• Health

Navigating ADHD Medication in Japan: Regulations and Considerations

Introduction

Living with ADHD can be challenging, and for future Interac ALTs and foreigners considering relocating to Japan, accessing stimulant medication to manage the condition presents unique hurdles. Japan has strict regulations on stimulants due to their potential for abuse, making the process of obtaining ADHD medication more complex compared to other countries. Some types of medication are impossible to receive or import. 

This article aims to provide essential information about the legality, availability, and importation regulations of stimulant medication for adult ADHD in Japan, to help you understand the factors at play, and make informed decisions about your healthcare when considering coming to Japan.

Concerta, Ritalin, Methylphenidate, Vyvanse

Legality and Availability of ADHD Medication in Japan

Stimulants are generally prohibited and illegal in Japan. As a result, the use of medical stimulants, particularly those prescribed for ADHD, is more controlled than in other countries.

Available medications for ADHD:

  • Intuniv/インチュニブ (Guanfacine Hydrochloride): Intuniv is another option available for ADHD treatment, and its prescription may be relatively more accessible compared to Concerta.
  • Strattera/ストラテラ (Atomoxetine Hydrochloride): Strattera is an alternative medication that can be considered for ADHD management. The availability of Strattera might vary depending on the prescribing doctor.
  • Concerta/コンサータ (Methylphenidate Hydrochloride): Concerta is an approved medication for ADHD treatment in Japan. It is extremely difficult to get it prescribed as a new adult patient.
  • Vyvanse/ビバンセ (Lisdexamfetamine Mesilate): Vyvanse, a popular medication for ADHD treatment in some countries, is available in Japan but can only be prescribed by certified physicians.  It is restricted to use in children under age 18 only.

 

Medications used overseas that are not available and banned in Japan:

  • Dextroamphetamine (Dexedrine)
  • Dextroamphetamine and amphetamine (Adderall, mixed amphetamine salts)
  • Dexmethylphenidate (Focalin)
  • Amphetamine sulfate (Dyanavel, Evekeo)
  • Serdexmethylphenidate and dexmethylphenidate (Azstarys)

Do not import any of these medications. Importing and possessing Adderall in Japan is illegal. The penal provision under the Stimulants Control Law for possession of illegal stimulants is:

Article 41-2(1)A person who possessed, assigned or acquired any Stimulants without due cause (excluding a person who falls under Article 42, item (v)) is punished by imprisonment with required labor for a term not exceeding ten years.

Several times narcotics control officers have given speeches to incoming Interac ALTs regarding the severity of drug control laws in Japan.  One thing that they will universally say is “It is not a question of if you will be arrested (for illegal drugs) but only a question of when you will be caught.”  We do not want you to come to Japan and end up in prison, so please pay careful attention and do not import these medications.  If you have questions about medication during the onboarding process, please make sure to ask your recruiter.

Bringing ADHD Medication to Japan: Importation Regulations

  • Carrying Medication on Arrival: Travelers are allowed to bring a maximum of 2,160mg of methylphenidate, regardless of its short or long-acting form. If the quantity exceeds this limit, individuals must obtain a special import certificate.
  • Postal Mail Importation: Importing psychotropic drugs, including methylphenidate, through postal mail is not legal.

There is no loophole allowing for a “30-day supply” importation of scheduled psychotropic drugs. Please do not attempt to have medication sent to Japan via mail.  There have been cases of arrests made when parents overseas sent their children living in Japan stimulants by postal mail.

Doctor's office in Japan

Obtaining a Prescription in Japan

To obtain a prescription for ADHD medicine in Japan, individuals must consult a psychiatrist or psychosomatic doctor and receive a diagnosis of adult ADHD. The prescribing doctor needs to have extra training in managing stimulants, and be certified by the manufacturer in advance as a prescribing doctor.

The pharmacy where patients receive stimulants must also be registered with the government and manufacturer.  The pharmacy may be limited in the amount of medication that it has in stock, typically ordering medication upon receipt of a new prescription.  This means that patients may not receive medication immediately and may have to come back to receive it.

New patients are also registered with the manufacturer and issued a numbered patient ID card that must be presented with additional ID when picking up stimulant medication.  This precaution is to prevent unauthorized persons from receiving stimulants.

Unfortunately, there is no centralized list of clinics and doctors publicly available, indicating their willingness to prescribe stimulants for adult ADHD. We cannot direct you to a clinic with 100% certainty in knowing if they will prescribe you medication or not.  Also, you will need to communicate with the prescribing doctor in Japanese, and, for Interac ALTs, we will not be able to go with you to provide interpretation.

Due to the lack of prescribing doctors in local areas, some patients may have to travel to other prefectures or major cities to find a suitable prescribing doctor.

You may try contacting an international/travel clinic in Japan prior to departure and setting up transfer of your prescription from your home doctor to a doctor in Japan.  Getting an introduction to a prescribing doctor in advance before leaving may make it easier to get medication after coming to Japan.  Any costs involved in setting up such an arrangement are your responsibility, and we cannot recommend any providers.

Known Issues

There are some issues that we have heard from past teachers who attempted to get prescriptions for ADHD medications.

  • Documenting Medical History: Bringing detailed documentation from the current doctor about your ADHD and your prescriptions is recommended. Many doctors can read English, making it helpful to have such documentation in the event of any questions or concerns.
  • Navigating Doctor Opinions: Some doctors may hold outdated views or skepticism about adult ADHD.  The prevailing opinion among many doctors is that ADHD is a child’s disorder and that adults “grow out” of it and no longer require treatment.

If a doctor is unwilling to prescribe or suggests alternative diagnoses or medications that don’t align with your medical history, you’ll likely need to find another doctor.  Some people have visited six or more doctors before they were diagnosed and received medication, so be prepared to spend time visiting different doctors if needed.

Drug Screening

Individuals taking methylphenidate should be aware that it may trigger a positive result on drug screenings.  When taking Interac’s drug screening, please inform the staff at the time of testing about your medication.

Conclusion

Living with adult ADHD in Japan comes with challenges, especially concerning the availability and regulations surrounding stimulant medication.

Individuals considering becoming an Interac ALT in Japan should be aware of the strict importation regulations and the current situation regarding stimulant medications.  When considering Japan, please understand that you will face serious difficulties in obtaining these medications and preserving your current quality of life.

If you’re interested in learning more about Japanese life and culture, our website is home to a wealth of free articles to give you a taste of life in Japan. For more information about living and working as an Interac ALT in Japan, check out our dedicated information pages.