Red tape stops SA kids from getting ADHD meds
Attention deficit and hyperactivity disorder (ADHD) affects between 5% and 7% of schoolgoing children, but because doctors can only prescribe treatment for a month at a time, many kids in South Africa, especially those who can't afford monthly doctor's visits, don't access medication regularly.
Methylphenidate, a central nervous system stimulant that can significantly reduce symptoms in about 70% of users with the condition and that the World Health Organization (WHO) recommends for the treatment of ADHD, helps people with ADHD to concentrate better, and to be less impulsive and overactive.
Studies have shown that when the methylphenidate — the gold standard for ADHD treatment — is used correctly, children's school marks improve and they become better equipped to develop social skills. In other words, effective ADHD treatment doesn't just help schoolgoers with ADHD to sit still and focus in class, but it also supports them to learn and socialise — outcomes that form the foundation of a healthy and productive adulthood.
Methylphenidate is, however, classified as a schedule six drug in South Africa, placing it in the same regulatory category as medicines with a high potential for abuse. Pharmacies are therefore only allowed to dispense the medicine to people with doctors' prescriptions, and by law, physicians can only prescribe 30 days' worth of methylphenidate treatment at a time.
This means patients need to visit their doctor each month for a new prescription, so in the private sector they'd need to pay for a doctor's visit each month, on top of paying for the medication, and in the public sector patients would need to take a day each month to queue up at their local clinic — and they'd have to make sure it's a day on which a doctor, as opposed to only nurses, are available at their health facility.
The current scheduling, as a result, creates huge administrative and financial difficulties for patients and caregivers when they try to get treated, especially for those navigating ADHD's very symptoms: executive dysfunction, forgetfulness and inattention.
As a psychiatrist, working in both the public and private healthcare sector, I've seen first hand the toll that untreated ADHD takes on children, adults and families — from fractured educational journeys to unemployment, depression, addiction and even suicide.
These are not theoretical risks but daily realities for many South Africans. And yet one of the biggest obstacles that locks people out of treatment — our own healthcare policies — remains unchanged.
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