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Cerebral became famous for selling Adderall and Xanax prescriptions as a subscription service. They advertised on social media sites like TikTok. The “patients”

Cerebral became famous for selling Adderall and Xanax prescriptions as a subscription service. They advertised on social media sites like TikTok. The “patients” were rushed through the minimal telehealth screenings that they could get away with before writing the prescription, as providers were incentivized to do as many calls per hour as they could. Worse, whistleblowers have revealed that the company was encouraging their providers to write more Schedule II prescriptions (high addictive potential) and avoid the non-addictive alternatives because they determined they the Schedule II patients had a higher retention rate: https://www.theverge.com/2022/5/9/23063356/cerebral-telehealth-prescriptions-investigation-adhd-adderall-doj-dea https://www.theverge.com/2022/5/9/23063356/cerebral-teleheal... Multiple major pharmacies refused to fill prescriptions from Cerebral because it was such a blatant internet prescription mill. I was a mentor in a remote mentoring program at a time and it was stunning to see the Slack side conversations where college students were bragging about how easily they were getting high-dose Adderall prescriptions from the company after consultations measured in a couple minutes. One person shared a link to a script people were using that would trigger the providers to increase their dose on every visit, including lying about certain factors to help overcome provider concerns about going into high doses. One student had reached 60mg of Adderall per day (the maximum dose, far above common dosing) and was clearly overstimulated, unwell, and, frankly, hooked on their new stimulant source. Terrible company. It’s going to leave a mark on the availability of ADHD treatment for years to come, I’m afraid.

whalesalad 4y ago
Done did the same thing. Massive growth. A new therapist every month. Pharmacies would stop supporting it, so that would change every month or so too. Absolutely terrible experience. It's easier to buy drugs illegally.
- dymk 4y ago
  Through Done, I was given a Zoom meeting with a Florida-based practitioner (I'm on the west coast). They wrote me an Adderall prescription after 15 minutes of questions. This felt sketchy at best, and malpractice at worst. I sought out a real, local doctor with a specialty in mental health, who I could make my primary care physician and have a long-term patient relationship with. Unsurprisingly, that route not only assures that I'm getting good medical treatment, but any Rx issues that pop up are resolved quickly and relatively painlessly.
hef19898 4y ago
Well, that adictive products result in a higher customer retention is something the British faught a war over against China. Such businesses shouldn't be legal.
thomastjeffery 4y ago
Everything you said is true, but the surrounding context is still incredibly important. There is a reason ADHD is such an open target for this behavior. We have a very significant problem with adult ADHD diagnosis and treatment in our healthcare system. In the overwhelming majority of cases, it simply isn't being done. In order for an adult with undiagnosed ADHD to receive treatment, they must navigate our healthcare system. That means finding insurance, finding providers, and setting appointments. Every one of those steps is hell for most people living with ADHD symptoms: they literally have an untreated disorder making those steps too difficult. And even when they do manage all of these steps, there is a very serious lack of education in healthcare about adult ADHD. Many doctors have an outdated belief that ADHD is a child's disorder, and that patients will simply "grow out of it". Studies have shown very thoroughly that this is not the case. And even when you do get a diagnosis, there is a serious hesitance to prescribe medication. There are two familiar narratives about stimulant medication. Despite being at odds with each other, both narratives are true. Stimulant medication is, in the overwhelming majority of cases, the single most effective part of treatment. Without stimulant medication, most ADHD patients are effectively stuck in therapy: they need to change their behavior to treat their symptoms, but it's their symptoms that are driving the behavior! The other story: stimulant medication is addictive and dangerous. People see their lives fall apart in addiction. It's a very serious problem that demands our attention. This is the story seen by law enforcement: particularly in the DEA. That is, after all, the set of circumstances they exist to respond to. So what do we do about it? Ban the substances? That clearly doesn't work. And we shouldn't simply be trying to keep every person from using them: the positive effects are incredibly positive. Another thing to be aware of: stimulant medication helps fight addiction, too. People with untreated ADHD are very likely to enter addiction, because they have a chronic deficit in stimulation. Giving those people stimulant medication resolves that deficit, and has been shown to very significantly reduce addiction, often even eliminating the addiction completely. This situation with Cerebral certainly increased the negative consequences of stimulant medication. It also increased the positive consequences. People who do not have ADHD, and should not be given stimulant medication were provided an easily abusable system to obtain that medication. People who do have ADHD and benefit greatly from stimulant medication were provided an easily useable system to obtain that medication. Please, for the love of all people, don't let us get so caught up in the negatives that we outlaw the positives! We need to take a long and hard look at how our healthcare system is failing us. It's failing potential addicts by playing fast and lose, and it is failing those with untreated ADHD by giving them impossible hurdles. Each failure demands the other as a solution. We need to break this cycle.
jaywalk 4y ago
These prescription mills have made it tough to get the drugs due to shortages. I've been prescribed Adderall for 10+ years, and while there were a handful or minor blips in the past, it was nothing like what I've seen for the past 6 months or so. It's a very real problem.
- opportune 4y ago
  The shortages stem from arbitrary production quotas set by the DEA. Pharmaceutical companies would be able to increase supply to meet demand without those quotas. Even with no quotas, pill mills could still be shut down and prosecuted.

whalesalad 4y ago

Done did the same thing. Massive growth. A new therapist every month. Pharmacies would stop supporting it, so that would change every month or so too. Absolutely terrible experience. It's easier to buy drugs illegally.

dymk 4y ago
Through Done, I was given a Zoom meeting with a Florida-based practitioner (I'm on the west coast). They wrote me an Adderall prescription after 15 minutes of questions. This felt sketchy at best, and malpractice at worst. I sought out a real, local doctor with a specialty in mental health, who I could make my primary care physician and have a long-term patient relationship with. Unsurprisingly, that route not only assures that I'm getting good medical treatment, but any Rx issues that pop up are resolved quickly and relatively painlessly.

hef19898 4y ago

Well, that adictive products result in a higher customer retention is something the British faught a war over against China. Such businesses shouldn't be legal.

thomastjeffery 4y ago

Everything you said is true, but the surrounding context is still incredibly important. There is a reason ADHD is such an open target for this behavior. We have a very significant problem with adult ADHD diagnosis and treatment in our healthcare system. In the overwhelming majority of cases, it simply isn't being done. In order for an adult with undiagnosed ADHD to receive treatment, they must navigate our healthcare system. That means finding insurance, finding providers, and setting appointments. Every one of those steps is hell for most people living with ADHD symptoms: they literally have an untreated disorder making those steps too difficult. And even when they do manage all of these steps, there is a very serious lack of education in healthcare about adult ADHD. Many doctors have an outdated belief that ADHD is a child's disorder, and that patients will simply "grow out of it". Studies have shown very thoroughly that this is not the case. And even when you do get a diagnosis, there is a serious hesitance to prescribe medication. There are two familiar narratives about stimulant medication. Despite being at odds with each other, both narratives are true. Stimulant medication is, in the overwhelming majority of cases, the single most effective part of treatment. Without stimulant medication, most ADHD patients are effectively stuck in therapy: they need to change their behavior to treat their symptoms, but it's their symptoms that are driving the behavior! The other story: stimulant medication is addictive and dangerous. People see their lives fall apart in addiction. It's a very serious problem that demands our attention. This is the story seen by law enforcement: particularly in the DEA. That is, after all, the set of circumstances they exist to respond to. So what do we do about it? Ban the substances? That clearly doesn't work. And we shouldn't simply be trying to keep every person from using them: the positive effects are incredibly positive. Another thing to be aware of: stimulant medication helps fight addiction, too. People with untreated ADHD are very likely to enter addiction, because they have a chronic deficit in stimulation. Giving those people stimulant medication resolves that deficit, and has been shown to very significantly reduce addiction, often even eliminating the addiction completely. This situation with Cerebral certainly increased the negative consequences of stimulant medication. It also increased the positive consequences. People who do not have ADHD, and should not be given stimulant medication were provided an easily abusable system to obtain that medication. People who do have ADHD and benefit greatly from stimulant medication were provided an easily useable system to obtain that medication. Please, for the love of all people, don't let us get so caught up in the negatives that we outlaw the positives! We need to take a long and hard look at how our healthcare system is failing us. It's failing potential addicts by playing fast and lose, and it is failing those with untreated ADHD by giving them impossible hurdles. Each failure demands the other as a solution. We need to break this cycle.

jaywalk 4y ago

These prescription mills have made it tough to get the drugs due to shortages. I've been prescribed Adderall for 10+ years, and while there were a handful or minor blips in the past, it was nothing like what I've seen for the past 6 months or so. It's a very real problem.

opportune 4y ago
The shortages stem from arbitrary production quotas set by the DEA. Pharmaceutical companies would be able to increase supply to meet demand without those quotas. Even with no quotas, pill mills could still be shut down and prosecuted.