A $6 Pill or a $1000 Diagnosis: Inside the Student ADHD Access Gap

New ADHD rules were supposed to broaden access to diagnosis. But Te Herenga Waka’s planned free assessment pathway never opened, private assessments still cost around $1000 or more, and publicly funded care remains limited. Salient investigates the gap—and the student market in prescription stimulants growing around it.

In several Signal group chats shown to Salient, prescription ADHD stimulants are advertised with the casual shorthand of any other student-marketplace sale. One seller posted “10mg Rits,” 15 to a tray, for $100 alongside a photograph of the box and pills. Another advertised dexamfetamine for $6 a pill, with “deals on 25+,” beneath a picture of a prescription bottle. A separate post offered “dexies $8pp,” its photograph showed five tablets beside a label clearly marked “controlled drug B1.” Another listing advertised “20mg ir ritz $90 Drops,” accompanied by a photograph of a cut blister tray.

The listings were not all from people presenting themselves simply as stimulant sellers. One account advertising Rubifen 10mg immediate-release trays for $50 also offered “Morphine Promethazine Lean” for between $120 and $200.

In a Wellington-based group seen by Salient, another seller advertised prescription stimulants alongside cannabis and ketamine. Ritalin 10mg was listed for $10 a tablet and Vyvanse 50mg for $20 a capsule. The post included photographs of the medication and described Vyvanse as “slow release adhd medication,” alongside listings for “ketamine shards” and three strains of cannabis. The seller advertised Ritalin LA and IR, both 10mg, and Vyvanse 50mg.

Salient was also shown messages from a second-year student who sells medication from his own ADHD prescription through Signal for extra cash.

Jamie, a third-year undergraduate student, has bought ADHD medication without a prescription before, usually through people they know and most often around exams. When their usual sources were unavailable, they bought from somebody on Signal instead. The pills arrived loose in a heat-sealed plastic bag.

“I felt really off: like I was high,” Jamie told Salient. They did not know what they had actually taken. “I never bought from that person again. It was pretty scary.”

Jamie did not go to a doctor or hospital afterwards for fear of repercussions having bought the medication illegally. That fear is worth separating from what Medsafe—New Zealand’s Medicines and Medical Devices Safety Authority—actually says about reporting harm: anybody can report a suspected adverse reaction even when a medicine was obtained illegally, and Medsafe does not prosecute people for making those reports.

The experience did not stop Jamie from continuing to buy stimulants. They receive StudyLink and work a casual job, and said they usually pay between $15 and $30 for a pill or $60 to $90 for a sheet. They believe they may have ADHD but have never been formally assessed, largely because they cannot afford it.

“With rent, food costs, and transport, and an insecure job, I’m always scraping by, there’s no room to save that much money,” they said. Jamie also said they do not have the parental financial support that could cover a private assessment.

At Te Herenga Waka—Victoria University of Wellington, private providers on a list previously supplied through Student Health generally charge between $900 and $1800, depending on the assessment. At Jamie’s usual illicit price, $900 would buy between 30 and 60 pills; $1800 would buy between 60 and 120.

That price difference sits at the centre of the market Salient found. We interviewed current and former university students who had bought, sold, or shared prescription stimulants and reviewed several Signal chats where the medicines were advertised alongside other drugs. All student names in this story (including Jamie’s) are pseudonyms.

New Zealand has just made one of its largest changes to ADHD treatment access in years. Since 1 February, vocationally registered specialist GPs and nurse practitioners working within their area of practice have been able to assess adults with ADHD and initiate stimulant treatment, reducing the system’s previous reliance on psychiatrists and paediatricians.

But the reform changed who can provide ADHD care, not how that care is funded. Ministry guidance explicitly states that ADHD services are not covered by core general-practice capitation, meaning patients still face significant out-of-pocket costs. It also notes that a comprehensive ADHD assessment cannot be completed in a standard 15-minute GP appointment. Instead, an assessment may take one to two hours across multiple appointments, followed by regular review appointments.

Documents released to Salient under the Official Information Act show that Mauri Ora’s proposed pathway was more resource-intensive still. The University estimated that assessments would take four to six hours per student, followed by regular appointments to ensure any prescribed medication was effective and safe.

Minister for Mental Health and Associate Minister of Health Matt Doocey told Salient that Healthpoint listings showed an 82 percent increase in providers offering adult ADHD assessment and diagnosis and a 44 percent increase in providers offering medication initiation. He said those figures were likely to underestimate the increase because not every general practice is listed on Healthpoint.

Salient analysis of Pharmac data provides another measure. Adult Special Authority approvals (enabling a GP to diagnose ADHD) found primary-care clinicians accounted for 66.7 percent of approvals in February, 67.8 percent in March, 68.1 percent in April, 67.6 percent in May, and 67.4 percent in June. By July, that proportion had reached 69.5 percent.

That represents a substantial increase from January, immediately before the new rules took effect, when primary care accounted for 53.3 percent of adult Special Authority approvals. The figures do not show how many people received an ADHD assessment, however, and should not be read as a count of individual patients. Pharmac said Special Authority approvals may be an indicator of access to ADHD medication; its data counts approvals rather than assessments or unique people. The dataset was held as at 30 August and Pharmac cautioned that it remains subject to change.

The Royal New Zealand College of General Practitioners told Salient there was no additional government funding for practices to train in or offer ADHD assessments. It identified workforce shortages, already-heavy workloads, the time needed to upskill, and the lack of additional funding as barriers to more practices taking the service on.

The College does not collect data on how many specialist GPs or practices are now offering adult ADHD services, but said it expects the number to increase as more clinicians upskill. Asked whether dedicated funding could increase the number of specialist GPs providing ADHD care, Medical Director Dr Prabani Wood said: “Potentially, yes.” But cautions New Zealand needs a sustainable GP workforce first. 

Student Health had planned to introduce free ADHD assessments from trimester two this year, the same OIA documents show the proposal had progressed well beyond an initial idea. By February, an internal operational plan listed an “ADHD Pathway (Assess, Diagnose, Prescribe)” as a service objective. All Mauri Ora GPs and its nurse practitioners were undertaking ADHD training, one GP was preparing to begin assessments with several students, and another had expressed interest in running a dedicated weekly ADHD session if funding could be secured.

Associate Director of Mauri Ora Dr Kevin Rowlatt had previously told Salient the service would require additional clinical staff and cost an estimated $200,000 to $300,000 a year. The intention was for students not to be charged, but on 7 April Rowlatt told staff the business case had failed to secure additional funding from the Student Services Levy pool. “Therefore, we will not be proceeding with the establishment of an ADHD pathway,” he wrote.

The University has since told Salient there remains “lots of interest” from students in an ADHD assessment pathway, although it could not provide meaningful numbers. Internal planning documents give some indication of demand: Mauri Ora said its former psychiatrist, who worked 0.5 FTE, routinely had a six-to-nine-month wait, largely because of increased requests for ADHD assessments. At the time the document was prepared, the nurse assessment pathway used to support GP referrals for diagnosis also had a six-month wait. The University said it explored funding through its Primary Health Organisation, Tū Ora Compass Health, but “there is no extra funding to support this pathway.” 

The decision not to establish an in-house pathway may not be permanent. Minutes from an August Student Services meeting say Mauri Ora had been unsuccessful in securing additional funding and could not provide the service within existing staffing without increasing waits for other appointments. But the minutes add that “the door is not closed.” Student Health plans to review its approach in the new year, once there is a clearer picture of how ADHD services are developing in primary care. 

In the meantime, Student Health can still help students access external assessment. Rowlatt previously told Salient Mauri Ora can provide a list of psychiatrists and telehealth providers, while students who require a referral can receive a nurse pre-assessment before seeing a GP. Others can approach private providers directly. The ADHD assessment itself, however, remains external and is not subsidised by Student Health.

Samantha, postgraduate student, went through that external process after first contacting Student Health in mid-July. They paid about $1000 for a Te Wheke assessment on 1 September, after completing questionnaires with their partner and parents and being asked for old school reports.

Te Wheke charges $1000 including GST and says its adult ADHD assessment can involve up to three hours of interviews and questionnaires, including consideration of other possible explanations for symptoms.

Samantha’s assessment itself lasted about two and a half hours, “which was very hard because I became disinterested very quickly,” they told Salient.

They were told a diagnosis would normally take around two weeks. At the two-week mark, however, their doctor went on holiday.

“They say it takes two weeks for diagnosis, but my doctor went on holiday at the two week mark, so I’ll have to wait about a month.”

The delay left Samantha racing to secure disability support before their October exams. The University advises students seeking exam accommodations to contact Disability Services “as early as possible,” with the 2026 end-of-year assessment period beginning on 16 October.

Two days before this piece went to print, Samantha received their ADHD diagnosis, more than two months after first approaching Student Health. Under Te Wheke’s published process, assessment findings are shared with a student’s GP or nurse practitioner, who can then formalise the diagnosis and discuss treatment.

Samantha’s Māori Ora appointment is now booked for the week beginning 12 October, leaving them only a short window to organise treatment and any disability support before the end-of-year assessment period begins on 16 October.

For students who cannot find $1000 or more for that process, the alternative can look very different. Alex, a first-year living in a hall, first took unprescribed ADHD medication during a week when five assignments were due and their procrastination, as they described it, was “at an all time high.” Friends had repeatedly suggested they might have ADHD, and Alex had already struggled with concentration before university.

They have since used both Ritalin and dexamphetamine for study, preferring dexamphetamine because they find it “smoother” and less jarring.

“I don’t want to rely on it,” they said, but when their mental health is poor and university work piles up, they use it for the “extra push.”

Asked whether their finances affected that decision, Alex said: “I can’t afford a diagnosis to ‘go private’,” and described the alternative as waiting “years for a cheaper alternative. This is affecting me now.”

Alex said stimulants make them feel clearer-headed and more deliberate in conversation rather than jumping between thoughts. But feeling calmer or more focused after taking a stimulant cannot establish an ADHD diagnosis. The Ministry says a proper assessment considers a person’s history, gathers information from people who know them, uses standardised questionnaires, and checks for other explanations for their symptoms.

Health New Zealand acknowledges that cost and waiting times can be barriers, but the publicly funded alternative is not a single queue available to every adult who suspects they have ADHD.

Health New Zealand National Chief Mental Health and Addictions Dr Leeanne Fisher told Salient that people seeking ADHD assessment through publicly funded services are assessed according to clinical need, and not everyone referred will meet the threshold for publicly funded specialist assessment. Referrals may be declined or redirected where a person’s needs can be more appropriately managed through primary care or other services.

There is no single national eligibility standard. Health NZ said access is influenced by whether somebody has other mental-health conditions indicating enough severity or complexity to meet the threshold for specialist mental-health services. It also cannot say nationally how many adult ADHD referrals are accepted, declined, or redirected, or provide a reliable national measure of waiting times.

That leaves some students in an awkward middle ground: concerned enough about their concentration or functioning to seek medication, but not necessarily eligible for public specialist care and unable to afford private assessment.

For Alex, the illegal route came through people around them and was free or available at “mates rates.” For Jamie, it could cost $15 to $30 per pill. On the Signal chats viewed by Salient, dexamphetamine was advertised for $6 or $8 per pill, while Ritalin and Rubifen products were sold by the tray.

Morgan, a former master’s student, began sharing their prescribed medication about a month after receiving it while working in a nightclub. They described coworkers finishing ten-hour shifts, studying during the day, then returning for another nine or ten hours at work.

Morgan sometimes worked 30 to 40 hours a week alongside full-time study and remembered trying to finish readings while club music and lights continued around them.

“There are so many things demanding focus out of us,” they said.

Morgan initially gave pills to coworkers who said they had taken ADHD medication before, then sometimes sold them to customers, at times for $50 a pill. They estimated they had supplied their medication around 20 times and could receive anywhere from $50 to $300 depending on how much they handed over.

Money was not the main reason, they said; they were financially comfortable. Instead, their prescribed dose felt too high to take consistently, leaving spare medication that became easy to circulate. Morgan said the process of changing medication or adjusting dosage could be slow, and believed that if the prescription had worked better for them they would not have had an “abundance mindset” about the excess.

There had also been consequences. Morgan recalled selling medication to a couple who “started freaking out when it kicked in,” leaving Morgan trying to calm them down.

Riley, a third-year undergraduate student, initially offered tablets to flatmates and now occasionally supplies them when somebody is overwhelmed by an assignment or planning a big night out. Because Riley does not take every tablet in their monthly prescription, they have leftovers; as they put it, if they have spares and can make a little money from friends, “then why not?”

Asked why students might want the medication recreationally, Riley’s answer was simple: “drugs are fun and it’s fun to try new ones.” For study, they described students as stressed, overloaded, and perpetually close to burnout.

Morgan and Riley also described pharmacy-dispensed stimulants as feeling safer or more ordinary than other illicit drugs. Morgan said there was “more trust that what's on the bottle is what's in the bottle.” Riley said they rationalised sharing their medication partly because their friends knew the stated dose and contents had originally come from a pharmacist.

Medsafe told Salient there is no assurance that medicines obtained online are safe, effective, or free from contamination. They may be poor quality, counterfeit, or contain something other than what they claim. Medsafe also said clinical assessment is important because stimulants affect the cardiovascular system and other body systems, while Health NZ said ADHD medicines can interact with other medications or health conditions and require baseline physical assessment and monitoring.

Mauri Ora’s prescribing pathway shows what that oversight can involve: baseline cardiovascular observations, medical and mental-health histories, substance-use screening and, where clinically indicated, blood tests or an ECG, followed by ongoing monitoring.

Rodger Wright Harm Reduction Network occasionally receives suspected methylphenidate and dexamphetamine for testing. National Harm Reduction Lead Jason George said the organisation uses Fourier-transform infrared spectroscopy alongside reagent testing and test strips, and that most samples believed to be pharmaceutical methylphenidate or amphetamine have been broadly consistent with what clients thought they had.

But not all. One sample presumed to be methylphenidate—provided in a pharmaceutical capsule—was found to contain MDMA, and other testing remained inconclusive. 

KnowYourStuffNZ’s said in the 2025–26 testing year, 12 samples were presented as dextroamphetamine/Adderall/Dexedrine or methylphenidate, compared with seven in 2024–25, five in 2023–24 and seven in 2022–23. The latest year covers testing only through the end of March 2026, and those figures record what clients believed they had—not a “consistent with presumed” rate. 

KnowYourStuffNZ told Salient it has seen an increase in ADHD medication being brought for checking, but its anonymous service does not collect demographic information that could show whether those people are students.

That leaves a broader problem: no single agency appears to collect enough information to show how widespread the illegal use of ADHD medication is, who is obtaining it, or what harm may be resulting.

Pharmac can measure dispensing and Special Authority approvals, but told Salient it has no role in monitoring diversion of funded medicines. Health NZ cannot provide a consistent national count of adults seeking public ADHD assessment or how long they wait. Medsafe maintains an adverse-reaction database, but did not provide Salient with a trend showing how frequently illegally obtained or counterfeit ADHD medicines are causing harm.

There is another unresolved access problem in the legitimate market: the Ministry says global stimulant shortages are expected to continue because of high demand and constrained manufacturing. Pharmac is managing those shortages, but did not answer Salient’s question about whether supply constraints themselves could contribute to people seeking medication outside pharmacies.

When Salient asked Minister Matt Doocey about the link between costly ADHD assessments and illicit stimulant use, his office did not answer the question.

Instead, Doocey pointed to the increase in Healthpoint-listed ADHD providers, the widened prescribing rules, the removal of the old two-year Special Authority renewal requirement, and the funding of another ADHD medicine. His office said it would take around 12 months for official data to provide a clearer picture of the effects of the February changes.

Two of those measures pre-date the February 2026 prescribing reform: Pharmac removed the two-year Special Authority renewal requirement and began funding lisdexamfetamine from 1 December 2024.

Labour mental-health spokesperson Ingrid Leary said affordability remained a barrier, describing the February changes as welcome but saying widening who could diagnose ADHD “does not, by itself, make assessment affordable or accessible.” She said lengthy appointments and training costs could still be passed on to patients without extra funding.

Leary did not commit Labour to funding adult ADHD assessments, instead pointing to its broader primary-care policies. Labour’s 2026 platform promises three free GP visits a year through Medicard and free prescriptions from July 2027, but no dedicated adult ADHD assessment programme.

None of this means cheaper ADHD assessment would eliminate the illegal stimulant market on campus. Riley describes recreational demand as well as study use. Morgan shows how legitimately prescribed medication can become available because somebody has excess tablets. The Signal groups place stimulants in a wider drug economy where the same accounts advertise other substances.

For Samantha, the formal route has meant finding $1000 and waiting while October exams move closer. Alex says they cannot afford that route in the first place. Jamie has continued buying pills for a fraction of the cost despite already having one frightening experience with a tablet whose contents they could not verify.

The alternatives are not equivalent. One involves clinical assessment, an individualised treatment decision, and ongoing medical oversight. The other can mean a free tablet from a friend or a message to a Signal seller, without any assessment of whether the medicine or dose is appropriate—and sometimes without certainty about what is in the pill at all.

As this article was being finalised, more listings appeared in a Signal chat. One advertised “20mg ir ritz”. Another user offered to trade “1.5 of ket” for a sealed bottle of 20mg long-acting Ritalin, while another listed “ritalin 10mg and concerta 54mg” for “bud+cash”. Dexamphetamine was again advertised for $6 a pill.

Jamie’s explanation for continuing to buy after their own bad experience captures why those posts still find customers.

“It can be dodgy/scary buying from online servers, but I don’t really have an alternative if I want to keep up academically.”

Where to Go for Help

If you are worried about your own or someone else’s drug use, support is available. If someone is seriously unwell or in immediate danger, call 111.

For free, confidential alcohol and drug support, call the Alcohol Drug Helpline on 0800 787 797 or text 8681. The service is available 24/7. The Māori Helpline is available on 0800 787 798, and the Pasifika Helpline on 0800 787 799.

You can also call or text 1737 at any time to speak with a trained counsellor about mental health or addiction concerns.

For Te Herenga Waka students, Mauri Ora—Student Health and Counselling offers counselling for issues including stress, mental health and addiction. Complete the online counselling intake form and call 04 463 5308 to make an appointment.

For information about drugs, their effects and ways to reduce harm, visit TheLevel.org.nz. The Level also has information about drug checking and links to local support services.

KnowYourStuffNZ provides free, confidential drug checking at clinics and events around Aotearoa, including Wellington. It can test many pharmaceuticals and other substances and provide harm-reduction advice, although drug checking cannot guarantee that a substance is safe or determine its exact purity. Visit knowyourstuff.nz to find an upcoming clinic.

The Rodger Wright Harm Reduction Network also provides free, confidential and non-judgemental drug checking, including services in Wellington, as well as broader harm-reduction information and support for people who use drugs. Visit rwharmreduction.org.nz for clinic information.

For official information about prescription medicines—including known side effects, consumer medicine information and safety alerts—visit Medsafe at medsafe.govt.nz. If you are experiencing side effects or are concerned about a medicine you have taken, Medsafe recommends contacting a healthcare professional or Healthline on 0800 611 116; call 111 in an emergency.

For support with drug use, Narcotics Anonymous Aotearoa New Zealand offers free, anonymous meetings and peer support. Visit nzna.org or leave a message on 0800 NA TODAY (0800 628 632).