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AJmsp79

Question about continuing care after moving home to Canada

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Hello,

I've been living in the the United States for well over twenty years. I have a diagnosis of panic disorder without agoraphobia, major depression, and generalized anxiety disorder.

My company has offered me a rather lucrative job opportunity, but it would require a job transfer to Ontario. I really want to take it, but I'm extremely concerned about finding a psychiatrist there and not having to switch up my meds. I currently take Effexor 150 MG and diazepam 15 MG daily. I have been on both for many years with no escalation or issues. They work quite well for me.

How difficult is it going to be to continue taking these meds and to get care in Canada? I am a Canadian citizen, so I would have insurance 3 months after arrival. Normally I would just fly home every four months and get my meds and see my PDOC here until I found someone in Toronto. That being said, you can't do that because importing RXs from the US is illegal, and I'm sure the diazepam could cause issues. I'm at a loss. I seriously may not be able to relocate because of this.

Any feedback from Canadians or someone who has gone through this would be appreciated.

AJ

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You can't take meds across the border?  You should be able to if the prescription is already filled, no?  Is filling in the US an option?

Otherwise, I'm not certain, but I think you should be able to get medical care in the first 3 months, but you'll have to pay out of pocket, it won't be covered by OHIP.  Both meds are available in Canada though, once you have a prescription, there should be no issue getting them.  

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Hello Jarn,

Thanks for your helpful response. I think I can bring up to a 90 day supply in (according to what it says on the Canada's website regarding bringing medications across the border). I don't mind paying out of pocket until insurance kicks in, but I'm nervous about the amount of time it will take to get in to see a PDOC. Is it challenging to find a psychiatrist in Toronto? What is the wait time to get in?

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It is pretty challenging to find a psychiatrist in Toronto.  Your best bet would be to start by finding a family doctor who could prescribe your medication.  Up here, if you are stable on your meds, it would be very common and expected for the family doctor to prescribe them on an ongoing basis, and only consult a psychiatrist if things get unstable or if they're in over their head.  You could then talk to the family doctor about a referral to a psychiatrist, because you'll need a referral to get in.  The wait time for a consult can be in the vicinity of 6 months+, and often times you only get a consult - it's very hard to find somebody willing to follow you long term, especially if you're stable.

Edited by tryp

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Thanks, Tryp. My primary concern is the benzo. I take it daily as prescribed my doc, and I'm nervous about encountering benzo phobic physicians. In the US, GPs (at least in my state) will refer you out to a PDOC and won't do maintenance RX's for benzos. Is this the same in Canada?

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AJ, I am a Canadian living in the US, looking at moving back to Ontario after living in the US for over a decade. I have a GP in Canada who has said he will accept me into his practice (he sees my parents) and is currently looking at finding me a psychiatrist to get me on a waiting list *now* even though I am not looking at moving until the spring. I am told waiting lists can be a year or more. He has said he will continue prescribing my meds after getting information from my American pdoc about my current cocktail and my recent history. He has said that getting in with a psychiatrist would be easier if I had a recommendation from a friend/family member (to see their pdoc) or if my pdoc has any contacts in Canada that she could refer me to (sadly, she doesn't). 

I have never been asked about prescription medication when crossing the border, for the record. I intend to bring with me the maximum I can get here (so, probably 90 days worth) because while I will buy insurance to cover the 3 month waiting period to qualify for OHIP, from my research those insurance plans don't cover pre-existing conditions. 

So, my recommendation is to get in with a GP ASAP. Don't wait to qualify for OHIP. You want to get on waiting lists for psychiatrists ASAP. Make plans with your current pdoc about transferring your care, don't drop this on them without notice. 

Good luck.

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20 hours ago, notloki said:

GP's generally are frowned upon if they prescribe controlled meds long term. I tend to agree with that.

I'm not sure what that even means.  Frowned upon by whom?  GPs here prescribe controlled substances long-term all the time.  There are challenges/issues associated (not all think that benzos are a good long term treatment for anxiety), but there are challenges with psychiatrists prescribing those meds too (many psychiatrists think similarly).

Edited by tryp

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I'm in the usa so we are talking about the DEA. 

I am saying I have never taken a controlled med every day and have the doc renew year after year that was scripted by a GP. PRN, sure. I am  asked to go see the appropriate specialist for that.

Edited by notloki

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Your personal experience isn't equivalent to "generally frowned upon."  And the OP asked a question specifically about Canada, so the DEA is fairly irrelevant.

AJ, Get a GP, talk to them about your concerns, see if they want to refer you to a psychiatrist either for a consult and/or ongoing follow up versus prescribing themselves.  A wait of 6 months to see a psychiatrist would be optimistic, and a year+ is more likely.  Be aware of the strong possibility that you'll only get a one time consult and be referred back to your GP with recommendations for ongoing follow up.  GPs (like psychiatrists) have wildly different opinions about benzodiazepines and their role in the long term treatment of anxiety - that's something that's going to be luck of the draw whether it's a GP or a psychiatrist doing the prescribing.

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Can you do some kind of Skype with your TDoc in the US until they have you on the waiting list long enough to find someone?  *Of if they find someone and its not a good match??

Be sure whatever meds you have are in the bottles and I say don't tell unless asked.  If asked I don't see how they can get upset unless your names not on the bottle or something?  *I'm not an expert.

Benzos are sort of political.  Some abusers of these have freaked people out and some doctors just don't want to complicate their lives so they just stop prescribing them.  I think its dumb.  I still think most doctors do whats best for the patient.   Pain pills btw are even more on the radar.  I was told to "take aspirin" when I complained about some major league pain (Metal Staples in the bladder) and had to go to a different doctor to get someone to take a new look at the problem.  This is another assumption that your intent is bad (When its not)

Good luck in Canada! 

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Im in Canada and my family dr has been prescribing me meds for years. I really dont think you are going to have a problem with the benzo. Ive seen several psychiatrists that have no problems with the meds I take and have taken. Its not easy to see a specialist here as you may know- the waits are very long. Im in BC but im guessing Ontario isnt too different.

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