8 ms·

The FDA has officially declared a shortage of Adderall

whateveracct 4y ago
There was a shortage about a decade ago, right? I remember because my partner had ADHD and had trouble getting adderall. I remember it was definitely a rough time, even after getting it back. Getting re-acclimated was not easy - the break definitely made the unpleasant parts of being on adderall 7 days a week apparent. They've long since stopped taking medication - but that was after we both decided the software industry is, for lack of a better word, stupid and de-prioritized it generally. We still make good money off it, but we do a worse job and have more free time for what matters in life. Thank goodness for remote work :)
opportune 4y ago
It’s affecting me pretty bad. There are a few root causes: telemedicine rapidly increasing prescriptions, the mentioned Teva production issues. But one of the main problems is that the DEA tries to project the amount of adderall that’s allowed to be made/imported per year, which makes it so companies can’t quickly scale up production or hold inventories to smooth over supply issues. IMO, the DEA should not have any input whatsoever in how much of a medicine can be produced or imported per year. Why should people who need medicine suffer just in case someone else might abuse it? It’s hard enough as it is to manage these prescriptions because of them being controlled substances. Now it’s 10x harder because I have to play middle man between pharmacy and physician (if they only have 15mg XR in stock I can’t just get that filled to replace my 15mg IR without resending a prescription - by the time my physician sends something over they might be out of stock of that dose already) and pound pavement to find pharmacies with stock at all. Plus you have to deal with all the pharmacy staff that’s pissed at all the other people in the same boat calling in to try to get their prescriptions filled, on top of the regular baseline judgment against people with controlled substance prescriptions
- CPLX 4y ago
  > Why should people who need medicine suffer just in case someone else might abuse it? This, in direct literal terms, was the argument made in favor of OxyContin.
  - opportune 4y ago
    The DEA could still go after pill mills or over-prescribers without supply limits. The main thing supply limits do is just make it inconvenient for everybody prescribed a particular medication to get it filled.
  - junofan 4y ago
    No, the argument for OxyContin was two-fold and targeted at doctors: 1. “Pain is the fifth vital sign.” You are a Bad Doctor if you do not consider pain. 2. OxyContin is not habit-forming.
    - opportune 4y ago
      1 is a little more complicated. I believe as part of the ACA hospitals were actually evaluated on subjective pain management as reported by patients with financial implications if it seemed pain was not being managed. Also, a lot of people got started on Oxy after a surgery in which they were given it on their way out. They either started taking it and liked it, or didn’t take it and possibly had it diverted to acquaintances/family. With adderall you have to get it prescribed for ADHD or (more rarely) narcolepsy - of course it could still get diverted, but it’s not something that’s being routinely given to the general population like painkillers.
      - lupire 4y ago
        It's a lot easier to tell a GP you have ADHD than to get a surgery.
        autoexec 4y ago
        Not if you actually need a surgery. If you need a surgery you can generally get one pretty quickly and with little complication. Getting a prescription for Adderall from a responsible doctor when you actually need it can take months and multiple visits to a psychiatrist.
      - junofan 4y ago
ScipioAfricanuz 4y ago
34679 4y ago
- thorncorona 4y ago
  > Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. When putting out such bold statements it'd behoove you to substantiate them or yourself.
  - 34679 4y ago
    I consider it to be closer to common sense than a "bold statement". Amphetamine is a highly addictive drug with serious side effects. As a nation, we prosecute those who engage in the unlicensed manufacture of amphetamine and its analogs. As for ADHD, the man who first described the condition later confessed he fabricated the whole thing. >Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. Was your comment more thoughtful or substantive than the one you responded to?
    - yyyttt 4y ago
    - trehalose 4y ago
      > As for ADHD, the man who first described the condition later confessed he fabricated the whole thing. What is that man's name?
      - 34679 4y ago
        Dr. Leon Eisenberg
        mrtranscendence 4y ago
        Eisenberg wasn't the first person who described the disease we know now as ADHD. In anti-ADHD circles he's called the "father of ADHD" or some other such epithet, and he clearly made significant research in the early days, but he was not the inventor nor the only one working on it.
xivusr 4y ago
I've found exercise (minimum of 5 hrs a week) to work better than any substance for curing depression, anxiety, and concentration. Individual results may vary.
- Spivak 4y ago
  Careful with this. I was “self-medicating” my ADHD with exercise for years simply thinking I just liked exercise and not ever realizing that I had worked up to 25-30 hours a week just to function. Exercise absolutely does 100% work but meds that raise your baseline so you don’t have to exercise is a much healthier relationship with it. There are a lot of habits that ADHD people fall into to “stim.” Whether or not it’s a healthy way of managing it is up to the person.
  - faeriechangling 4y ago
    Evidence points to exercise and meds being a good idea most of the time for ADHD. Can't stand meds though.
  - bobro 4y ago
    seems really bizarre to claim taking a light form of meth several times a day is healthier than exercising.
    - lupire 4y ago
      We all breathe a light form of fire several times per minute. Putting things in spooky terms is deceptive.
  - autoexec 4y ago
    > Exercise absolutely does 100% work Exercise works for you, but we should be careful about overbroad generalizations. Exercise is a pretty good thing for just about everyone with lots of benefits, and it likely can help many with ADHD, but it's never going to be enough for some people. I doubt there's anything that will 100% work for everyone. Even stimulants can't help everyone with ADHD, and for those who do benefit from medication some medications will work better than others. Ultimately it's a lifelong process to figure out what helps with symptoms, what makes them worse, and what doesn't do much if anything at all. It's probably worth giving exercise shot for people who aren't already active enough, but don't expect miracles.
braingenious 4y ago
I’m kind of surprised by this. I thought a lot of folks switched over to Vyvanse over the past decade.
- Spivak 4y ago
  And if you also have depression and anxiety I’ve seen a few doctors use Wellbutrin.
  - braingenious 4y ago
    That’s wild. I would be very concerned if my psychiatrist treated all phenylethylamines as interchangeable. I guess people have to make do with what is available though.
- schwartzworld 4y ago
  Vyvanse is definitely better than Adderall, but it can be annoying to get insurance on board. Also, is there an instant release Vyvanse? I thought it was just extended release.
  - braingenious 4y ago
    As far as I understand it, Vyvanse is specifically designed not to be instant release. It is amphetamine attached to lysine that only becomes active after the lysine is cleaved from it in your gut.
  - water554 4y ago
    Dexedrine
- navjack27 4y ago
  I can't do Vyvanse. Lasts too long. I take 2x 30mg instant release mixed amphetamine a day. Well, usually just one a day but I'm prescribed two. Not everyone needs long lasting meds.
rtev 4y ago
While this is too bad, maybe it will push people toward effective alternatives. Monoamine oxidase inhibitors help me more than ADHD stimulants ever did, and they aren’t known to be neurotoxic like Adderall.
- gregoryl 4y ago
  Maoi have serious side effects, dangerous interactions with other drugs (and food!) and have withdrawal effects. These do not combine well with ADHD symptoms, and are not a first line treatment for a good reason.
  - rtev 4y ago
    They also don’t cause emotional flattening or weight gain like every other mental health medication. On top of that, they’re some of the most effective medications available, commonly polled much higher than SSRIs, SNRIs, or tricyclics. Setting aside blue cheese and kombucha was an easy choice for me.
    - gregoryl 4y ago
      None of those medications are primay treatments for ADHD, nor do the side effects you list map to Adderal or Ritalin, which are. I'm glad your sample size of 1 MAOI use is working well, but your statements are at best uninformed, if not blatantly spreading misinformation.
      - rtev 4y ago
        You’re right, it’s not scientific or authoritative information. Anecdotally, though, MAOIs solve my attention issues where Ritalin and Adderall failed.
- emptysongglass 4y ago
  I was going to say the same thing but for Modafinil. It has been demonstrated to be not only non-neurotoxic but neuroprotective, you don't need to sleep sixteen hours when you cycle off, and it doesn't change your personality. I'm diagnosed ADHD and Modafinil has been saving my life (defined as my ability to hold a high paying professional job in tech and provide for my family) for a decade and a half.

There was a shortage about a decade ago, right? I remember because my partner had ADHD and had trouble getting adderall. I remember it was definitely a rough time, even after getting it back. Getting re-acclimated was not easy - the break definitely made the unpleasant parts of being on adderall 7 days a week apparent. They've long since stopped taking medication - but that was after we both decided the software industry is, for lack of a better word, stupid and de-prioritized it generally. We still make good money off it, but we do a worse job and have more free time for what matters in life. Thank goodness for remote work :)

opportune 4y ago

It’s affecting me pretty bad. There are a few root causes: telemedicine rapidly increasing prescriptions, the mentioned Teva production issues. But one of the main problems is that the DEA tries to project the amount of adderall that’s allowed to be made/imported per year, which makes it so companies can’t quickly scale up production or hold inventories to smooth over supply issues. IMO, the DEA should not have any input whatsoever in how much of a medicine can be produced or imported per year. Why should people who need medicine suffer just in case someone else might abuse it? It’s hard enough as it is to manage these prescriptions because of them being controlled substances. Now it’s 10x harder because I have to play middle man between pharmacy and physician (if they only have 15mg XR in stock I can’t just get that filled to replace my 15mg IR without resending a prescription - by the time my physician sends something over they might be out of stock of that dose already) and pound pavement to find pharmacies with stock at all. Plus you have to deal with all the pharmacy staff that’s pissed at all the other people in the same boat calling in to try to get their prescriptions filled, on top of the regular baseline judgment against people with controlled substance prescriptions

CPLX 4y ago
> Why should people who need medicine suffer just in case someone else might abuse it? This, in direct literal terms, was the argument made in favor of OxyContin.
- opportune 4y ago
  The DEA could still go after pill mills or over-prescribers without supply limits. The main thing supply limits do is just make it inconvenient for everybody prescribed a particular medication to get it filled.
- junofan 4y ago
  No, the argument for OxyContin was two-fold and targeted at doctors: 1. “Pain is the fifth vital sign.” You are a Bad Doctor if you do not consider pain. 2. OxyContin is not habit-forming.
  - opportune 4y ago
    1 is a little more complicated. I believe as part of the ACA hospitals were actually evaluated on subjective pain management as reported by patients with financial implications if it seemed pain was not being managed. Also, a lot of people got started on Oxy after a surgery in which they were given it on their way out. They either started taking it and liked it, or didn’t take it and possibly had it diverted to acquaintances/family. With adderall you have to get it prescribed for ADHD or (more rarely) narcolepsy - of course it could still get diverted, but it’s not something that’s being routinely given to the general population like painkillers.
    - lupire 4y ago
      It's a lot easier to tell a GP you have ADHD than to get a surgery.
      - autoexec 4y ago
        Not if you actually need a surgery. If you need a surgery you can generally get one pretty quickly and with little complication. Getting a prescription for Adderall from a responsible doctor when you actually need it can take months and multiple visits to a psychiatrist.
    - junofan 4y ago

ScipioAfricanuz 4y ago

34679 4y ago

thorncorona 4y ago
> Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. When putting out such bold statements it'd behoove you to substantiate them or yourself.
- 34679 4y ago
  I consider it to be closer to common sense than a "bold statement". Amphetamine is a highly addictive drug with serious side effects. As a nation, we prosecute those who engage in the unlicensed manufacture of amphetamine and its analogs. As for ADHD, the man who first described the condition later confessed he fabricated the whole thing. >Comments should get more thoughtful and substantive, not less, as a topic gets more divisive. Was your comment more thoughtful or substantive than the one you responded to?
  - yyyttt 4y ago
  - trehalose 4y ago
    > As for ADHD, the man who first described the condition later confessed he fabricated the whole thing. What is that man's name?
    - 34679 4y ago
      Dr. Leon Eisenberg
      - mrtranscendence 4y ago
        Eisenberg wasn't the first person who described the disease we know now as ADHD. In anti-ADHD circles he's called the "father of ADHD" or some other such epithet, and he clearly made significant research in the early days, but he was not the inventor nor the only one working on it.

xivusr 4y ago

I've found exercise (minimum of 5 hrs a week) to work better than any substance for curing depression, anxiety, and concentration. Individual results may vary.

Spivak 4y ago
Careful with this. I was “self-medicating” my ADHD with exercise for years simply thinking I just liked exercise and not ever realizing that I had worked up to 25-30 hours a week just to function. Exercise absolutely does 100% work but meds that raise your baseline so you don’t have to exercise is a much healthier relationship with it. There are a lot of habits that ADHD people fall into to “stim.” Whether or not it’s a healthy way of managing it is up to the person.
- faeriechangling 4y ago
  Evidence points to exercise and meds being a good idea most of the time for ADHD. Can't stand meds though.
- bobro 4y ago
  seems really bizarre to claim taking a light form of meth several times a day is healthier than exercising.
  - lupire 4y ago
    We all breathe a light form of fire several times per minute. Putting things in spooky terms is deceptive.
- autoexec 4y ago
  > Exercise absolutely does 100% work Exercise works for you, but we should be careful about overbroad generalizations. Exercise is a pretty good thing for just about everyone with lots of benefits, and it likely can help many with ADHD, but it's never going to be enough for some people. I doubt there's anything that will 100% work for everyone. Even stimulants can't help everyone with ADHD, and for those who do benefit from medication some medications will work better than others. Ultimately it's a lifelong process to figure out what helps with symptoms, what makes them worse, and what doesn't do much if anything at all. It's probably worth giving exercise shot for people who aren't already active enough, but don't expect miracles.

braingenious 4y ago

I’m kind of surprised by this. I thought a lot of folks switched over to Vyvanse over the past decade.

Spivak 4y ago
And if you also have depression and anxiety I’ve seen a few doctors use Wellbutrin.
- braingenious 4y ago
  That’s wild. I would be very concerned if my psychiatrist treated all phenylethylamines as interchangeable. I guess people have to make do with what is available though.
schwartzworld 4y ago
Vyvanse is definitely better than Adderall, but it can be annoying to get insurance on board. Also, is there an instant release Vyvanse? I thought it was just extended release.
- braingenious 4y ago
  As far as I understand it, Vyvanse is specifically designed not to be instant release. It is amphetamine attached to lysine that only becomes active after the lysine is cleaved from it in your gut.
- water554 4y ago
  Dexedrine
navjack27 4y ago
I can't do Vyvanse. Lasts too long. I take 2x 30mg instant release mixed amphetamine a day. Well, usually just one a day but I'm prescribed two. Not everyone needs long lasting meds.

rtev 4y ago

While this is too bad, maybe it will push people toward effective alternatives. Monoamine oxidase inhibitors help me more than ADHD stimulants ever did, and they aren’t known to be neurotoxic like Adderall.

gregoryl 4y ago
Maoi have serious side effects, dangerous interactions with other drugs (and food!) and have withdrawal effects. These do not combine well with ADHD symptoms, and are not a first line treatment for a good reason.
- rtev 4y ago
  They also don’t cause emotional flattening or weight gain like every other mental health medication. On top of that, they’re some of the most effective medications available, commonly polled much higher than SSRIs, SNRIs, or tricyclics. Setting aside blue cheese and kombucha was an easy choice for me.
  - gregoryl 4y ago
    None of those medications are primay treatments for ADHD, nor do the side effects you list map to Adderal or Ritalin, which are. I'm glad your sample size of 1 MAOI use is working well, but your statements are at best uninformed, if not blatantly spreading misinformation.
    - rtev 4y ago
      You’re right, it’s not scientific or authoritative information. Anecdotally, though, MAOIs solve my attention issues where Ritalin and Adderall failed.
emptysongglass 4y ago
I was going to say the same thing but for Modafinil. It has been demonstrated to be not only non-neurotoxic but neuroprotective, you don't need to sleep sixteen hours when you cycle off, and it doesn't change your personality. I'm diagnosed ADHD and Modafinil has been saving my life (defined as my ability to hold a high paying professional job in tech and provide for my family) for a decade and a half.