Here are the hoops this St. John’s man had to go through just to fill a prescription

Ethan Crann is frustrated with Newfoundland and Labrador’s health-care system’s lack of clear answers for filling prescriptions for controlled substances without a primary-care provider. (Mike Moore/CBC)

A St. John’s man says he was left on his own to figure out how to refill his controlled drug prescription after graduating from Memorial University. 

Ethan Crann sought help at MUN’s student wellness centre after his second year of university where, after a few visits, it was recommended he be assessed for attention deficit hyperactivity disorder. 

He was, and doctors prescribed Vyvanse — a stimulant medication that is used to treat ADHD in children and adults.

“It seemed to be working. All my friends and family agreed that I seemed a lot better off and a lot more focused on both my work and juggling a lot of things at the university,” Crann told CBC News on Monday.

But after graduation Crann lost access to the student clinic. He doesn’t have a family doctor and faced closed door after closed door while trying to fill his needed prescription. 

Vyvanse is considered a controlled substance, which walk-in clinics won’t prescribe. 

After calling 811, pharmacists and even emergency rooms — all of which pointed Crann back to walk-in clinics — the frustration of the repeating cycle of dead ends began to mount. Crann said the emergency room staff were dismissive and agitated by his call. 

“I opted to try for a bit just [being] unmedicated,” he said.

“I went some months without taking it until I reached the point again where just the downside kind of just got to the point where I want to start up again and I’m willing to go through the hoops, basically.” 

Central Newfoundland-based virtual care company Medicuro sees similar situations often, according to owner and medical director Dr. Todd Young. 

WATCH I  This doctor explains why it’s so hard to renew some medications without a family doctor: 

The plight of ‘orphaned patients,’ who are stranded when the ER, health line and walk-in clinics can’t renew a prescription

Ethan Crann needed to renew his medication that he was taking to treat his ADHD. Without a family doctor, Crann was turned down by the 811 health line, walk-in clinics and even when he presented himself to the ER. Dr. Todd Young, who owns the virtual-care company Medicuro, explains the cycle.

Crann was able to have his prescription filled by Young’s team but both say there has to be a better way to take care of patients and provide answers to those who have been orphaned by the province’s health-care system and need prescriptions filled for ADHD or chronic pain. 

“They’re really having a challenge. So if they go to emerg for a refill, most are turned away. Or, if they do get it, it’s for one or two weeks. It’s just a short-term solution, just to get them out of the department, I think [is] maybe how the patient would interpret that,” Young said.

“There is no pathway for patients like this if you’re orphaned. So if you’re not attached to a physician or a provider, it becomes quite stressful. I would even argue they’re being stigmatized based on their medical condition.” 

Medicuro isn’t without its own challenges. 

Young said patients can experience delays if doctors are out, not all doctors feel comfortable prescribing controlled substances, and Medicuro won’t fill a prescription for a patient without knowing their medical history first.

A grey exterior of a hospital with a sign that reads St. Clare's Mercy Hospital.
As a final effort, Crann called emergency rooms to see if his prescription could get filled. He said he was told to continue trying walk-in clinics. (CBC)

But first-time patients are common, he said, and most are almost apologetic after exploring the same avenues and dead ends like Crann.

“The patients are desperate,” said Young. “Ultimately, the system is broken.”

The province needs to get as many Newfoundlanders and Labradorians connected to care providers as possible, he said.

“It’s urgently needed, and this is just another example of how urgent this is needed.”

Although his situation has been mostly resolved, said Crann, his main frustration is with what he says is confusion within the province’s health system.

“I can tell that if I’m having this problem and the lack of clarity around these answers, I know other people have to be having this problem as well,” he said.

“I don’t know exactly what the solution is — I just know that I would like to see some clear path that, in general, people within the health-care industry in Newfoundland can point people towards when they have the same issue I have.”

In a statement to CBC News on behalf of the Health Department, spokesperson Laura Thomas said beginning this week nurse practitioners with the 811 health line will be able to renew or extend prescriptions for controlled drugs and substances for patients who are no longer attached to a primary-care provider.

“This policy change enables nurse practitioners to renew or extend ongoing documented prescriptions of benzodiazepines and stimulants for patients on long-term therapy and who have demonstrated compliance with a treatment regime,” the statement reads.

“This enhancement to 811 will mitigate the potential serious medical impacts of abrupt discontinuation, mitigate regular lengthy waits at emergency departments for prescription, or illicit acquisition.”

The Health Department and Newfoundland and Labrador Health Services said patients without a primary health provider should register with Patient Connect N.L. to be connected to a family-care team or a primary-care provider as soon as one becomes available in their area.

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