where we achieved nothing, some that led to getting my dose of medikinet halved, some that led to getting proposed to switch to xr+ir, and some that led to getting reverted to ir multiple times a day. the first time I tried to convince them to switch me over I had given up before I got anywhere, the second time I had enough stashed medication to be able to make it.
I guess the moral of the story is that persistence is the only way to achieve anything medically in this country and that the only accepted currency is time x_x