Q about ADHD meds during a long stay in Guatemala.
April 23, 2010 2:20 PM   Subscribe

Here in the US, I'm prescribed Adderall for ADHD. This summer, I'll be spending 2+ months doing a mentally taxing project in rural Guatemala. Help me figure out how to make this work. Bonus points for any first-hand knowledge about ADHD treatment in Guatemala — legal aspects, practical aspects, whatever — or for any good sources to consult on the subject.

One catch is that Adderall — and, for that matter, all the other stimulant medications for ADHD — are Schedule II in the US. This means, as I understand it, that my psychiatrist can't prescribe me more than a one-month supply at a time, and can't write me a refillable prescription. It would be technically legal for him to write me multiple post-dated prescriptions for one month each, but he's not comfortable doing it. And anyway, I don't know if that would help, because....

...the other catch is that I've been unable to find information on the legality or practical availability of ADHD meds in Guatemala. (The subject is essentially ungoogleable as far as I can tell — all I get is 0NL1N3 PH4RMAC1ES!!1, articles about the US drug war spilling over into Central America, and Spanish-language Scientologist anti-psychiatry propaganda.) So I don't know if an Adderall prescription would be fillable there even if I had one.

Any suggestions on making this work without going off my meds for the summer would be greatly appreciated.

Since they're bound to come up:
  1. I am not interested in doing anything illegal. When it comes to crossing borders, I'm not even interested in doing anything vaguely suspicious if I can help it.
  2. My psychiatrist is an honest guy, and very good at what he does. Having him fudge my prescription (i.e. by tripling the "dosage" so I get three months' supply) is almost certainly out of the question, and I'm reluctant even to ask because I want to maintain a good relationship with him.
  3. I've found non-stimulant ADHD meds — in particular, Wellbutrin and Strattera — to be unhelpful. I haven't tried any of the stimulant meds besides Vyvanse and Adderall, but I might be willing to switch to one of them temporarily if it was available in Guatemala in a straightforward way.
  4. I'll be about halfway between Chichicastenango and Quetzaltenango. With a little work, I could make a weekend trip to Guatemala City or Antigua. In a pinch, I could stop someplace like Mexico City on my way down, and it's not totally inconceivable that I might be able to stop somewhere in Belize. Coming back to the US for a doctor's appointment partway through my trip is out of the question — too expensive.
  5. Please don't try to convince me to go off my meds. I'm going down there to do linguistic fieldwork. Essentially, I'll be learning a non-Indo-European language from scratch. I would totally just go off them for the summer if this were a recreational trip; as is, though, I want to be at my best attention-wise.
posted by nebulawindphone to Travel & Transportation around Guatemala (11 answers total) 3 users marked this as a favorite
Have you asked your doctor what your options are? It's not unusual for people to travel for long periods of time and need meds.
posted by greta simone at 2:24 PM on April 23, 2010

Anecdotally, I have heard that Mexican pharmacies have such medicines available with more or less no documentation required. I have no information, anecdotally or otherwise, about Guatamalan pharmacias.
posted by norm at 2:33 PM on April 23, 2010

Definitely see what your doctor has to say about this. He is going to want to make sure you stay on your meds, too. I know you said you don't know about being able to fill prescriptions down there, but sometimes if I'm going to be in a pinch, my doc will write me a post-dated prescription so I don't have to go through the rigamarole of getting down to her office every time I need a refill. Then she doesn't have to write for extra drugs, and I don't have 3 extra steps to getting my medication. This might be a good compromise for you & your doc if you find out that you'll be able to actually fill the script down there.

Good luck; this sounds like a total PITA. We have ADD! How are we supposed to keep track of this stuff?! Gosh!
posted by Fui Non Sum at 2:37 PM on April 23, 2010

In have bought many drugs in Guatemala without a prescription. If you do need a prescription, a doctor is very cheap to see. Of course, you'll probably have to be in a larger city to find what you are after--Quetzaltenango, Antigua, the capital should suffice.

I would search around for the larger pharmacy chains down there and give them a call to make sure they stock your medication, and inquire as to what, if any, prescription (local or from your US doctor) you might need.

Here's some places you might want to try calling (in the capital), from WikiTravel:

Centro Médico, 6 Avenida 3-47, Zona 10. Tel 334-2157/384-2600/332-3555. 24 hour service.
Hospital Bella Aurora, 10 Calle 2-31, Zona 14. Tel 384-3535. 24 hour service.
Hospital Universitario Esperanza, 6 Avenida 7-49, Zona 10. Tel 362-8626.
posted by mixer at 2:47 PM on April 23, 2010

Health information for Guatemalan travel, from the CDC. The State Department suggests contacting the Guatemalan Embassy in the US for specific concerns; I would wager you could also contact the US Embassy in Guatemala if you wanted to talk to other Americans in-country.
posted by fairytale of los angeles at 2:55 PM on April 23, 2010

you should be able to get a special vacation prescription for a larger quantity. ask the doc for it.
posted by saraindc at 3:09 PM on April 23, 2010

Response by poster: I've read around on the CDC/State Department/Embassy websites, but I don't see anything helpful. I'll give the embassy a call on Monday if I'm still having trouble finding information.

Those pharmacy numbers also look helpful, and I'll give 'em a try for sure.
posted by nebulawindphone at 3:19 PM on April 23, 2010

Nthing explain to your doctor the situation and ask for a larger quantity. As greta simone said, it's really not an unusual request. When I moved to Cameroon my (scrupulously honest and ethical) doctor gave me a year's worth of my meds.
posted by hapax_legomenon at 4:52 PM on April 23, 2010

I take Vyvanse and the only way I can get more than one month supply is through my health plan script mail order. Do you have mail order capability on your plan? That way you can get a 90 day supply.

Another option is to ask your prescribing doctor if they have any connections in the city you are staying in. Perhaps they can put you in touch with someone down there who can write a script.

Good luck - these meds are highly controlled (due to the high abuse rate) and they sure don't make it easy.
posted by mnb64 at 6:07 PM on April 23, 2010

The doctor can and will prescribe you a double dose, which = two months.
posted by borkingchikapa at 2:06 AM on April 25, 2010

Response by poster: Here's what I've learned:
  • You can't buy just anything over the counter in Guatemala. Antibiotics and such are unregulated here, sure — but there are definitely psych meds that are prescription-only, and the stimulants are on that list.
  • Adderall (dexamfetamina) does not seem to be available at all. In fact, almost none of the pharmacists who I asked had even heard of it. I get the impression that the other amphetamines aren't used either, but I'm not positive.
  • Ritalin (ritalina or metilfenidato) is legal with a prescription, but few pharmacies carry it. I asked the doc who wrote my prescription, and he was able to point me towards a specialist place that did.
  • Concerta also appears to be on the menu. Same story: prescription-only, not available everywhere.
  • You get a prescription for psych meds from a neurólogo. There are several around town.
I went to Centro Neurologico de Occidente, which is up the street from the Hospital de San Juan de Dios in Zone 9. (Take a taxi or bus to the hospital, then take the pedestrian bridge across the street and walk uphill for a block or so. Their phone number is 7736-8691, and you'll need to call ahead for an appointment.) They were fine, and I'd definitely recommend them to someone who just needed a prescription re-written, but I have no idea how they'd do at diagnosing a new patient or juggling dosages or whatever.
posted by nebulawindphone at 3:49 PM on June 16, 2010

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