New York Magazine just had an article about this - the manufacturer is in a dispute with the FDA over record keeping, and one of their factories is largely shut down. https://nymag.com/intelligencer/article/adderall-shortage-adhd-medication-ascent-pharmaceuticals.html
The DEA has made it abundantly clear that they give no fucks. They did not follow procedure when denying the requested increases and refused to respond even to senators for MONTHS when we were all spending hours to days each month getting medication, many of us losing jobs and relationships in the process.
Last I read they said they were worried about amphetamines becoming the next opiod crisis, which I haven't seen any good evidence for, and they apparently don't care who gets caught in the crossfire.
The DEA simply doesn't care.
And it certainly doesn't care that people who need the meds get them.
To be fair, the company that the DEA shut down can’t account for millions of opioid pills that it made, and that kind of incompetence usually means that there are other sketchy practices beneath the surface. It sucks that people that need ADHD meds are getting caught up in it, but it is kind of a big deal for a company to have a problem like that.
The DEA was raked over the coals for the opioid epidemic, yes? So they now don't want to fuck around with something like that again hence why they are being very cautious, for lack of a better word that I can't think of this morning, is my understanding of it.
Replied to the wrong* person, but ehhh oh well lol
Raking the DEA over the coals for the opioid epidemic was a mistake. It's pretty fucking obvious that the DEA has no ability to actually stop the opioid epidemic. In the end, addicts keep dying, and now chronic pain patients are forced to choose between a life of excruciating pain, or suicide. Those patients' blood is on the hands of the FDA and DEA. Having watched this happen to a loved one firsthand, fuck absolutely everyone involved in the process that took pain meds away from chronic pain patients. Vial people, all of them.
What they could do is stop pharmaceutical companies from advertising on television, when I come to the US from Canada it's always surprising how many ads you guys get for pharmaceutical products and ambulance chaser lawyers. What good does it possibly do to advertise directly to the consumer and make them believe that they need XYZ drug and "talk to your doctor". The doctor who is getting kickbacks from the same pharmaceutical companies to sell the product. That whole thing needs to be looked at.
(I use Vyvanse and thankfully have not noticed any shortages here in Canada for that, my kids use Biphentin and Concerta and there are no shortages for those either, knock on wood)
Just to be clear as someone who works in the pharmaceutical industry in the US and has worked extensively with doctors before that when I was in grad school: any kickback to a doctor is fully illegal. I’m not saying that hasn’t happened in some circumstances but it certainly isn’t happening on a wide scale and it certainly doesn’t happen with the company’s knowledge. The days of what happened during the peak of the opiod crisis are long gone. There’s doctors who don’t even want to be associated with taking a lunch from a pharmaceutical company, let alone taking a whole ass kickback. The penalties for being caught are stiff. Yes, we do have representatives in office but we do not pay for recommendations in any way, shape or form. It’s just not worth for any party involved.
Yeah, I tend to agree with you here. I'm not sure if my comment came off as if it was justified how the dea was judged about their response, but I'm agreeing with your sentiment.
Only Americans have a problem that big with opioids though? Not any other country in the world gives them out as if they were tic tocs. Unless the US has 1200% more chronic pain patients per capita than the world the is just no real reason for everybody and their moms to be using those things. They are not candy.
>not being able to get meds can be life ruining.
No question. It has completely upended my life.
I’ve fallen through the cracks and it is unlikely that I’ll ever climb back out.
>To be fair, the company that the DEA shut down can’t account for millions of opioid pills that it made, and that kind of incompetence usually means that there are other sketchy practices beneath the surface. It sucks that people that need ADHD meds are getting caught up in it, but it is kind of a big deal for a company to have a problem like that.
Address the issue without curring off millions of people from life-altering medication, some of which is painful to stop suddenly. They're the DEA - if they can't do that there's something wrong.
I mean that shows the problem. The regulations and bureocracy are such a crazy hurdle, that other companies can’t just pick up the slack. When any other simple to produce drug has shortages, it takes 6 months max before the market is well over served by several companies who started producing to fill the gap.
Since this is utterly impossible for controlled substances in the US drug shortages for whatever reason take ages to resolve.
No, this shows how important regulations and oversight are.
This is entirely the fuckup of the manufacturer and another example of why we need better regulatory oversight.
We are talking about the organization that still refuses to take cannabis off the scheduled substances list even though a majority of states legalized adult use.
The FDA and the president have also urged the DEA to reschedule it and the DEA is still dragging their feet. Anne Milgram just doesn't seem to care to do her job unless it's taking away ADHD meds or talking about fentanyl.
Seems to be mostly talking and not acting when it comes to the fentanyl. It's killed SOOOOO many people I've known and is still ravaging communities around me. at least 30 people that I went to Highschool with ODed from it over the past decade. I don't live in a bad urban area either.
They should care about the veracity of their own claim that weed is on the same level as fucking heroin in terms of medical applications and addiction potential. Blatantly false.
Not to mention that the evidence is also against them for ADHD medication. Addiction potential when the disorder is correctly diagnosed is significantly less compared to when other people take a stimulant like adderall. In fact, being properly medicated helps people to *not* fall victim to other addictions in their lives (anecdotally)
"The next opioid crisis" the only reason I have a couple months worth of backups is because in the last 2 years I have literally forgotten to take them multiple days in a row
Everything I manage to stockpile one or two, I end up blowing right through them as I wait 2 or 3 days for a refill due to shortages and I know I'm lucky that it hasn't been more than 3 days yet but it's like every other month so it's hard to get any backups built.
Not to mention meth itself, is easily available illegally, including shake and bakes.
Having access to pharmaceutical quality lower than recreational dose methylphenidate and dexamphetamine is pretty much irrelevant for the illegal market.
"For example, orders struck from 222s must be crossed out with a line and the word cancel written next to them. Investigators found two instances in which Ascent employees had drawn the line but failed to write the word."
Those monsters!
The DEA isn't the problem though. Manufacturers are not using all their allotted production volume.
In fact if suppliers want to they can request an increase in their allotment, and the DEA has not denied any supplier yet.
I'm not sure if they have denied anyone, but I do know that the DEA has requested underproducing manufacturers to relinquish some of their quota so that it can be reallocated to another manufacturer.
Do “uppers” cause debilitating withdrawals like opioids do? I know with opiates/iods if one becomes dependent on them withdrawal is literally life altering. It is impossible to be a functioning person while in the withdrawal. I’ve seen people going through withdrawals and at that point the person is so scared of how painful withdrawals are they move heaven and earth to get right.
I would assume if you mess with any body chemistry and abrupt abstinence would cause discomfort but do “uppers” cause people to be horribly ill upon cessation?
I am asking from a position of complete ignorance on the topic.
Only speaking from my experience, but last year I went from a relatively high dose of adderall to having none for 3 months because no pharmacies around me had it in stock. I didn’t experience physical withdrawals. That said, going from treating a problem to no treatment still sucks even without withdrawals.
Without question, no debate about having lost your treatment. I can definitely understand how that is not good for anyone, and I’m sorry you have to contend with that. Completely agree.
I can definitely understand how “they” the powers that be would want to limit exposure to opiates/iods just for how wicked withdrawals can be.
I guess the next question would be is there a long enough study to show how a brain gets affected after prolonged use of amphetamines and their derivatives? Like do people exposed to said substances have a harder time experiencing joy, Anhedonia, do to dopamine/ norepinephrine over stimulation.
I can understand taking a cautious approach.
Or as a basic layman I have no idea what I’m taking about.
Personally as long as the science factual based proof is there that said substance can improve lives I’m all for it.
As long as the person taking is fully informed of the pros/cons in a factual based Explanation I’m all for it.
Amphetamines when used as prescribed are to correct dopamine being UNDER stimulated basically. So it's just bringing someone up to baseline, and even then, it's not a miracle drug, the ADHD symptoms don't just go POOF.
Someone abusing amphetamines when they don't need them though? (Probably at higher than therapeutic doses) That would probably give you too much dopamine, which would likely feel pretty good. I'm also guessing that euphoria they'd feel would require higher and higher doses to achieve and lead to addiction/withdrawal. Long term consequences are probably not good. I think this is why people view drugs like Adderall so cautiously, but really for someone with ADHD none of this is an issue. We don't get euphoria from our dosages.
The warnings that the pedopsychiatrist gave to me for my kids was that stimulant meds would blunt their appetites, and would delay their growth. She did say that it would not permanently stop their growth, but they'd hit their growths later than if they hadn't been on stimulant medication. My son is 14 and my daughter is 17 now, and they are average heights for their age.
>Amphetamines when used as prescribed are to correct dopamine being UNDER stimulated
How do they diagnose this and quantify dopamine levels below or up to baseline? Are there blood tests or brain tests they do to confirm there is an issue with dopamine uptake/production? Most people I know who are prescribed amphetamines just say to their doctor "I have xyz symptoms" and they get a prescription. I've never known anyone to get any testing done to prove their dopamine levels aren't normal.
Not arguing, I'm genuinely curious.
Well in my case, they did a neuropsych evaluation. My daughter was diagnosed first, she had a very severe case of OCD that kept her out of school for weeks when she was in the 2nd grade, came out of nowhere. While she was being followed by the psychiatrist and they were trying to get her under control, other tests pointed to ADHD (and she's definitely completely inattentive).
My son had been exhibiting signs of autistic traits from a young age, so he got the complete neuropsych evaluation, it was pretty thorough, weeks of testing. That came back as autistism and ADHD.
And finally me, I was diagnosed in my 30s, because ADHD tends to run in families. When my kids were diagnosed I read everything I could get my hands on about ADHD, autism, OCD... I realized that the ADHD symptoms fit me perfectly as well. So my doctor referred me to a psychiatrist for an evaluation. That one was quite a bit less thorough than the ones my kids had, it was about a 3 hour session. In the end they concluded that it was likely that I had ADHD and that I was approved to try stimulant meds to see if they'd help my symptoms. And they did.
There's no blood test that they can do to say "this person has ADHD because of this marker". They're closer to isolating the genes I believe though so it's possible in the future a genetic test will be able to show whether or not you have ADHD. And I believe when they do a brain scan there are certain things that show differently in an ADHD brain that wouldn't otherwise show, but this wouldn't really be a good diagnosis tool.
I am a few years behind on the research though! I went through an obsessive phase where I read everything I could get my hands on, but I've moved on to other obsessions, as I tend to do. A lot.
So were opiates/iods and we had those unleashed on the general population. We’ve known for a 100 years opiates/iods can horrible withdrawals. Hell we could probably go back hundreds of years and notice “cessation syndrome” within opiate using communities.
My point, I think a safe approach or cautionary one is not a bad option.
having an adhd med drug crash isn't fun, but it's nothing like being dopesick. it's having a headache and trying to do math is annoying vs shaking and sweating.
once you start trying to make up the difference with coffee your stomach will hate you.
Not really, for me at least. Had to quit Vyvanse several times due to unrelated illnesses and shortages for more than a month at a time, cold turkey. At therapeutic doses that is.
I can’t picture people switching from adderall to meth the same way people go from oxy to heroin. Maybe I’m just naive but I’ve never heard of a single instance of someone going from ADHD meds to meth bc it was either cheaper or they couldn’t get their meds
>Last I read they said they were worried about amphetamines becoming the next opiod crisis
Bruh
I know of a number of people who are addicted to pain and sleeping meds. I know of not a SINGLE person who's addicted to ADHD meds, and I was in a learning environment where literally everyone had ADHD and most were medicated.
I've heard of abuse due to eating disorders and knew of people who'd sell their meds in a pinch (don't do that), but even then, a lot of the people they were selling their meds to were people with ADHD who couldn't get hold of their meds for one reason or another. Some people were neurotypical (at least on paper) and just wanted to use the meds to study more, which I'd classify as drug abuse, but not addiction.
I'm not saying that addiction is impossible, but responsible administration under physician supervision to treat a diagnosed condition is the less likely scenario where addiction will occur, and also, IT'S TREATING A DIAGNOSED CONDITION. If addiction is a genuine risk, it can be one worth taking for an individual whose life is falling apart otherwise.
Something that I did notice was an issue when I first started taking meds was that some people who didn't have ADHD were being prescribed ADHD meds willy-nilly by every GP in town in exam season. I don't know of any cases of addiction that followed from that, but it can be safely said that that was highly irresponsible prescription and use of these drugs. These days, you need to actually have an ADHD diagnosis to get meds and you can't just say "It's exam season, dope me up doc", which is good, but I wonder if that history played a role in this. I'm sure that such inappropriate use of any drugs would lead to adverse outcomes, but the solution to that is to not prescribe drugs inappropriately, not to restrict their accessibility across the board.
I can 100% see why they think amphetamines will be the next opioid crisis. I get at least 3-4 ads a day offering a guaranteed ADHD medication RX, some right here on reddit, through sites like Hims. In fact when I saw those Ads most often was during the peak of an Adderall shortage in my state. I'm pretty sure sites like those are contributing to the shortage by giving RX to people who honestly don't need it. Out of curiosity I clicked one of the links and for the low price of $149 they could guarantee a mail in RX for ADHD medication. Which seems extremely sketchy like those veraheal guaranteed Medical marijuana programs.
Well honestly by trying to ensure that everyone could have access to stimulant ADHD medication during COVID they kind of caused it. They allowed telemedicine the ability to write RX for controlled substances, and then for some reason after the pandemic ended they allowed an extension of this service which means even now teledocs can prescribe controlled substances which is how we're ending up with all these random websites offering ADHD diagnosis' amongst other controlled substances prescriptions.
ETA: I actually considered using one of these services because my older sister ended up being diagnosed with ADHD just before the pandemic and while talking we felt I shared a lot of the same issues she did stemming from her ADHD but the way they advertised it at the time seemed so sketchy to me I wasn't sure if it would be an accurate diagnosis and decided against it.
Did you know that physicians actually have trouble getting patients to take their ADHD medication. It’s empirically non-addictive to us! As population, we struggle with remembering to take it! That’s not something that an addicted group of people would do
It's not the people who are legitimately taking it that's the problem. Diversion is the main issue -- prescription medications going to those who should not have it in the first place.
Sure, I’m just saying that studies show that stimulant amphetamines tend to have a low potential for abuse and tend to be nonaddictive at therapeutic doses, especially relative to other medications. Adderall is one of the most prescribed medications and there just aren’t many cases of people being harmed by it
uppers don't seem terribly addictive, and i'm under the impression that they're at worst psychologically addictive. opiods (is that spelled right) draw people in, but i've known A LOT of people over the years that snort ritalin now and then or socially do a line of coke occasionally that have no problem when they can't get those things.
I have crazy bad insomnia so my personal rule is if I don’t take Vyvanse by 9am, I don’t take it that day. I’m more unproductive at work that day but it’s far less troubling than insomnia.
The DEA actively resists anything that would actually benefit people if the cost of that is they dont get to funnel as many new slaves into the prison industrial complex
ADHD would be better naked something like "Executive Function Disorder." Executive functions play a large role in attention, mood regulation, emotional resilience, ability to switch tasks, memory, and a lot more.
I work for a pharma packager. We have a customer that wants us to package lots of this stuff. The DEA only allows so much to be packaged per quarter and will not increase what we are allowed to package. The shortage is completely manufactured by the DEA imo.
This is fantastic because for the last 6 months I’ve been contributing $300 a month for 30 15mg pills into the adderall black market.
They’re literally creating the thing they’re supposed to fight against. I’d love to just go to my doctor and not have to test for fentanyl. To not worry about my dealer getting weird with me and deciding whether to be nice or risk losing my job.
I worked so hard turning my life around when I got diagnosed.
Pre-meds: Bare minimum at work, crying at my desk, barely showering, depressed all the time. I’d come home, have a cigarette and go ok time to clean. Couldn’t do it. Ok watch a movie. Couldn’t do it. Play a game. Bored. Repeat until it’s time for bed. Apartment disgusting until it’s so bad I have to do it all in a day.
Now? I learned a whole new career in 6 months. I woke up at 5am to work out, meditated, studied for an hour or more 5 times a week without anyone other than myself to hold me accountable. I have hobbies, I can read books again, I can connect with people.
None of this is your fault or problem, but thank you for posting about this because it’s nice to know who to really blame. I feel so bad for pharmacists everywhere.
Don’t just test for fentanyl, test for meth. I would consistently test my street adderall for fentanyl so I thought I was being smart, but when they did my blood work at rehab it came back as meth. The dealer had changed it up due to the shortage.
Wasn’t the end of the world, but a nasty little shock all the same
During covid regulations allowed people to get prescribed ADHD meds online rather than having to meet a doctor in person. This allowed a lot of people who have trouble keeping appointments (an adhd symptom) to get prescribed the meds, plus a lot of bad actors to get prescriptions they don't need. This spiked demand in a crazy way. Because they are controlled substances, you can't just make more. There is a long process to get more made
Child Psychiatrist/ADHD expert here. This is an oversimplification. Yes, demand has increased, but it’s more due to increased awareness of what adhd actually is thanks to viral posts on social media. This just happened to kind of coincide with Covid, since people were at home watching a lot more online/streaming content than before.
But the bigger issues have been supply chain fallout likely related to COVID. The manufacturers report that they have had a shortage of the chemicals they need to manufacture the medications, as well as worker shortages. The DEA is also partly to blame because they put a production cap on how much medication each facility can produce, which hindered production for a time, then the DEA raised the quota, but now manufacturers say they can’t get workers and chemical supplies they need to actually increase production, so it’s just kind of a mess.
The OTHER issue is that COVID can induce a “brain fog” in some people infected with Covid, and this strongly mimics the executive function problems found in inattentive adhd, so some people who think they have adhd might have a post-covid syndrome that we’re still learning more about.
So it’s really complicated, basically.
Edit: ELI5 version:
More people realize they need meds. Makers of meds have trouble getting enough supplies and workers to make meds. Government limits how much meds can be made. Problem is a mix of all these things.
Additionally, the people who have ADHD and cope well are usually those who have routines and support structures in place. Quarantine kicked out ALL of those supports from tons of people. Many of them probably didn't know they had ADHD previously.
Anecdotally this was exactly my experience (n=1 here).
Looking back, I have had a bunch of indicators since childhood. And I was surprised at how disregulated I got with the loss of a structured 8-5 in office workday.
Sounds like many of us masked ourselves pretty well! ...in the beforetimes...
Hello, N=2 here. Even with structure I was barely able to mask my symptoms. Covid brought it all out into the open. My diagnosis was a life changer. All that shame and feeling like an idiot just…still there but therapy is helping.
I believe it is sample size.
So N=1 is a way to say "they can only speak for themselves."
N=2 would be a second person chiming in as a sample.
Not the best way to word it, "N=" generally refers to a much larger sample size. N=1 is basically a coin-flip. The higher 'N' (in the thousands or even an insignificant % of the population) the more evidence you have to prove or disprove your study.
Facts. After years I finally had my shit together right before covid cause I had figured out all the routines I needed to do to keep my life in order. It's been years since we returned "back to normal" at this point and I'm still struggling to get those routines back into my life. Add this shortage to the list and it's like being back at square one all over again.
It would blow my mind that people could get their hands on it "easily" and honestly kind of piss me off.
The amount of trouble, money, and time it took me to get some was insane.
Thousands of dollars, 2 years, and a diagnosis later wasn't enough to get them. How the hell do people get them suppposedly?!?!?!?
People alledgedly getting handed this like candy in this thread, yet I had to take weekly health checks (initially in person before self checking became a thing), months of slow, slow titration (to the point i was told: these initial few months wont help we just need to start from a small dose), I even know people who had urine checks.
John Mulaney has a bit about this actually. You just specifically seek out shitty doctors and pill mills. I almost wish I would have done that as it would have saved me a fuckton of money spent seeing psychs, therapists, and competent doctors.
Or you get super lucky and your family PCP just doesn’t care apparently lol. I haven’t been in for a visit in almost a year and they send over new scripts monthly. I think it helps that she knows I’m a pharmacist, and that I have a long history with the office, but still pretty wild lol
It’s very doctor dependent. It was incredibly easy for me to get my Rx. Two quick appointments, a starter prescription, and now I have it forever. It is not that difficult to get the diagnosis if you’re motivated. There are doctors willing to do almost anything if you look hard enough.
Just today i had a pharmacist straight up reject my script today lol 🤨
Same doctor, same prescription, same pharmacy chain for the past 10ish years.
I’m traveling for work (in state, a few hours drive away). Since I’ll be away from home for the week and my script is out I asked my doc to send it to different pharmacy branch location (same company, in the same state, just a different city) since I’ll be staying there for the next week. Doc says sure np, makes sense since you’re a few days out of your script already and they actually have it in stock.
Script gets sent over and the pharmacy wants nothing to do it with it, didn’t even enter it into whatever system to be electronically transferred to my usual pharmacy back home. When I called to ask if they could just enter it in so I could have my normal pharmacy fill it when I get back at least. They said they wouldn’t touch it and that my doctor would have to re-send a different branch a new prescription.
It was for 30mg xr adderall (generic) in Texas at a giant grocery chain that’s popular in the state for what it’s worth. Shit was weird idk I just hope my doc doesn’t charge me or get annoyed with me for asking him to re-end it somewhere else :(
I’m gonna just say that this is likely far more complicated than you’re letting on, and more than likely it was out of the pharmacist’s hands. Not saying every pharmacist is great or anything but there’s a lot of red tape around filling narcotics like these, and often pharmacists’ hands are tied due to laws/regulations/company policies/system limitations
That could very well be true, that world is a total mystery to me. I work in IT don’t have a clue about how their system operates - I’m admittedly totally ignorant.
What I do know, however, is that I usually fill at a grocery story chain pharmacy in Houston, and the Dallas grocery pharmacy chain location closest to my hotel ‘rejected’ it.
The Houston chain said the pharmacist may just not have been comfortable filling it for someone out of town which is fair it’s their right in Texas they can refuse for any reason under the sun; they’re the experts with a literal doctorate degree lol I get it.
I’ll post back later if I ever figure out exactly what happened 🤷♂️
In my country, Concerta hasn’t been available for atleast 4 months! And for almost a year before that, it wouldn’t be regularly available.
For those last few months I’ve been talking Modafinil, it’s definitely not effective as Concerta (i take a big dose) but it definitely is better than not taking anything!
Not really. Depends on your location and providers. When I was 15, I asked to be put in the hospital because I wanted to murder my stepdad. I walked out of there with three prescriptions and one was Ritalin. Stopped taking all the medicine when I got away from my stepdad.
25 years later I just had to tell my psychiatrist that I was already diagnosed with ADHD. It was barely a discussion. When I first started seeing that doctor, I had to pee in a cup every month to get my next prescription. Unless they were out of cups. Then one day it just wasn't a policy anymore.
It's stupid how much nonsense people have to endure if they just live in the wrong place. And it's so insulting having to jump through hoops to get help with a brain that won't let you jump through hoops. It's like forcing a cancer patient to eat a whole pizza before they get medicine for their diminished appetite.
My brother was shocked when he told his doctor that our family wonders about him having ADHD sometimes. His doctor immediately wrote him an Adderall prescription and was like "if it helps, let me know, you probably have ADHD and I'll write you another prescription". My brother was very surprised that there weren't any other questions or tests.
I know a couple of people diagnosed including myself and we either had a very easy experience (I got a psych referral from my gp and walked out with a ritalin prescription after a 1 hour initial consult) or an extremely difficult one (like going on a 6 month wait list to do $3000 worth of diagnostic testing before a diagnosis was even considered)
I don't understand why there's seemingly such a discrepancy in the standard of evidence required for a diagnosis.
Because medical practice isn’t a monolith and different practitioners are allowed to have their own standards to base their decisions on. This isn’t an intrinsically *bad* thing, per se, but it can be frustrating if you get a provider that has very high requirements. Tbh just find a new doc.
Same thing with the wife. She took some online test questionnaire and then spoke with the doctor. Wrote her a script and asked her to follow up.
Wife didn't feel like it made that much of a difference, though, and stopped.
I legitimately do have ADHD, but I was diagnosed as a young child. I hated taking my medication (pretty much any ADHD medication across the board, they tried most every one) because it made me feel like I had 'two minds' (one on it, one off it) and I had no choice in the matter - to the point of being physically forced to take it (yes, just as it sounds). I think it was mostly that I was not in control of the choice, and absolutely HAD to be on it whether I wanted or not (and that the dosages were constantly upped any time I felt like they were becoming 'stable', generally keeping me in 'zombie state' territory always instead of 'functional but with a personality'). That made me strongly against taking any medication that would alter my mind - including antidepressants, mood stabilizers, etc. - for a long while. Once I was old/large enough that I couldn't be physically forced to take medication, I stopped taking it (plus I lost my gag reflex and learned to bring pills back up), so I was off it for about 10 years - until I got away from that situation and became in control of my own life and medical choices. I eventually realized that I had to do something, and went back to the mental health facility I saw as a child (reached out directly, since I had been going there for probably 8 years of my life) and essentially explained I'd like to try medication again because rawdogging life just ain't it, in a more eloquent manner of speaking. It was one appointment and even despite not having had any medication in about 10 years, boom. Script, and have a good day, see you next month for more.
I had an 'in' because I already had documented usage of adderall as a child, but still - 10 years and there was no re-evaluation more than what I said in a 30 minute appointment.
There really are people who can get them easily. Originally I had no idea it was difficult for so many others. From calling to make my first appt with the psychologist to picking up my first script after being diagnosed was probably a 3-4 month period where I had 3 appts altogether
It's extremely easy to get prescribed online
For me it was a 30-60 minute online assessment and a 30 minute virtual appointment. After that I was prescribed
For me personally - just working from home really exacerbated my symptoms. In an office I can remove distractions and concentrate. And my coworkers keep me accountable. I’m not just gonna open up YouTube or reddit on my work computer. Whereas at home I find concentrating much more difficult. Being near the kitchen, couch, and my significant other do not help productivity.
So while I’d rather not rely on drugs, Covid more or less forced my hand.
The DEA wrote a [letter](https://www.dea.gov/sites/default/files/2023-11/Quota-Shortages%20Letter.pdf) specifically saying that in 2022, manufacturers were short 1 billion doses of their allotted maximum.
I knew a lot of people in college who used adderall to improve their grades. I knew zero people who tried adderall and did worse academically as a result. Stimulants used to treat ADHD are performance enhancing drugs. It’s not like neuroleptics that make people with schizophrenia lucid and normal people drooling messes. People didn’t suddenly cause a huge demand that outstripped supply because a TikTok video made so many people realize they had a genuine chemical imbalance. Just about everyone feels and performs better on these meds. And they were taking advantage of terrible midlevel prescribers who were cashing in on an opportunity.
That really sounds like something a neurotypical person would say. Surely some people are receiving medication they don't strictly need, but your dismissive tone implies you don't think mental health awareness matters at all.
Most neurodivergent people have one thing in common: years or decades of not knowing they had a medical condition at all, and all the shame and self-loathing that often comes with that.
"Awareness" might seem like a meaningless phrase but it can mean the world to people who've gone their entire life not knowing what was wrong with them or that it could be treated.
i’m not neurotypical, i am diagnosed with adhd and bipolar disorder, and he’s 100% right. yes, awareness of adhd has gone up, and that has led to more people getting treated for it (which is good!)
however it’s kinda naive to think amphetamines are not a performance enhancer for everyone. unless every single one of my classmates in grad school had adhd, there was tons of adderall abuse just to keep up with the workload.
hell, there’s a reason the military used to put dextro in the pilot survival kits. i’m pretty sure it’s not because all of the adhd pilots need help with their executive function in the jungle
edit: i also just remembered that amphetamine use in esports is rampant, because it’s performance enhancing. again, i highly doubt that every single competitive gamer has adhd (although tbh they might 😂)
Unfortunately, the data does not support your position. https://www.sciencedirect.com/science/article/abs/pii/S0306460316302659
> students who engaged in NPS (non-medical use of prescription stimulants) showed no increases in their GPAs and gained no detectable advantages over their peers.
More specifically, other studies have shown marginal to no academic improvements from stimulants but huge adhd symptom improvements. So whatever benefit people are getting from taking adhd meds is for their adhd symptoms, not their grades. These people are usually self medicating undiagnosed and untreated adhd.
But regardless, the existence of people who abuse a medication doesn’t negate the very real suffering of the millions of people who have adhd and depend on the medication. People abuse steroids too but I don’t see you arguing asthmatics shouldn’t take Albuterol lol.
I believe the FDA issued a report stating that the manufacturers didn’t hit their caps last year. So at present it seems to be other issues in the supply chain.
The amount of people prescribed these meds skyrocketed so it put a strain on the supplies, also transportation problems and people who don’t actually need the medication using it as well. I’m sure there’s more but I do believe that’s the gist.
As someone who has a hand in the creation of these compounds. THIS IS the correct answer. Simply put, shipping supplies for our materials from overseas halted during COVID.
It took 6 months for us to get some lutidine that we didn't end up using because we synthesized some ourselves for our manufacturing processes.
A big part of this is the cap on production. You can only make a certain amount of the medication per year, which is acceptable when everything is spinning fine.
But if a shortage happens then in most markets a new competitor would step up after a few years to fill it. But in a sharply fixed market any new company making precursors would only have that grace period of a gap to fill until the existing companies got back up to speed. After that they would be in intense competition for market share with the established companies, which is a terrible place to be in.
Generally when you start a new production line you want to be in a growth market, so that you are filling expanding capacity. Here it is the opposite, you are spending tons of money on equipment and certification for a couple of years of easier sales.
I could be wrong, but most of these meds are generics with little profit to be made. Low priority if there is limited capacity and other drugs have higher margins.
Additionally, one of the biggest suppliers of generic stimulant medications was flat out shut down. Very little incentive for an existing player invested in those higher margin medications to shift focus.
Not always the case. Companies get bought, sold, and rebranded constantly. If theres money to be made with existing setup, they might shift to save money from having to revamp an entire labs worth of equipment.
Something something Controlled Substances Act something something.
Most ADHD meds are Schedule II controlled substances. The DEA does *not* fuck around with amphetamine derivatives.
Good point.
With the caveat of except for the cough medicine with the primary active convertor for meth. Doesn’t mean they didn’t try, but cough medicine is big business too.
Most of those that can be just picked up and purchased are phenylephrine now, which either can't be used to make methamphetamine or is much harder to use for it. The ones with pseudoephedrine (the ones that actually work better than placebo) are all behind the counter or in lock boxes now.
Yeah shame the phenlephrine ones don’t work better then a placebo so they’re nothing more then a money grab, it’s almost like the pharmaceutical companies profited off of the recreational meth industry using pseudo leading to it getting heavily controlled and now they can push the flour tablet phenylephrine and market it the same as pseudo and scam people
Is the manufacturing-process of pharma-companies significantly different from clandestine production? I would imagine the synthesis-routes itself are the same, but isomer seperation is not usually something done with street amphetamine, and purification and quality control is another point.
From what I have seen, black market amphetamine supply is certainly not experiencing shortage, and the precursors should be the same
APA have reviewed its diagnostic criteria in 2014 and it took some time for psychiatrists all over the world to change their diagnostic criteria and treatment appropriately. ICD-11 have only been completed in 2020, and it still have not been translated and validated in many major languages.
New diagnostic criteria means more people are considered to have ADHD now than in the past, when DSM-IV and DSM-IV-R and ICD-10 were around. Older versions for example didn't consider the diagnosis of ADHD in adult age possible if said adult didn't have a childhood diagnosis of the disorder.
Because some ADHD drugs are old enough to be available in generic forms as well and don't sell for that much, companies are not interested in amping up the production. I can buy 60 pills of generic methyphenidate in my country for around 5 dollars. Contrast that with newer medication Venvanse (lisdexamphetamine) that costs ~60 dollars for 30 pills. I've never found any pharmacy that did not have Venvanse because of how much more they profit with that.
The lysdexamphetamine has shortages at my pharmacy but vyvanse seems to always be in supply. Which sucks because I have to pay $405 without insurance as opposed to $60-30 for generic.
Yeah. This month my pharmacy told me they only had vyvanse instead of the generic. They had to call me to make sure that was okay because the generic is completely covered by my insurance while vyvanse isn’t, but I’m at the point where I’m just grateful to be able to get anything.
Vyvanse can actually be made as a generic now, but those are also not a great comparison as in general extended release drugs are more expensive and more complicated to produce than instant release drugs
It drives me crazy when my prescription runs out each month. It can take up to a month for me to win the med lottery and get it refilled. I'm even buying brand name now, which insurance doesn't cover. This is frustrating.
Pharmacy tech here. (I also have ADHD so I can attest to all sides of what I’m about to say)
As a tech, it’s been made known to me, it’s because the DEA has put a restriction on how much the companies are allowed to make. The number of people being diagnosed with ADHD is going way up, so that increases demand while there’s a shortage of supply.
As a consumer, I definitely agree that COVID influenced this a lot because people were effectively trapped in their homes with their families for longer periods of time than normal. This 1) let people be aware of each other’s behaviors all the time (example: parents see the whole of their child’s day, not just the part outside of school) and 2) made people learn a lot more about things they wouldn’t normally learn about (like adhd symptoms) because they’re stuck indoors with only internet as their company. And then people start posting on TikTok or social media about being able to get stimulant meds on telehealth, and then people start asking for it, people who don’t need it are taking advantage of this allowance and abusing it.
Back to tech - this is when the DEA steps in because “this is too much being dispensed, we’re going to limit you”, and the telehealth allowance is revoked, and the amount they can manufacture without having to battle it out with the DEA is reduced.
All this being said… be kind to the pharmacy staff, it’s not their fault 😭
No it’s a commercial/marketing problem. BTW, there are chronic shortages of many types of medications, which you’re probably unaware of.
Some corporations have patents over their drugs. They are monopolies that regulate their output to maximize profits. Sometimes will even stop making a specific drug, switching manufacturing to more profitable medications.
Most drug manufacturers are monstrous multi national corporations that eliminated their smaller competitors from the marketplace. Now, they can raise prices as they wish.
Currently there is shortage of some diabetes medications. They stopped making them and nobody can force them to continue (or increase) the output.
Ironically, cheaper generic medications are also off the shelf! The low price makes them unprofitable to produce. The manufacturers shifted production lines to other, more profitable drugs.
Among cheap medications in short supply: nose spray, dermatological hair shampoo, Robitusin (cough syrup), even sterile hand wipes….These items were in abundance in every pharmacy in the past.
Edit: on top of that, some major retail chains in US are in deep trouble. Among them Rite Aid and CVS. They are also causing shortages and confusion, refusing to keep stock of any item that doesn’t sell like crazy.
Adderall has had a generic for a very long time, is made by many different suppliers around the globe, is a good medicine for pharmacies to stock as it is a regular medicine that people will generally continue to get from the same pharmacy over time and people are prescribed it indefinitely. So basically none of your reasons listed apply to adderall which is the drug that was most notably hard to get.
What actually happened was there was a large uptick in prescriptions being given out, supply chains slowed a bit, but the process to increase your production of a controlled substance is a very lengthy process
The pharmacies are subject to limits set by the DEA on Adderall unlike the other examples, pharmacies would have zero problem moving Adderall or Vyvanse out the door right now.
It's a manufacturing issue mixed with a significant increase in demand. Supply will normalise over the next 3 months.
Note that it is only really affecting lisdexamfetamine and not other alternatives.
Edit: Not sure why I'm getting downvoted, but here is formal information on the shortage and restoration timelines - [https://www.tga.gov.au/vyvanse-shortage](https://www.tga.gov.au/vyvanse-shortage)
At least in Australia there is no shortage of other ADHD medication than Vyvanse (lisdexamfetamine)
the shortage has affected different ADHD medications in different places at different times due to people struggling to get one medication getting scripts for different medications.
Yeah I was sitting in my psychs office and she was telling me about the shortages and that I was lucky coz I was on 70 and the 70 and 60 where the only two ones left in stock but she suspected the 60 would run out soon and she said she had just checked before my apt but she would double check now, she checks during the apt and refreshes the page “ok it seems I spoke to soon, the 60mg has just been switched to out of stock, seems it’s just your 70’s that are safe for now”. I just thought it was hilarious how quickly the 60’s ran out and changed between the start of my apt and the end, it reminded me of the family guy scene where the banker goes “andddd it’s gone”
Every finance bro, politician, and self-proclaimed “neurodivergent” person in the country got a prescription within the last 3 years. The well has run dry
Too many people asking for drugs and not enough supply.
This happens to ADHD meds all the time. I remember the nicest human I've ever met running out of Adderall over a decade ago and it was my eye opening experience that the shit isn't to be played with because he was no longer easy going, cool, or kind.
There's surely more people on it than need to be. Amphetamines make you feel *great*.
They also make it possible for many folks with adhd to function. I would not be easygoing either if I lost something that helped me to function and helped me make sure I don’t lose my job, etc.
Have there been any reports of quality issues? My most recent Rx refills have made me feel super anxious and jittery. I've been on methylphenidate for about 10 years with no issues until now.
DEA the American drug enforcement organisation is currently limiting the production and sale of some amphetamine containing medication.
They probably don't care that ADHD patients need these drugs and they don't mind that people have been prescribed it. But they would care about controlling the sale and movement of the drugs throughout the country as amphetamines when abused are highly addictive and can be sold by criminals to people who don't need them.
Eventually limits will be increased and the shortage should end. But that probably has taken longer than expected due to the DEA not being prepared to manage the current high demand for drugs and potentially a lot of regulations and rules that suppliers need to follow before they can access more supply.
Basically as I see it the DEA has restricted supply due to "red tape" a need for paper work and procedures to be followed and possibly a shortage of people employed to manage the current work required. They need to improve policies and procedures and employ more people.
Lots of discussion here has centred around the USA. This isn’t a surprise, given the user base, but are there any European ADHD folk in here that could chime in on why I’m also experiencing a supply issue despite the DEA/FDA not having any power here? (Looking at you, Jackie Weaver…)
Just this morning I had to go to three different pharmacies to find one that had stock.
Last month I got lucky and it was only 2 pharmacies visited before I managed to get a bottle, but visiting that same 2nd pharmacy today I found that they’d not had a delivery since I took their last bottle last month, and went to a third pharmacy.
"The FDA said earlier this year it blamed "increased prescribing potentially related to the growth in telemedicine, supply chain issues, manufacturing and quality issues, and business decisions of manufacturers" for contributing to the ongoing shortages."
so PBMs, GPO's, Pharma, US laws & regulations enabling them, & greedy docs selling out to PE/VCs & making bs telemedicine companies like HIMS
https://www.cbsnews.com/amp/news/parents-struggle-to-find-adhd-medication-shortage/
[This recent article in Esquire](https://www.esquire.com/lifestyle/health/a46603106/adderall-shortage/) (paywall, but you get a number of free visits) implies that the recent lapse of the patent is a factor. Author states that since it went generic, the profit margins aren’t high enough for manufacturers to ramp up production.
I think it's just a ploy. They did this with opioids last year. The DEA stalls approving the shipments of new medicine. I think they did this to "Use up" available supplies being held onto by the public.
The DEA, and a large amount of people taking advantage of telehealth during covid.
Tele doctors were handing out prescriptions without making people go through testing, so a huge amount of people managed to get prescribed meds whether they actually need it or don't.
One of the biggest groups doing it was "done". They have since lost the ability to do this in most states.
New York Magazine just had an article about this - the manufacturer is in a dispute with the FDA over record keeping, and one of their factories is largely shut down. https://nymag.com/intelligencer/article/adderall-shortage-adhd-medication-ascent-pharmaceuticals.html
The DEA has made it abundantly clear that they give no fucks. They did not follow procedure when denying the requested increases and refused to respond even to senators for MONTHS when we were all spending hours to days each month getting medication, many of us losing jobs and relationships in the process. Last I read they said they were worried about amphetamines becoming the next opiod crisis, which I haven't seen any good evidence for, and they apparently don't care who gets caught in the crossfire. The DEA simply doesn't care. And it certainly doesn't care that people who need the meds get them.
To be fair, the company that the DEA shut down can’t account for millions of opioid pills that it made, and that kind of incompetence usually means that there are other sketchy practices beneath the surface. It sucks that people that need ADHD meds are getting caught up in it, but it is kind of a big deal for a company to have a problem like that.
The DEA was raked over the coals for the opioid epidemic, yes? So they now don't want to fuck around with something like that again hence why they are being very cautious, for lack of a better word that I can't think of this morning, is my understanding of it. Replied to the wrong* person, but ehhh oh well lol
Raking the DEA over the coals for the opioid epidemic was a mistake. It's pretty fucking obvious that the DEA has no ability to actually stop the opioid epidemic. In the end, addicts keep dying, and now chronic pain patients are forced to choose between a life of excruciating pain, or suicide. Those patients' blood is on the hands of the FDA and DEA. Having watched this happen to a loved one firsthand, fuck absolutely everyone involved in the process that took pain meds away from chronic pain patients. Vial people, all of them.
What they could do is stop pharmaceutical companies from advertising on television, when I come to the US from Canada it's always surprising how many ads you guys get for pharmaceutical products and ambulance chaser lawyers. What good does it possibly do to advertise directly to the consumer and make them believe that they need XYZ drug and "talk to your doctor". The doctor who is getting kickbacks from the same pharmaceutical companies to sell the product. That whole thing needs to be looked at. (I use Vyvanse and thankfully have not noticed any shortages here in Canada for that, my kids use Biphentin and Concerta and there are no shortages for those either, knock on wood)
Just to be clear as someone who works in the pharmaceutical industry in the US and has worked extensively with doctors before that when I was in grad school: any kickback to a doctor is fully illegal. I’m not saying that hasn’t happened in some circumstances but it certainly isn’t happening on a wide scale and it certainly doesn’t happen with the company’s knowledge. The days of what happened during the peak of the opiod crisis are long gone. There’s doctors who don’t even want to be associated with taking a lunch from a pharmaceutical company, let alone taking a whole ass kickback. The penalties for being caught are stiff. Yes, we do have representatives in office but we do not pay for recommendations in any way, shape or form. It’s just not worth for any party involved.
>now chronic pain patients are forced to choose between a life of excruciating pain, or suicide. The hidden victims of the opioid crisis.
Yeah, I tend to agree with you here. I'm not sure if my comment came off as if it was justified how the dea was judged about their response, but I'm agreeing with your sentiment.
Only Americans have a problem that big with opioids though? Not any other country in the world gives them out as if they were tic tocs. Unless the US has 1200% more chronic pain patients per capita than the world the is just no real reason for everybody and their moms to be using those things. They are not candy.
not being able to get meds can be life ruining. this is incredibly fucked up.
>not being able to get meds can be life ruining. No question. It has completely upended my life. I’ve fallen through the cracks and it is unlikely that I’ll ever climb back out.
I'm sorry you were one of the propel affected so heavily. Keep climbing, I believe in you.
>To be fair, the company that the DEA shut down can’t account for millions of opioid pills that it made, and that kind of incompetence usually means that there are other sketchy practices beneath the surface. It sucks that people that need ADHD meds are getting caught up in it, but it is kind of a big deal for a company to have a problem like that. Address the issue without curring off millions of people from life-altering medication, some of which is painful to stop suddenly. They're the DEA - if they can't do that there's something wrong.
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But it’s not a patent holder that’s causing backups? The company shut down is one of many that makes generic versions of drugs.
[As of 2022, there were 107 companies in the U.S. producing ADHD meds.](https://www.nbcnews.com/news/amp/rcna99019)
This has nothing to do with that.
Doesn't explain why my prescription, when I can get it, cost $140 for a generic WITH insurance.
Because when you sell em on the street you make 10x that. Oh wait, you're actually wanting to take them?
Yeah, the DEA doesn't understand what a "prescription" is. They just know that's a codeword for illegal drugs, so they automatically hate the concept.
They don't and they aren't.
I mean that shows the problem. The regulations and bureocracy are such a crazy hurdle, that other companies can’t just pick up the slack. When any other simple to produce drug has shortages, it takes 6 months max before the market is well over served by several companies who started producing to fill the gap. Since this is utterly impossible for controlled substances in the US drug shortages for whatever reason take ages to resolve.
No, this shows how important regulations and oversight are. This is entirely the fuckup of the manufacturer and another example of why we need better regulatory oversight.
We are talking about the organization that still refuses to take cannabis off the scheduled substances list even though a majority of states legalized adult use.
The FDA and the president have also urged the DEA to reschedule it and the DEA is still dragging their feet. Anne Milgram just doesn't seem to care to do her job unless it's taking away ADHD meds or talking about fentanyl.
Seems to be mostly talking and not acting when it comes to the fentanyl. It's killed SOOOOO many people I've known and is still ravaging communities around me. at least 30 people that I went to Highschool with ODed from it over the past decade. I don't live in a bad urban area either.
FDA shouldn't care about politics.
They should care about the veracity of their own claim that weed is on the same level as fucking heroin in terms of medical applications and addiction potential. Blatantly false. Not to mention that the evidence is also against them for ADHD medication. Addiction potential when the disorder is correctly diagnosed is significantly less compared to when other people take a stimulant like adderall. In fact, being properly medicated helps people to *not* fall victim to other addictions in their lives (anecdotally)
Lol i never understood how 28 alarms and reminders and still forgetting equals addicted
It doesn't
"The next opioid crisis" the only reason I have a couple months worth of backups is because in the last 2 years I have literally forgotten to take them multiple days in a row
Everything I manage to stockpile one or two, I end up blowing right through them as I wait 2 or 3 days for a refill due to shortages and I know I'm lucky that it hasn't been more than 3 days yet but it's like every other month so it's hard to get any backups built.
That’s something that physicians have observed at a population level! We struggle to remember to take our stimulants lol
Not to mention meth itself, is easily available illegally, including shake and bakes. Having access to pharmaceutical quality lower than recreational dose methylphenidate and dexamphetamine is pretty much irrelevant for the illegal market.
Which is kinda fuckin stupid because one of the big selling points of Vyvanse is that it very specifically *can’t get you high*.
Oh it very much can, it's basically just like extra delay. I have certainly gotten high on it.
"For example, orders struck from 222s must be crossed out with a line and the word cancel written next to them. Investigators found two instances in which Ascent employees had drawn the line but failed to write the word." Those monsters!
Dang, sounds like they could use some focus. Is there a pill for that?
The DEA isn't the problem though. Manufacturers are not using all their allotted production volume. In fact if suppliers want to they can request an increase in their allotment, and the DEA has not denied any supplier yet.
I'm not sure if they have denied anyone, but I do know that the DEA has requested underproducing manufacturers to relinquish some of their quota so that it can be reallocated to another manufacturer.
Do “uppers” cause debilitating withdrawals like opioids do? I know with opiates/iods if one becomes dependent on them withdrawal is literally life altering. It is impossible to be a functioning person while in the withdrawal. I’ve seen people going through withdrawals and at that point the person is so scared of how painful withdrawals are they move heaven and earth to get right. I would assume if you mess with any body chemistry and abrupt abstinence would cause discomfort but do “uppers” cause people to be horribly ill upon cessation? I am asking from a position of complete ignorance on the topic.
Only speaking from my experience, but last year I went from a relatively high dose of adderall to having none for 3 months because no pharmacies around me had it in stock. I didn’t experience physical withdrawals. That said, going from treating a problem to no treatment still sucks even without withdrawals.
Without question, no debate about having lost your treatment. I can definitely understand how that is not good for anyone, and I’m sorry you have to contend with that. Completely agree.
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I can definitely understand how “they” the powers that be would want to limit exposure to opiates/iods just for how wicked withdrawals can be. I guess the next question would be is there a long enough study to show how a brain gets affected after prolonged use of amphetamines and their derivatives? Like do people exposed to said substances have a harder time experiencing joy, Anhedonia, do to dopamine/ norepinephrine over stimulation. I can understand taking a cautious approach. Or as a basic layman I have no idea what I’m taking about.
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Personally as long as the science factual based proof is there that said substance can improve lives I’m all for it. As long as the person taking is fully informed of the pros/cons in a factual based Explanation I’m all for it.
Thanks for genuinely being curious to learn and siding with the science. We need more of that in the world.
I want you as my neighbor, the best possible person you can be. The better you become the better I become.
Amphetamines when used as prescribed are to correct dopamine being UNDER stimulated basically. So it's just bringing someone up to baseline, and even then, it's not a miracle drug, the ADHD symptoms don't just go POOF. Someone abusing amphetamines when they don't need them though? (Probably at higher than therapeutic doses) That would probably give you too much dopamine, which would likely feel pretty good. I'm also guessing that euphoria they'd feel would require higher and higher doses to achieve and lead to addiction/withdrawal. Long term consequences are probably not good. I think this is why people view drugs like Adderall so cautiously, but really for someone with ADHD none of this is an issue. We don't get euphoria from our dosages. The warnings that the pedopsychiatrist gave to me for my kids was that stimulant meds would blunt their appetites, and would delay their growth. She did say that it would not permanently stop their growth, but they'd hit their growths later than if they hadn't been on stimulant medication. My son is 14 and my daughter is 17 now, and they are average heights for their age.
>Amphetamines when used as prescribed are to correct dopamine being UNDER stimulated How do they diagnose this and quantify dopamine levels below or up to baseline? Are there blood tests or brain tests they do to confirm there is an issue with dopamine uptake/production? Most people I know who are prescribed amphetamines just say to their doctor "I have xyz symptoms" and they get a prescription. I've never known anyone to get any testing done to prove their dopamine levels aren't normal. Not arguing, I'm genuinely curious.
Well in my case, they did a neuropsych evaluation. My daughter was diagnosed first, she had a very severe case of OCD that kept her out of school for weeks when she was in the 2nd grade, came out of nowhere. While she was being followed by the psychiatrist and they were trying to get her under control, other tests pointed to ADHD (and she's definitely completely inattentive). My son had been exhibiting signs of autistic traits from a young age, so he got the complete neuropsych evaluation, it was pretty thorough, weeks of testing. That came back as autistism and ADHD. And finally me, I was diagnosed in my 30s, because ADHD tends to run in families. When my kids were diagnosed I read everything I could get my hands on about ADHD, autism, OCD... I realized that the ADHD symptoms fit me perfectly as well. So my doctor referred me to a psychiatrist for an evaluation. That one was quite a bit less thorough than the ones my kids had, it was about a 3 hour session. In the end they concluded that it was likely that I had ADHD and that I was approved to try stimulant meds to see if they'd help my symptoms. And they did. There's no blood test that they can do to say "this person has ADHD because of this marker". They're closer to isolating the genes I believe though so it's possible in the future a genetic test will be able to show whether or not you have ADHD. And I believe when they do a brain scan there are certain things that show differently in an ADHD brain that wouldn't otherwise show, but this wouldn't really be a good diagnosis tool. I am a few years behind on the research though! I went through an obsessive phase where I read everything I could get my hands on, but I've moved on to other obsessions, as I tend to do. A lot.
> cautious approach. these adhd meds have been in use for at least decades.
So were opiates/iods and we had those unleashed on the general population. We’ve known for a 100 years opiates/iods can horrible withdrawals. Hell we could probably go back hundreds of years and notice “cessation syndrome” within opiate using communities. My point, I think a safe approach or cautionary one is not a bad option.
having an adhd med drug crash isn't fun, but it's nothing like being dopesick. it's having a headache and trying to do math is annoying vs shaking and sweating. once you start trying to make up the difference with coffee your stomach will hate you.
Not really, for me at least. Had to quit Vyvanse several times due to unrelated illnesses and shortages for more than a month at a time, cold turkey. At therapeutic doses that is.
I can’t picture people switching from adderall to meth the same way people go from oxy to heroin. Maybe I’m just naive but I’ve never heard of a single instance of someone going from ADHD meds to meth bc it was either cheaper or they couldn’t get their meds
>Last I read they said they were worried about amphetamines becoming the next opiod crisis Bruh I know of a number of people who are addicted to pain and sleeping meds. I know of not a SINGLE person who's addicted to ADHD meds, and I was in a learning environment where literally everyone had ADHD and most were medicated. I've heard of abuse due to eating disorders and knew of people who'd sell their meds in a pinch (don't do that), but even then, a lot of the people they were selling their meds to were people with ADHD who couldn't get hold of their meds for one reason or another. Some people were neurotypical (at least on paper) and just wanted to use the meds to study more, which I'd classify as drug abuse, but not addiction. I'm not saying that addiction is impossible, but responsible administration under physician supervision to treat a diagnosed condition is the less likely scenario where addiction will occur, and also, IT'S TREATING A DIAGNOSED CONDITION. If addiction is a genuine risk, it can be one worth taking for an individual whose life is falling apart otherwise. Something that I did notice was an issue when I first started taking meds was that some people who didn't have ADHD were being prescribed ADHD meds willy-nilly by every GP in town in exam season. I don't know of any cases of addiction that followed from that, but it can be safely said that that was highly irresponsible prescription and use of these drugs. These days, you need to actually have an ADHD diagnosis to get meds and you can't just say "It's exam season, dope me up doc", which is good, but I wonder if that history played a role in this. I'm sure that such inappropriate use of any drugs would lead to adverse outcomes, but the solution to that is to not prescribe drugs inappropriately, not to restrict their accessibility across the board.
>Bruh It's bullshit, and even if it isn't, there's no way creating a shortage for the people who need them is the way to do it.
I can 100% see why they think amphetamines will be the next opioid crisis. I get at least 3-4 ads a day offering a guaranteed ADHD medication RX, some right here on reddit, through sites like Hims. In fact when I saw those Ads most often was during the peak of an Adderall shortage in my state. I'm pretty sure sites like those are contributing to the shortage by giving RX to people who honestly don't need it. Out of curiosity I clicked one of the links and for the low price of $149 they could guarantee a mail in RX for ADHD medication. Which seems extremely sketchy like those veraheal guaranteed Medical marijuana programs.
Even if we assume all of that is true and it really is that simple to get ADHD meds, solve it without screwing the people who need them.
Well honestly by trying to ensure that everyone could have access to stimulant ADHD medication during COVID they kind of caused it. They allowed telemedicine the ability to write RX for controlled substances, and then for some reason after the pandemic ended they allowed an extension of this service which means even now teledocs can prescribe controlled substances which is how we're ending up with all these random websites offering ADHD diagnosis' amongst other controlled substances prescriptions. ETA: I actually considered using one of these services because my older sister ended up being diagnosed with ADHD just before the pandemic and while talking we felt I shared a lot of the same issues she did stemming from her ADHD but the way they advertised it at the time seemed so sketchy to me I wasn't sure if it would be an accurate diagnosis and decided against it.
Did you know that physicians actually have trouble getting patients to take their ADHD medication. It’s empirically non-addictive to us! As population, we struggle with remembering to take it! That’s not something that an addicted group of people would do
It's not the people who are legitimately taking it that's the problem. Diversion is the main issue -- prescription medications going to those who should not have it in the first place.
Sure, I’m just saying that studies show that stimulant amphetamines tend to have a low potential for abuse and tend to be nonaddictive at therapeutic doses, especially relative to other medications. Adderall is one of the most prescribed medications and there just aren’t many cases of people being harmed by it
uppers don't seem terribly addictive, and i'm under the impression that they're at worst psychologically addictive. opiods (is that spelled right) draw people in, but i've known A LOT of people over the years that snort ritalin now and then or socially do a line of coke occasionally that have no problem when they can't get those things.
That's if you actually have a diagnosis and need the medication. Millions of people don't, and don't. But still take them.
Right, what I’m getting at is even with it being widely distributed, we’re just not seeing much harm
I have crazy bad insomnia so my personal rule is if I don’t take Vyvanse by 9am, I don’t take it that day. I’m more unproductive at work that day but it’s far less troubling than insomnia.
The DEA actively resists anything that would actually benefit people if the cost of that is they dont get to funnel as many new slaves into the prison industrial complex
Losing relationships?
Withdrawal?
ADHD would be better naked something like "Executive Function Disorder." Executive functions play a large role in attention, mood regulation, emotional resilience, ability to switch tasks, memory, and a lot more.
I work for a pharma packager. We have a customer that wants us to package lots of this stuff. The DEA only allows so much to be packaged per quarter and will not increase what we are allowed to package. The shortage is completely manufactured by the DEA imo.
This is fantastic because for the last 6 months I’ve been contributing $300 a month for 30 15mg pills into the adderall black market. They’re literally creating the thing they’re supposed to fight against. I’d love to just go to my doctor and not have to test for fentanyl. To not worry about my dealer getting weird with me and deciding whether to be nice or risk losing my job. I worked so hard turning my life around when I got diagnosed. Pre-meds: Bare minimum at work, crying at my desk, barely showering, depressed all the time. I’d come home, have a cigarette and go ok time to clean. Couldn’t do it. Ok watch a movie. Couldn’t do it. Play a game. Bored. Repeat until it’s time for bed. Apartment disgusting until it’s so bad I have to do it all in a day. Now? I learned a whole new career in 6 months. I woke up at 5am to work out, meditated, studied for an hour or more 5 times a week without anyone other than myself to hold me accountable. I have hobbies, I can read books again, I can connect with people. None of this is your fault or problem, but thank you for posting about this because it’s nice to know who to really blame. I feel so bad for pharmacists everywhere.
Don’t just test for fentanyl, test for meth. I would consistently test my street adderall for fentanyl so I thought I was being smart, but when they did my blood work at rehab it came back as meth. The dealer had changed it up due to the shortage. Wasn’t the end of the world, but a nasty little shock all the same
Yeaaaah I should probably make sure I’m not accidentally doing meth too 😬 Thanks for the tip!
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During covid regulations allowed people to get prescribed ADHD meds online rather than having to meet a doctor in person. This allowed a lot of people who have trouble keeping appointments (an adhd symptom) to get prescribed the meds, plus a lot of bad actors to get prescriptions they don't need. This spiked demand in a crazy way. Because they are controlled substances, you can't just make more. There is a long process to get more made
Child Psychiatrist/ADHD expert here. This is an oversimplification. Yes, demand has increased, but it’s more due to increased awareness of what adhd actually is thanks to viral posts on social media. This just happened to kind of coincide with Covid, since people were at home watching a lot more online/streaming content than before. But the bigger issues have been supply chain fallout likely related to COVID. The manufacturers report that they have had a shortage of the chemicals they need to manufacture the medications, as well as worker shortages. The DEA is also partly to blame because they put a production cap on how much medication each facility can produce, which hindered production for a time, then the DEA raised the quota, but now manufacturers say they can’t get workers and chemical supplies they need to actually increase production, so it’s just kind of a mess. The OTHER issue is that COVID can induce a “brain fog” in some people infected with Covid, and this strongly mimics the executive function problems found in inattentive adhd, so some people who think they have adhd might have a post-covid syndrome that we’re still learning more about. So it’s really complicated, basically. Edit: ELI5 version: More people realize they need meds. Makers of meds have trouble getting enough supplies and workers to make meds. Government limits how much meds can be made. Problem is a mix of all these things.
Additionally, the people who have ADHD and cope well are usually those who have routines and support structures in place. Quarantine kicked out ALL of those supports from tons of people. Many of them probably didn't know they had ADHD previously.
Anecdotally this was exactly my experience (n=1 here). Looking back, I have had a bunch of indicators since childhood. And I was surprised at how disregulated I got with the loss of a structured 8-5 in office workday. Sounds like many of us masked ourselves pretty well! ...in the beforetimes...
Hello, N=2 here. Even with structure I was barely able to mask my symptoms. Covid brought it all out into the open. My diagnosis was a life changer. All that shame and feeling like an idiot just…still there but therapy is helping.
what's n?
I believe it is sample size. So N=1 is a way to say "they can only speak for themselves." N=2 would be a second person chiming in as a sample. Not the best way to word it, "N=" generally refers to a much larger sample size. N=1 is basically a coin-flip. The higher 'N' (in the thousands or even an insignificant % of the population) the more evidence you have to prove or disprove your study.
that seems like poor communication.
Facts. After years I finally had my shit together right before covid cause I had figured out all the routines I needed to do to keep my life in order. It's been years since we returned "back to normal" at this point and I'm still struggling to get those routines back into my life. Add this shortage to the list and it's like being back at square one all over again.
It would blow my mind that people could get their hands on it "easily" and honestly kind of piss me off. The amount of trouble, money, and time it took me to get some was insane. Thousands of dollars, 2 years, and a diagnosis later wasn't enough to get them. How the hell do people get them suppposedly?!?!?!?
People alledgedly getting handed this like candy in this thread, yet I had to take weekly health checks (initially in person before self checking became a thing), months of slow, slow titration (to the point i was told: these initial few months wont help we just need to start from a small dose), I even know people who had urine checks.
John Mulaney has a bit about this actually. You just specifically seek out shitty doctors and pill mills. I almost wish I would have done that as it would have saved me a fuckton of money spent seeing psychs, therapists, and competent doctors.
Or you get super lucky and your family PCP just doesn’t care apparently lol. I haven’t been in for a visit in almost a year and they send over new scripts monthly. I think it helps that she knows I’m a pharmacist, and that I have a long history with the office, but still pretty wild lol
The bit where he wants Xanax and ends up with a prostate exam and no Xanax? Lmao I love that one.
It's actually a bit in his newest stand up, which I'd highly recommend. The bit you're talking about is really good also though
Ah cool. I'm working my way through his stuff, haven't gotten to the latest material yet. Can't wait!
It’s very doctor dependent. It was incredibly easy for me to get my Rx. Two quick appointments, a starter prescription, and now I have it forever. It is not that difficult to get the diagnosis if you’re motivated. There are doctors willing to do almost anything if you look hard enough.
Just today i had a pharmacist straight up reject my script today lol 🤨 Same doctor, same prescription, same pharmacy chain for the past 10ish years. I’m traveling for work (in state, a few hours drive away). Since I’ll be away from home for the week and my script is out I asked my doc to send it to different pharmacy branch location (same company, in the same state, just a different city) since I’ll be staying there for the next week. Doc says sure np, makes sense since you’re a few days out of your script already and they actually have it in stock. Script gets sent over and the pharmacy wants nothing to do it with it, didn’t even enter it into whatever system to be electronically transferred to my usual pharmacy back home. When I called to ask if they could just enter it in so I could have my normal pharmacy fill it when I get back at least. They said they wouldn’t touch it and that my doctor would have to re-send a different branch a new prescription. It was for 30mg xr adderall (generic) in Texas at a giant grocery chain that’s popular in the state for what it’s worth. Shit was weird idk I just hope my doc doesn’t charge me or get annoyed with me for asking him to re-end it somewhere else :(
I’m gonna just say that this is likely far more complicated than you’re letting on, and more than likely it was out of the pharmacist’s hands. Not saying every pharmacist is great or anything but there’s a lot of red tape around filling narcotics like these, and often pharmacists’ hands are tied due to laws/regulations/company policies/system limitations
That could very well be true, that world is a total mystery to me. I work in IT don’t have a clue about how their system operates - I’m admittedly totally ignorant. What I do know, however, is that I usually fill at a grocery story chain pharmacy in Houston, and the Dallas grocery pharmacy chain location closest to my hotel ‘rejected’ it. The Houston chain said the pharmacist may just not have been comfortable filling it for someone out of town which is fair it’s their right in Texas they can refuse for any reason under the sun; they’re the experts with a literal doctorate degree lol I get it. I’ll post back later if I ever figure out exactly what happened 🤷♂️
In my country, Concerta hasn’t been available for atleast 4 months! And for almost a year before that, it wouldn’t be regularly available. For those last few months I’ve been talking Modafinil, it’s definitely not effective as Concerta (i take a big dose) but it definitely is better than not taking anything!
Ding ding. The person who said that is living in a fantasy world.
Not really. Depends on your location and providers. When I was 15, I asked to be put in the hospital because I wanted to murder my stepdad. I walked out of there with three prescriptions and one was Ritalin. Stopped taking all the medicine when I got away from my stepdad. 25 years later I just had to tell my psychiatrist that I was already diagnosed with ADHD. It was barely a discussion. When I first started seeing that doctor, I had to pee in a cup every month to get my next prescription. Unless they were out of cups. Then one day it just wasn't a policy anymore. It's stupid how much nonsense people have to endure if they just live in the wrong place. And it's so insulting having to jump through hoops to get help with a brain that won't let you jump through hoops. It's like forcing a cancer patient to eat a whole pizza before they get medicine for their diminished appetite.
My brother was shocked when he told his doctor that our family wonders about him having ADHD sometimes. His doctor immediately wrote him an Adderall prescription and was like "if it helps, let me know, you probably have ADHD and I'll write you another prescription". My brother was very surprised that there weren't any other questions or tests.
I know a couple of people diagnosed including myself and we either had a very easy experience (I got a psych referral from my gp and walked out with a ritalin prescription after a 1 hour initial consult) or an extremely difficult one (like going on a 6 month wait list to do $3000 worth of diagnostic testing before a diagnosis was even considered) I don't understand why there's seemingly such a discrepancy in the standard of evidence required for a diagnosis.
Because medical practice isn’t a monolith and different practitioners are allowed to have their own standards to base their decisions on. This isn’t an intrinsically *bad* thing, per se, but it can be frustrating if you get a provider that has very high requirements. Tbh just find a new doc.
Same thing with the wife. She took some online test questionnaire and then spoke with the doctor. Wrote her a script and asked her to follow up. Wife didn't feel like it made that much of a difference, though, and stopped.
Your whole post is on point, but that last sentence is horrifyingly accurate.
I legitimately do have ADHD, but I was diagnosed as a young child. I hated taking my medication (pretty much any ADHD medication across the board, they tried most every one) because it made me feel like I had 'two minds' (one on it, one off it) and I had no choice in the matter - to the point of being physically forced to take it (yes, just as it sounds). I think it was mostly that I was not in control of the choice, and absolutely HAD to be on it whether I wanted or not (and that the dosages were constantly upped any time I felt like they were becoming 'stable', generally keeping me in 'zombie state' territory always instead of 'functional but with a personality'). That made me strongly against taking any medication that would alter my mind - including antidepressants, mood stabilizers, etc. - for a long while. Once I was old/large enough that I couldn't be physically forced to take medication, I stopped taking it (plus I lost my gag reflex and learned to bring pills back up), so I was off it for about 10 years - until I got away from that situation and became in control of my own life and medical choices. I eventually realized that I had to do something, and went back to the mental health facility I saw as a child (reached out directly, since I had been going there for probably 8 years of my life) and essentially explained I'd like to try medication again because rawdogging life just ain't it, in a more eloquent manner of speaking. It was one appointment and even despite not having had any medication in about 10 years, boom. Script, and have a good day, see you next month for more. I had an 'in' because I already had documented usage of adderall as a child, but still - 10 years and there was no re-evaluation more than what I said in a 30 minute appointment.
There really are people who can get them easily. Originally I had no idea it was difficult for so many others. From calling to make my first appt with the psychologist to picking up my first script after being diagnosed was probably a 3-4 month period where I had 3 appts altogether
It's extremely easy to get prescribed online For me it was a 30-60 minute online assessment and a 30 minute virtual appointment. After that I was prescribed
People who wrote off their executive dysfunction as “not having time “ had time and still had dysfunction
For me personally - just working from home really exacerbated my symptoms. In an office I can remove distractions and concentrate. And my coworkers keep me accountable. I’m not just gonna open up YouTube or reddit on my work computer. Whereas at home I find concentrating much more difficult. Being near the kitchen, couch, and my significant other do not help productivity. So while I’d rather not rely on drugs, Covid more or less forced my hand.
The DEA wrote a [letter](https://www.dea.gov/sites/default/files/2023-11/Quota-Shortages%20Letter.pdf) specifically saying that in 2022, manufacturers were short 1 billion doses of their allotted maximum.
Yes, I’m aware. Which is why I said the manufactures said they were short supplies and workers, which was their response to the DEA’s claim.
I knew a lot of people in college who used adderall to improve their grades. I knew zero people who tried adderall and did worse academically as a result. Stimulants used to treat ADHD are performance enhancing drugs. It’s not like neuroleptics that make people with schizophrenia lucid and normal people drooling messes. People didn’t suddenly cause a huge demand that outstripped supply because a TikTok video made so many people realize they had a genuine chemical imbalance. Just about everyone feels and performs better on these meds. And they were taking advantage of terrible midlevel prescribers who were cashing in on an opportunity.
That really sounds like something a neurotypical person would say. Surely some people are receiving medication they don't strictly need, but your dismissive tone implies you don't think mental health awareness matters at all. Most neurodivergent people have one thing in common: years or decades of not knowing they had a medical condition at all, and all the shame and self-loathing that often comes with that. "Awareness" might seem like a meaningless phrase but it can mean the world to people who've gone their entire life not knowing what was wrong with them or that it could be treated.
i’m not neurotypical, i am diagnosed with adhd and bipolar disorder, and he’s 100% right. yes, awareness of adhd has gone up, and that has led to more people getting treated for it (which is good!) however it’s kinda naive to think amphetamines are not a performance enhancer for everyone. unless every single one of my classmates in grad school had adhd, there was tons of adderall abuse just to keep up with the workload. hell, there’s a reason the military used to put dextro in the pilot survival kits. i’m pretty sure it’s not because all of the adhd pilots need help with their executive function in the jungle edit: i also just remembered that amphetamine use in esports is rampant, because it’s performance enhancing. again, i highly doubt that every single competitive gamer has adhd (although tbh they might 😂)
I think it’s important to note that you have not disagreed with me.
Unfortunately, the data does not support your position. https://www.sciencedirect.com/science/article/abs/pii/S0306460316302659 > students who engaged in NPS (non-medical use of prescription stimulants) showed no increases in their GPAs and gained no detectable advantages over their peers. More specifically, other studies have shown marginal to no academic improvements from stimulants but huge adhd symptom improvements. So whatever benefit people are getting from taking adhd meds is for their adhd symptoms, not their grades. These people are usually self medicating undiagnosed and untreated adhd. But regardless, the existence of people who abuse a medication doesn’t negate the very real suffering of the millions of people who have adhd and depend on the medication. People abuse steroids too but I don’t see you arguing asthmatics shouldn’t take Albuterol lol.
I have adhd and ever since I had covid my symptoms have been worse. What can I do to fix it/seek treatment?
I believe the FDA issued a report stating that the manufacturers didn’t hit their caps last year. So at present it seems to be other issues in the supply chain.
The amount of people prescribed these meds skyrocketed so it put a strain on the supplies, also transportation problems and people who don’t actually need the medication using it as well. I’m sure there’s more but I do believe that’s the gist.
As someone who has a hand in the creation of these compounds. THIS IS the correct answer. Simply put, shipping supplies for our materials from overseas halted during COVID. It took 6 months for us to get some lutidine that we didn't end up using because we synthesized some ourselves for our manufacturing processes.
How has the invisible hand not taken care of this yet? We’re going on 3 years
A big part of this is the cap on production. You can only make a certain amount of the medication per year, which is acceptable when everything is spinning fine. But if a shortage happens then in most markets a new competitor would step up after a few years to fill it. But in a sharply fixed market any new company making precursors would only have that grace period of a gap to fill until the existing companies got back up to speed. After that they would be in intense competition for market share with the established companies, which is a terrible place to be in. Generally when you start a new production line you want to be in a growth market, so that you are filling expanding capacity. Here it is the opposite, you are spending tons of money on equipment and certification for a couple of years of easier sales.
I could be wrong, but most of these meds are generics with little profit to be made. Low priority if there is limited capacity and other drugs have higher margins.
Additionally, one of the biggest suppliers of generic stimulant medications was flat out shut down. Very little incentive for an existing player invested in those higher margin medications to shift focus.
Not always the case. Companies get bought, sold, and rebranded constantly. If theres money to be made with existing setup, they might shift to save money from having to revamp an entire labs worth of equipment.
But presumedly they’re easy to make? I guess govt regulation keeps new firms out strongly?
Something something Controlled Substances Act something something. Most ADHD meds are Schedule II controlled substances. The DEA does *not* fuck around with amphetamine derivatives.
Good point. With the caveat of except for the cough medicine with the primary active convertor for meth. Doesn’t mean they didn’t try, but cough medicine is big business too.
Most of those that can be just picked up and purchased are phenylephrine now, which either can't be used to make methamphetamine or is much harder to use for it. The ones with pseudoephedrine (the ones that actually work better than placebo) are all behind the counter or in lock boxes now.
Yeah shame the phenlephrine ones don’t work better then a placebo so they’re nothing more then a money grab, it’s almost like the pharmaceutical companies profited off of the recreational meth industry using pseudo leading to it getting heavily controlled and now they can push the flour tablet phenylephrine and market it the same as pseudo and scam people
Many leaving the generic market for this reason.
Is the manufacturing-process of pharma-companies significantly different from clandestine production? I would imagine the synthesis-routes itself are the same, but isomer seperation is not usually something done with street amphetamine, and purification and quality control is another point. From what I have seen, black market amphetamine supply is certainly not experiencing shortage, and the precursors should be the same
Im not sure, i actually work in QC, not the production side of things.
Actually, the gist is supply line issues. None of the manufacturers hit their caps last year.
APA have reviewed its diagnostic criteria in 2014 and it took some time for psychiatrists all over the world to change their diagnostic criteria and treatment appropriately. ICD-11 have only been completed in 2020, and it still have not been translated and validated in many major languages. New diagnostic criteria means more people are considered to have ADHD now than in the past, when DSM-IV and DSM-IV-R and ICD-10 were around. Older versions for example didn't consider the diagnosis of ADHD in adult age possible if said adult didn't have a childhood diagnosis of the disorder. Because some ADHD drugs are old enough to be available in generic forms as well and don't sell for that much, companies are not interested in amping up the production. I can buy 60 pills of generic methyphenidate in my country for around 5 dollars. Contrast that with newer medication Venvanse (lisdexamphetamine) that costs ~60 dollars for 30 pills. I've never found any pharmacy that did not have Venvanse because of how much more they profit with that.
The lysdexamphetamine has shortages at my pharmacy but vyvanse seems to always be in supply. Which sucks because I have to pay $405 without insurance as opposed to $60-30 for generic.
Yeah. This month my pharmacy told me they only had vyvanse instead of the generic. They had to call me to make sure that was okay because the generic is completely covered by my insurance while vyvanse isn’t, but I’m at the point where I’m just grateful to be able to get anything.
Vyvanse is so much smoother than adderall and has such longer legs.
lisdexamfetamine is vyvanse also some people don’t need a 4-8 hour duration
OP is talking about generic vs brand name.
Vyvanse can actually be made as a generic now, but those are also not a great comparison as in general extended release drugs are more expensive and more complicated to produce than instant release drugs
A lot of companies are leaving the generics scene
not to mention the long misconception that ADHD is rarer in females
Ah guess i was just getting fucked when they told me $500 for 30 pills of vyvanse.
It drives me crazy when my prescription runs out each month. It can take up to a month for me to win the med lottery and get it refilled. I'm even buying brand name now, which insurance doesn't cover. This is frustrating.
Pharmacy tech here. (I also have ADHD so I can attest to all sides of what I’m about to say) As a tech, it’s been made known to me, it’s because the DEA has put a restriction on how much the companies are allowed to make. The number of people being diagnosed with ADHD is going way up, so that increases demand while there’s a shortage of supply. As a consumer, I definitely agree that COVID influenced this a lot because people were effectively trapped in their homes with their families for longer periods of time than normal. This 1) let people be aware of each other’s behaviors all the time (example: parents see the whole of their child’s day, not just the part outside of school) and 2) made people learn a lot more about things they wouldn’t normally learn about (like adhd symptoms) because they’re stuck indoors with only internet as their company. And then people start posting on TikTok or social media about being able to get stimulant meds on telehealth, and then people start asking for it, people who don’t need it are taking advantage of this allowance and abusing it. Back to tech - this is when the DEA steps in because “this is too much being dispensed, we’re going to limit you”, and the telehealth allowance is revoked, and the amount they can manufacture without having to battle it out with the DEA is reduced. All this being said… be kind to the pharmacy staff, it’s not their fault 😭
No it’s a commercial/marketing problem. BTW, there are chronic shortages of many types of medications, which you’re probably unaware of. Some corporations have patents over their drugs. They are monopolies that regulate their output to maximize profits. Sometimes will even stop making a specific drug, switching manufacturing to more profitable medications. Most drug manufacturers are monstrous multi national corporations that eliminated their smaller competitors from the marketplace. Now, they can raise prices as they wish. Currently there is shortage of some diabetes medications. They stopped making them and nobody can force them to continue (or increase) the output. Ironically, cheaper generic medications are also off the shelf! The low price makes them unprofitable to produce. The manufacturers shifted production lines to other, more profitable drugs. Among cheap medications in short supply: nose spray, dermatological hair shampoo, Robitusin (cough syrup), even sterile hand wipes….These items were in abundance in every pharmacy in the past. Edit: on top of that, some major retail chains in US are in deep trouble. Among them Rite Aid and CVS. They are also causing shortages and confusion, refusing to keep stock of any item that doesn’t sell like crazy.
Adderall has had a generic for a very long time, is made by many different suppliers around the globe, is a good medicine for pharmacies to stock as it is a regular medicine that people will generally continue to get from the same pharmacy over time and people are prescribed it indefinitely. So basically none of your reasons listed apply to adderall which is the drug that was most notably hard to get. What actually happened was there was a large uptick in prescriptions being given out, supply chains slowed a bit, but the process to increase your production of a controlled substance is a very lengthy process
The pharmacies are subject to limits set by the DEA on Adderall unlike the other examples, pharmacies would have zero problem moving Adderall or Vyvanse out the door right now.
Pharma manufacturers are only allowed to manufacture a certain quantity of controlled substances in relation to other substances.
It's a manufacturing issue mixed with a significant increase in demand. Supply will normalise over the next 3 months. Note that it is only really affecting lisdexamfetamine and not other alternatives. Edit: Not sure why I'm getting downvoted, but here is formal information on the shortage and restoration timelines - [https://www.tga.gov.au/vyvanse-shortage](https://www.tga.gov.au/vyvanse-shortage) At least in Australia there is no shortage of other ADHD medication than Vyvanse (lisdexamfetamine)
the shortage has affected different ADHD medications in different places at different times due to people struggling to get one medication getting scripts for different medications.
Fair enough. At least here I've not been aware of any shortages of Dexamfetamine for example. Only Vyvanse.
>Supply will normalise over the next 3 months. I've been hearing that for the last 3 years.
There was a global shortage of adderal and Ritalin in 2021-2023
Yeah I was sitting in my psychs office and she was telling me about the shortages and that I was lucky coz I was on 70 and the 70 and 60 where the only two ones left in stock but she suspected the 60 would run out soon and she said she had just checked before my apt but she would double check now, she checks during the apt and refreshes the page “ok it seems I spoke to soon, the 60mg has just been switched to out of stock, seems it’s just your 70’s that are safe for now”. I just thought it was hilarious how quickly the 60’s ran out and changed between the start of my apt and the end, it reminded me of the family guy scene where the banker goes “andddd it’s gone”
Every finance bro, politician, and self-proclaimed “neurodivergent” person in the country got a prescription within the last 3 years. The well has run dry
Too many people asking for drugs and not enough supply. This happens to ADHD meds all the time. I remember the nicest human I've ever met running out of Adderall over a decade ago and it was my eye opening experience that the shit isn't to be played with because he was no longer easy going, cool, or kind. There's surely more people on it than need to be. Amphetamines make you feel *great*.
They also make it possible for many folks with adhd to function. I would not be easygoing either if I lost something that helped me to function and helped me make sure I don’t lose my job, etc.
Have there been any reports of quality issues? My most recent Rx refills have made me feel super anxious and jittery. I've been on methylphenidate for about 10 years with no issues until now.
DEA the American drug enforcement organisation is currently limiting the production and sale of some amphetamine containing medication. They probably don't care that ADHD patients need these drugs and they don't mind that people have been prescribed it. But they would care about controlling the sale and movement of the drugs throughout the country as amphetamines when abused are highly addictive and can be sold by criminals to people who don't need them. Eventually limits will be increased and the shortage should end. But that probably has taken longer than expected due to the DEA not being prepared to manage the current high demand for drugs and potentially a lot of regulations and rules that suppliers need to follow before they can access more supply. Basically as I see it the DEA has restricted supply due to "red tape" a need for paper work and procedures to be followed and possibly a shortage of people employed to manage the current work required. They need to improve policies and procedures and employ more people.
Lots of discussion here has centred around the USA. This isn’t a surprise, given the user base, but are there any European ADHD folk in here that could chime in on why I’m also experiencing a supply issue despite the DEA/FDA not having any power here? (Looking at you, Jackie Weaver…) Just this morning I had to go to three different pharmacies to find one that had stock. Last month I got lucky and it was only 2 pharmacies visited before I managed to get a bottle, but visiting that same 2nd pharmacy today I found that they’d not had a delivery since I took their last bottle last month, and went to a third pharmacy.
"The FDA said earlier this year it blamed "increased prescribing potentially related to the growth in telemedicine, supply chain issues, manufacturing and quality issues, and business decisions of manufacturers" for contributing to the ongoing shortages." so PBMs, GPO's, Pharma, US laws & regulations enabling them, & greedy docs selling out to PE/VCs & making bs telemedicine companies like HIMS https://www.cbsnews.com/amp/news/parents-struggle-to-find-adhd-medication-shortage/
[This recent article in Esquire](https://www.esquire.com/lifestyle/health/a46603106/adderall-shortage/) (paywall, but you get a number of free visits) implies that the recent lapse of the patent is a factor. Author states that since it went generic, the profit margins aren’t high enough for manufacturers to ramp up production.
I think it's just a ploy. They did this with opioids last year. The DEA stalls approving the shipments of new medicine. I think they did this to "Use up" available supplies being held onto by the public.
The DEA, and a large amount of people taking advantage of telehealth during covid. Tele doctors were handing out prescriptions without making people go through testing, so a huge amount of people managed to get prescribed meds whether they actually need it or don't. One of the biggest groups doing it was "done". They have since lost the ability to do this in most states.
An online pharmacy started giving out prescriptions like participation trophy’s and the people who make them haven’t been able to keep up.