GPs And Nurse Practitioners Able To Start ADHD Treatment From Next Year
From February 2026, general practitioners (GPs) and nurse practitioners will be able to start medical treatment for adults with ADHD, following decisions by Medsafe and Pharmac.
This is a change to the current system, under which GPs and nurse practitioners can only prescribe ADHD stimulant medicines to patients on a written recommendation from a paediatrician or psychiatrist, or after someone has already been diagnosed with ADHD and given a first prescription.
Pharmac's Acting Director Advice and Assessment, Catherine Epps says the new rules, which come into effect in February 2026, will mean that over time, more GPs and nurse practitioners will be able to diagnose and start adults on treatment for ADHD. For children and adolescents, who currently require input from a paediatrician or psychiatrist to initiate medical treatment for ADHD, the changes will allow nurse practitioners, working within child health or mental health services, to diagnose and start treatment for ADHD.
'The decision, which is based on feedback from psychiatrists, paediatricians, GPs, nurse practitioners and patients, is one of many changes we are making to increase access to ADHD medicines. It follows our decision last year to remove the two-yearly renewal criteria for these medicines, making it easier to access ongoing treatment,' says Epps.
Medsafe Group Manager Chris James says the change draws on the skills of GPs and nurse practitioners to improve access to ADHD treatment for the public.
'We have a workforce of highly experienced general practitioners and nurse practitioners, a number of whom are already working closely with specialists to treat patients with ADHD. Implementing this change will mean they can do this work more quickly and efficiently without needing to wait for approval from a specialist.
'It's important we ensure a high quality of ADHD assessment, and that people can expect to receive appropriate care and support. We have been working closely with sector representatives to develop a clinical framework which will set out principles for diagnosing and treating ADHD, including the appropriate clinical care required of healthcare practitioners,' says Chris James.
Earlier this year, Medsafe and Pharmac asked for feedback on the proposal to change the regulatory and funding restrictions for stimulant treatments for ADHD. More than 940 people and organisations responded to the consultation.
Overall, most of the feedback was supportive. People explained how this decision will improve access to diagnosis and treatment for people with ADHD.
Some were concerned about the supply issues affecting methylphenidate, and the impact this decision would have on it.
To respond to these concerns, health agencies have delayed the implementation date of the decision. It will now come into effect in February 2026, rather than July 2025.
This will also allow more time for more GP and nurse practitioners to develop further clinical expertise to begin assessing adults for ADHD and initiating their treatment.
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health life and society 15 minutes ago GPs and nurse practitioners have been given the green light to diagnose and begin treating adults with ADHD from February next year. ADHD NZ's Darrin Bull spoke to Alexa Cook.
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Being diagnosed with and treated for ADHD in Aotearoa is set to get much easier. Here's what you need to know. What's all this then? Yesterday, government drug-funding agency Pharmac and medical regulatory body Medsafe announced changes to the rules relating to stimulant treatments for ADHD (attention deficit hyperactivity disorder). From February 1, 2026, general practitioners (GPs) and nurse practitioners (NPs) will be able to prescribe methylphenidate, dexamfetamine and lisdexamfetamine (often known by their brand names, including Ritalin, Rubifen, Concerta and Teva) to adults aged 18 and over. For those aged 17 and younger, nurse practitioners working in mental health services will also be able to prescribe them. Who can prescribe these drugs currently? Initially, only 'a medical practitioner with a vocational scope of practice of paediatrics or psychiatry'. That essentially means, for adults, a psychiatrist (clinical psychologists can diagnose ADHD but not prescribe medication). After diagnosing ADHD and getting the patient established on the correct meds at the correct dose, the psychiatrist can write a written recommendation to the patient's GP or NP, after which they too can prescribe the drugs. (People prescribed ADHD meds used to have to be reviewed by their psychiatrist every two years in order to keep getting them, but that onerous requirement was ditched in December last year.) Interesting. But if GPs can already prescribe (eventually), and the two-year review is already goneburger, what's the problem? It can be very difficult to secure that crucial appointment with a psychiatrist or clinical psychologist (for adults) or paediatrician (for kids) to get the diagnosis that is a prerequisite for being prescribed the medication. Nabbing a referral through the public system can be nigh on impossible in many regions, and even if you happen to be successful, the wait for an appointment is likely to be months. Even people who can afford to go privately or have health insurance – the cost for an assessment is usually upwards of $1,000 – might have to wait up to a year or longer for an appointment. Aside from the cost, which has led to inequities in treatment, there's the cruel irony of all this administrative hoop-jumping being particularly gruelling for the ADHD brain. It was this ' broken system ' that resulted in Auckland GP Tony Hanne, a leading ADHD specialist, being suspended and fined for flouting the rules and prescribing meds to his patients. Not ideal then. Why such long waits for treatment? A combination of the much-documented pressures on our health system (mental health is an area that's particularly stretched) and an increase in demand: between 2006 and 2022, the number of adults being prescribed ADHD medication in New Zealand rose tenfold as this neurodevelopmental disorder became better understood (the reality for ADHDers is far more complex than the old stereotype of the naughty little boy disrupting class). ADHD is still believed to be under-diagnosed, however: according to research published last year, 0.6% of the adult population was being treated for ADHD in 2022, but an estimated 2.6% have the condition. Why are the prescribing rules so strict? GPs lost the ability to prescribe the meds in 1999 due to fears they were being overprescribed, likely linked to a moral panic originating in the US around overmedicated kids. There were also concerns about misuse and 'diversion', ie when people prescribed the drugs give or sell them to others. ADHD drugs are safe and not addictive if used as prescribed, by people who actually have the condition – they amplify the release of dopamine, which has a calming and focusing effect. But they can be used recreationally – usually crushed and snorted at higher doses, or as a ' study drug ', and there were reportedly fears that gangs could use them to make methamphetamine. Any evidence of that actually happening? The gang thing, no, and there is no evidence that people prescribed ADHD meds are more likely to abuse substances either. There is, however, evidence of a link between undiagnosed and untreated ADHD and substance abuse. That's just one of many societal costs of untreated ADHD that have been identified, alongside, to name just a few, lost productivity, absenteeism, welfare and education costs and costs to the criminal justice system – various studies suggest people with ADHD are overwhelmingly overrepresented among the prison population worldwide. Hmm. Surely the overprescribing thing is a valid concern though – how can an overworked GP be expected to provide an accurate diagnosis, especially if the patient has been influenced by all the ADHD content out there and is adamant they've got it? Not all GPs and NPs will be offering ADHD diagnoses and treatment, and it won't be squeezed into a 15-minute appointment, say the decision-makers. 'It's important we ensure a high quality of ADHD assessment, and that people can expect to receive appropriate care and support,' said Medsafe group manager Chris James in the press release announcing the changes. 'We have been working closely with sector representatives to develop a clinical framework which will set out principles for diagnosing and treating ADHD, including the appropriate clinical care required of healthcare practitioners.' But writing for Newsroom in February this year, when the proposal to change the rules was being consulted on, an associate professor in psychological medicine at the University of Otago said that the consequences were likely to be 'double-edged' if it was accepted. Ben Beaglehole, who led the recent research into the ADHD treatment gap referenced above, said that while the changes would give more people access to life-changing treatment, they were 'likely to cause inadvertent harm through less thorough assessments, poorly targeted treatment, and greater community misuse of stimulants'. Oh. What do other people in the industry reckon? The Royal New Zealand College of General Practitioners (RNZCGP), which has been at the forefront of the campaign for change, welcomed the news, with medical director Luke Bradford telling the Herald that GPs would be doing some serious upskilling and assessments would be thorough. 'It's not going to be, 'I'm going to the doctor about my sore knee, and by the way, I always thought I'm not very good at concentrating. Do you think I've got ADHD? Can I have some Ritalin?' That's not what is going to happen.' Mental health nurse practitioner Anna Elders echoed this. 'I think there's going to be some misconceptions that GPs and nurse practitioners can diagnose within a 15- or a 30-minute consult, and that's not accurate,' she said, in comments made via the Science Media Centre. 'There are really firm guidelines from the working group, the ministry, and all of the colleges around what a really good, comprehensive assessment will look like. GPs are going to have to identify that they want to develop special skills and knowledge and undertake training in working with ADHD, just like they would if they developed a specialism in skin cancer, for example.' Well, valid concerns aside, it's good to see these barriers to accessing treatment coming down. Anything else I should know about? Oh yeah, there is the small problem of a global shortage of methylphenidate, the most commonly prescribed ADHD drug, which is why the start date for the changes has been pushed out till next year, in the hope that the situation will have improved by then. Currently, many ADHDers in New Zealand can't access their prescribed medication, and are instead receiving alternatives that may not be as effective. 'Pharmac is exploring several options to assist with the supply of methylphenidate,' said the agency when announcing the changes yesterday.
1News
a day ago
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GPs, nurses able to diagnose, treat ADHD from next year
GPs and nurse practitioners will soon be able to diagnose and treat patients with Attention-Deficit Hyperactivity Disorder (ADHD), it has been announced. Under the current system, GPs and nurses can only prescribe ADHD stimulant medicines on a written recommendation from a paediatrician or psychiatrist or after the patient has already been previously diagnosed with ADHD. Pharmac's acting director of advice and assessment Catherine Epps said that the new rules decided by Pharmac and Medsafe will mean that, over time, more GPs and nurses will be able to diagnose people with ADHD and start treatment. "The decision, which is based on feedback from psychiatrists, paediatricians, GPs, nurse practitioners and patients, is one of many changes we are making to increase access to ADHD medicines," said Epps. For children and adolescents, the changes will enable nurse practitioners working within child health or mental health services to diagnose and initiate treatment for ADHD. ADVERTISEMENT Medsafe group manager Chris James said that New Zealand has a workforce of highly experienced GPs and nurse practitioners, with many already working closely with specialists to treat patients with ADHD. "Implementing this change will mean they can do this work more quickly and efficiently without needing to wait for approval from a specialist," James said. Minister for Mental Health Matt Doocey applauded the decision and said it was a step forward for patient support and system efficiency. The morning's headlines in 90 seconds including Iran's retaliation, Auckland Council's catering cost, and the new way to look deep into space. (Source: 1News) "This is a common-sense change that will make a meaningful difference in many lives of New Zealanders," Doocey said. "I have heard stories of many people with ADHD who have been unable to get a diagnosis and treatment in a timely manner because of long wait items and costs associated with seeing a specialist." Earlier this year, Medsafe and Pharmac received feedback from more than 940 people and organisations on the proposed change. ADVERTISEMENT The Ministry of Health said that most of the feedback was supportive, and people believed the decision would improve access to diagnosis and treatment. However, some people were concerned about supply issues affecting the availability of methylphenidate. To address this, health agencies have delayed the implementation date from July 2025 to February 2026. This will also allow GPs and nurse practitioners more time to develop further clinical expertise in ADHD. Doocey said that the Ministry of Health is working with sector representatives to develop a clinical principles framework for the assessment and treatment of ADHD which will ensure quality and consistency for supporting patients. "We have heard your feedback loud and clear, and we know the positive impact this decision will have on many people's ability to access what is often life-changing medicines."
