from-nibly 3 days ago

Nothing feels (in my personal life don't @ me) as much of an attack on my neurodivergence as the nonsense that is getting medication for my ADHD. I have to go to a doctors appointment to get a prescriprion, I have to call to get that prescription filled, I can't fill the prescription early so I don't run out, I have to go to the pharmacy to pick it up. All so we can pretend that college kids wont be able to obtain a substance that is arguably safer than caffeine. (They sell Tylenol over the counter and you can kill yourself with that even easier don't @ me).

If you don't know, all of the steps listed above are what my medication helps me accomplish. Its like they designed a wheelchair store with a full flight of stairs in order to get in.

  • phaedrus 3 days ago

    This rigamarole is why I stopped taking ADHD medicine.

    I waited too long to make an appointment once (because, you know, ADHD), and then ran into a problem that my doctor's office had reorganized duties to give the renewing prescriptions role to a newly hired nurse aid without considering that he can't refill controlled substances. I kinda wondered how that could work, but either because was new to the job or overconfident he assured me I was wrong about the legality of that and he definitely would get the prescription scrip for me.

    By the time he / the doctor's office realized actually no, he can't refill my ADHD medication, my doctor was out and a four day weekend would soon begin. At this point I was already a few days off the meds and going through withdrawals, which got worse over the weekend. By the time Tuesday rolled around I'd essentially been forced to "quit" cold turkey, and so I was like, what is the point of re-starting this now I've gone through the hardest part of getting off it?

    • buffington 3 days ago

      > what is the point of re-starting this now I've gone through the hardest part of getting off it?

      For me, the point of re-starting would be because I have ADHD.

      I've had to jump through the same stupid hoops, even going without for months, and I can say that the single hardest thing for me is not having the meds.

    • whalesalad 3 days ago

      Same. it was always a nightmare. hated the way everything needed to be literally scheduled down to the very day. prescribers would get shit wrong all the time, there would inevitably days without. I was using an online service at one point (done, the worst of the worst) and they just straight up ignored my pleas for help for 3 solid weeks. when they finally came back and said sorry we fucked up I had basically decided to just quit, and quitting cold turkey is never fun. After years of being on/off I decided to say fuck this for once and for all and will never touch them again. Until they are available in vending machines - which I firmly believe is how they should be available.

      People cry about the comparison to "legal meth" but that is literally what it is. There is no difference. Your dealer is replaced by a licensed psychyatrist but at the end of the day they are just a dealer with a nice office and a certificate from a university.

      • buffington 3 days ago

        There is a difference. Adderall is a combo of amphetamine and dextroamphetamine, while "meth" is typically mostly methamphetamine (with other "enhancements" or impurities). They are chemically different.

        While Adderall isn't the same as meth, there is a ADHD medication that is pure methamphetamine: Desoxyn, and it's significantly more difficult to get a prescription for, and comes with far more warnings about its use since it is pure meth. I've never tried it, nor have I ever had a doctor recommend it.

        The doctor who I was seeing when I was first diagnosed with ADHD explained the differences between Adderall and meth by saying "Adderall is like a bright line painted on the ground helping remind you of where to go. Meth is like riding a bullet train. It'll lock you in tight and take you for a ride, hurtling at full blast whether you want to be a part of it or not until you and everything you love shakes to pieces and you die. And it'll tell you it's fun while it's happening."

        I had a friend who'd been addicted to meth and is in recovery say "Adderall is like taking a comfortable stroll around the block, while Meth is like travelling to the moon and back. Yeah, they're both 'getting you somewhere', but they're not remotely the same activity."

        • whalesalad 3 days ago

          I agree they are chemically different, but their effects are the same. Dosage is the most important thing here.

          • buffington 3 days ago

            Weird, because in another comment, you said:

            > it's literally the same thing. anyone who claims otherwise is uninformed.

            That they are chemically different is a fact, but their physical effects have also been proven to be different as well. I've never tried meth, but I know people who have, and who have also used Adderall, and the descriptions of their experiences would suggest the two drugs have different effects, regardless of dosage.

            But I can't prove those differences, so won't argue further.

          • alan-hn 2 days ago

            Methamphetamine not only has a different volume of distribution, meaning it is distributed in tissues differently than amphetamine but methamphetamine also has much greater serotonergic activity which greatly impacts the effects.

    • Aloisius 3 days ago

      > what is the point of re-starting this now I've gone through the hardest part of getting off it?

      Wait, what? Withdrawal is the hardest part? Not, you know, untreated ADHD?

  • harrisi 3 days ago

    One of the frustrating things is even if you can get a prescription, pharmacies run out randomly. They'll often tell you neighboring pharmacies that have it, but you can't just pick it up down the street - you have to have your prescriber call in a new prescription. Just a couple weeks ago this happened to me, and by the time my prescriber could get it sent to a new pharmacy, they were also out. It took two weeks to fill a mild prescription, and it was made worse since I was unmedicated and had difficulties talking to people to get it fixed.

  • tzs 3 days ago

    It is safe and not too painful or stressful to occasionally skip a day of your medicine?

    If you can occasionally skip a day then maybe you could try skipping a day every so often until you've got a comfortable gap between when they think you've run out and when you actually run out.

    • harrisi 3 days ago

      I think this is a suggestion made with the best intentions, but hopefully the absurdity of it isn't lost. We don't suggest people should keep their glasses in their cases on the weekend, or avoid insulin on holidays.

      • tzs 3 days ago

        OF course it is absurd--but having to see your doctor for each refill and only being allowed to refill when you are almost completely out is also absurd. Sometimes an absurd situation calls for an absurd response.

        At least two people so far have described glitches at their doctor's office combined with not being allowed to request a refill until they are almost out resulting in them running out and missing their medicine for days.

        Your glasses comparison doesn't really fit. A better fit would be disposable contact lenses, which you are supposed to only wear once and not wear for more than a day. I wear glasses, not contacts, but if I switched to such contacts and they would only give me a 30 day supply, would not give me a new supply until I'm on the last few days of my current supply, and made me see an optometrist for each refill probably would try to use my old glasses every now and then instead of the contacts to widen the resupply window.

        The insulin comparison also doesn't really fit because from what I've read missing your insulin for even a few hours, let alone a day, can cause serious and dangerous problems quickly. The skipping to build a reserve would only be an option with medicines where an occasional missed dose doesn't have any serious consequences.

        • from-nibly 2 days ago

          It's not that its unsolveable by me. It's that it even has to be solved. People who need wheelchairs could also figure out creative ways to go to a wheelchair store with no ramps. That doesn't mean its not insane that that would exist.

  • _boffin_ 3 days ago

    Give me a break… yes, it’s frustrating, but manageable. I’m in the exact same boat as you, but to consider it an attack, really?

    1) tele appointments are avail

    2) the doctor sends in it

    3) you can’t fill, but you can have it ready to be picked up.

    4) the travesty of going to the pharmacy.

    • halfcat 3 days ago

      It depends on the prescribing doctor. When I’d get meds from my general practitioner (who was associated with a big hospital chain, i.e. more CYA red tape), there were all kinds of hoops. No teladoc, in-office only, hard copy prescription only, urine tests and subsequent interrogation, etc.

      I had a psychiatrist start managing it, and it’s a breeze, a 5-minute video appointment every 3 months, sent electronically.

      • _boffin_ 3 days ago

        That’s fantastic to hear that you were able to alleviate those issues! Finding the right person to treat, amazing things can happen.

        If I may ask, why did you go through the first approach in the first place?

        • amanaplanacanal 3 days ago

          A lot of insurance plans require you to get a referral from your general practitioner before you can see a specialist. If the GP wants to handle it, I’m not sure what else you could do.

        • halfcat 3 days ago

          When you know better you do better.

          I was originally diagnosed 20+ years ago. Back then it was even worse, appointments with an “ADD specialist” were 3-4 hours, blood draws, etc and it was all very thorough. So once my meds were stable and not changing, going through my GP (and not having to take a day off work) was an improvement.

          • _boffin_ 3 days ago

            I guess one thing I got lucky with was that I got into the federal MTA study when I was a child and then was with it for a long time. Anytime a doc wanted to play games, I’d just refer back to that and it pretty much quashed any issues they had.

            The changing of meds was and is a horrific experience. I still remember the last time I took Adderall, it made me feel like I was locked in a jail within my own body. Glad I’m now on something else.

    • whalesalad 3 days ago

      A lot of individuals have experienced what the op describes. Your comments are so dismissive and lame.

      • _boffin_ 3 days ago

        As have I and yes, I’ll agree that it’s dismissive, especially without knowing the explicit circumstances of OP.

        • zackmorris a day ago

          Just for anyone curious - pharmacists explained the situation to me about the government limiting the supply of ADHD meds and the resulting shortages, then I found news that confirmed it.

          Mental health is a private matter, so I will just say that nurses can prescribe these meds in many states and often work with patients without insurance. Please see someone if you struggle with depression, anxiety, chronic fatigue, or similar nebulous issues. There really are treatments starting at about $1 per day that can drastically improve the quality of your life.

          -

          In my case, I've been healing from my second burnout with physical symptoms since my first one in 2019. My high cortisol levels overwhelmed my other hormones, and the way I found out is that I stopped recovering after workouts and took some injuries. For men, the dopamine-testosterone pathway is the weak link in the chain that governs our overall vitality. For women, I think it's oxytocin-estrogen but I haven't done a deep dive on it.

          Anyway for overweight men, the aromatase in their fat converts testosterone to estrogen, which tells their body to lower production of testosterone to prevent tumors and eventually even cancer from the estrogen. Also phytoestrogens from foods like legumes and estrogenic chemicals in plastic cause the body to think that estrogen is higher than it is, which shuts down testosterone production. In women, BPA and other endocrine disruptors might cause conditions like PCOS and throw off their hormones, but I don't know enough about that to speak more on it. Basically these environmental factors are messing with our hormones, and I believe that's why young men today have lower testosterone (so probably dopamine too) than previous generations, which may be causing a rise in mental health issues and dopamine-seeking behaviors like video game addiction (the horror!)

          Since endocrine disruptors are unavoidable in the modern world, people are juicing with leafy greens and other vegetables to combat them. I've heard good things about Man Greens and estrogen blockers like white button mushrooms. You can also eat walnuts, 1-3 brazil nuts per day, a serving of dark chocolate over 72%, pomegranate juice, bacon and 2-4 eggs, and various other foods to raise dopamine and testosterone and lower estrogen. It's also good to aim for about 8% body fat before pursuing other fitness goals. The quickest way to do that is to walk briskly for 45-60 minutes at least 3 times per week in addition to your current exercise, and add a large loose leaf salad with a low calorie dressing like a vinaigrette each day. I mention this because I've found that improving my physical health has had a drastic effect on my mental health and I'm working towards being free of all medication until late in life. YMMV

apsec112 3 days ago

"About 90% of the diverted immediate-release stimulants are used by a narrow demographic: white male college students"

I'll eat my hat if this is actually true. US college students are about half white right now. The other half, plus all women, plus all people who don't go to college, plus everyone who isn't 18 to 22, are 10% of the illicit-stimulant market combined? This has to be something made-up to attack what they feel is an outgroup.

  • throwup238 3 days ago

    It's "diverted immediate-release stimulants", which usually means patients who sell their legally prescribed drugs instead of taking them. It's not immediately believable without looking at their methodology but I don't think it's all that farfetched. When I was in college the stuff was at least $5/pill with prices rising as high as $20/pill around finals. I suspect it's mostly just socioeconomic bias as it was an easy way for students to earn extra income while having their own supply. Maybe doctors are giving white males extra scrutiny when they ask for their own prescription?

    It'd be interesting if other demographics preferred non-immediate release stimulants like Vyvanse or less abusable ADHD drugs because they were easier to source without going black market.

    • IIAOPSW 3 days ago

      Reasons to be skeptical:

      1. white, male, college (at least middle class) is exactly the demographic that the system would have provided the benefit of a script to since middle school if they wanted it.

      Reasons to believe:

      1. this is what men do instead of therapy.

      • throwup238 3 days ago

        > 1. white, male, college (at least middle class) is exactly the demographic that the system would have provided the benefit of a script to since middle school if they wanted it.

        Yeah I felt weird writing that.

        That said, if they’re abusing it their legal prescription is probably not enough. My doctor gave scripts like candy and even he would only give 60 20mg pill per month in addition to the 30 days of 70mg Vyvanse. If the college kids are snorting it, it goes fast.

        Also just realized that it could be because of exposure to the drug in frats.

        • verdverm 3 days ago

          > That said, if they’re abusing it their legal prescription is probably not enough.

          Adderall is also called kiddie cocaine. It's used as a party drug by crushing it up and snorting it before and during the binge drinking that is also common.

          Note that only the quick release Adderall works this way and many other ADD drugs cannot be used as a stimulant like this

          • buffington 3 days ago

            It's so weird to me that people use Adderall recreationally. It's as "recreational" in my mind as functional shoes are. I usually need them, but they're usually not what makes an activity fun.

            How is crushing up Adderall and snorting it even worth doing?

            I've accidentally taken my "normal" Adderall twice and it's an extremely uncomfortable experience. The last place I'd want to be in that state would be at a party, getting drunk. Sitting in a quiet place and rocking/sweating/puking until it's done is more what comes to mind.

            For what it's worth, there's no "quick release" Adderall. There's a normal kind, and an "extended release" kind (officially Adderall XR). The latter encapsulates little beads of the drug in coatings that dissolve at different rates, allowing the dose to be spread out over a longer period of time. What I think you're referring to when you say "quick release" is the non-XR variant of the drug.

            The drug found in Adderall XR is identical to that of Adderall with the exception of the coatings on the beads. I think crushing up those beads would likely work the same as crushing up an Adderall tablet, assuming the coatings on the beads were also suitably crushed. Not something I'll be testing any time soon though.

            • verdverm 3 days ago

              > How is crushing up Adderall and snorting it even worth doing?

              Same reason people do cocaine, it's an upper that allows you to keep partying.

              > I've accidentally taken my "normal" Adderall twice and it's an extremely uncomfortable experience. The last place I'd want to be in that state would be at a party, getting drunk. Sitting in a quiet place and rocking/sweating/puking until it's done is more what comes to mind.

              That's not the experience most have when doing it, afaik, most of these people are not prescribed adderall to begin with. They also weren't railing a whole pill, they were often shared among several people, smaller doses

            • alan-hn 2 days ago

              Snorting a drug allows it to reach the brain faster in a larger bolus, just a larger concentration increase faster means it feels better than a slow come up. Someone referring to a quick release is simply referring to IR formulations

jameskraus 3 days ago

It seems this article is trying argue in favor of deregulation of production of drugs, such that drug companies can more freely produce to fill demand. Is that necessarily a good solution with addictive substances like amphetamines?

We saw that production and consumption of opiates was far too high, eventually leading to the bankruptcy of Purdue Pharma. In that case it seems like the DEA was not taking a strong enough regulatory role, leading to much harm to Americans.

Are we facing an upcoming epidemic of amphetamine addiction and the DEA is holding it back, or is the DEA causing more harm through regulation of production? It’s impossible to tell from this article alone, but it seems clear we need at least some regulation of production, since the pharmaceutical industry cannot completely self regulate.

  • jrflowers 3 days ago

    > Are we facing an upcoming epidemic of amphetamine addiction

    Illicit methamphetamine is already easier to get and cheaper than adderall for virtually anybody motivated enough in the US.

    • fleischhauf 3 days ago

      I was under the impression that the opioid crisis was partially due to doctors just prescribing them and claiming they are an easy pain killer that is not really addictive

      • jrflowers 3 days ago

        Amphetamines and opioids are very different classes of drugs. For one thing, ADHD is a much more narrow diagnosis than pain (the latter being something every single human experiences), for another amphetamine sulphate has been available as a generic for a long time so there’s much less incentive for a company like Purdue/Insys to lie/cheat/bribe doctors en masse in the same way.

thebigspacefuck 3 days ago

Dr Dodson has been helping pharma companies push these drugs for a long time:

https://archive.ph/2024.04.17-223802/https://www.nytimes.com...

Full disclosure, he was my doc and diagnosed me with ADHD. I kind of think the whole thing is a scam now in large part due to this.

  • buffington 3 days ago

    Adderall has been significantly beneficial in my life, for which I'm grateful, but yeah. There are problems, both with the drug, and with how easily[1] it's prescribed.

    That anyone has ever said the drugs are benign is insane. I've been on Adderall for close to 20 years now, and there are consequences. Heart problems are the biggie. I'm very fit, eat healthy, don't smoke, run a few miles a week, bike, hike, etc, and there are some alarming issues with my heart that are likely due to Adderall use. Maybe I'd have the same issues even without Adderall, but odds are, it's the Adderall.

    [1] "easily" is a tricky word here. It's hard to get Adderall, as the article describes pretty well, if you're someone like me - someone who actually uses the drug for its intended purposes. My experiences have often been worse than what the article describes. Because of the shortage, my local pharmacies require that you bring a physical copy of the prescription to them, with a fill date of the exact date you're trying to get it filled. One day too late? They need a new prescription. One day too early? They need a new prescription. You're also required to pick up the same day. If you don't pick up the same day, they'll send the pills back to inventory so they can fill for all other people stuck in the same boat as me. I've not been able to consistently fill meds that help me function for at least 3 years now. Maybe if I'd turned to the black market, I wouldn't have this problem?

drewbug01 3 days ago

Something is very weird with that site and adblockers. Here’s an archive link if you’re having issues loading it, like I was: https://archive.is/sZglD

wannacboatmovie 3 days ago

[flagged]

  • Someone1234 3 days ago

    It may be over-prescribed but calling it "legal meth" and those who take it "addicts" is unconstructive at best.

    • pcdoodle 3 days ago

      I had a customer offer me a pill once while touring his warehouse along with a stick of gum (said it kicks in faster). In about 15 minutes, I was shocked they give this stuff to kids. It's very close to meth.

      • _fs 3 days ago

        Yes, someone without ADHD will have a vastly different experience to someone with ADHD. People without almost always talk about the burst of energy and happiness (flow of dopamine) following by a wired effect (heart racing, poor sleep, etc), while people with ADHD tend to experience a calming, quieting effect.

      • tpmoney 2 days ago

        A friend of mine gave me an injection of his insulin once and I almost died. I was shocked they give this stuff to kids.

        Which is of course ridiculous because for other medical conditions we understand that people without the condition might experience the treatments for that condition differently or even dangerously. It’s almost like you shouldn’t take medications for conditions you don’t have.

      • whalesalad 3 days ago

        it's literally the same thing. anyone who claims otherwise is uninformed.

        • November_Echo 3 days ago

          > it's literally the same thing. anyone who claims otherwise is uninformed.

          It's also extremely emotional language. I'm curious what your issue is with legally prescribed stimulats?

          Stimulats allow me to be a functional human being who can do things like wash the dishes after dinner or put my clothes out to dry. Can you imagine not being able to function at even that basic level? It's literally suicide inducing.

        • halfcat 3 days ago

          You’re not making a point by saying they’re the same.

          It can be true that they’re exactly the same, and still be beneficial for people to take it.

          This is true for most medications. The same dose of insulin that saves the life of one person, would be life threatening to another.

  • phendrenad2 3 days ago

    I think if anything it's under-prescribed. Many of my nerd friends growing up showed signs of ADHD, but in adult life very few have taken it. Why? Mostly due to pervasive moral equivalizing "drugs = sinful" that transcends religious boundaries in the US.

  • hollerith 3 days ago

    What is the source of your knowledge of this issue?

    Why should anyone let your opinion influence their own opinion?