8 ms·

Anatomy of the Great Adderall Drought

82 points by pier0 15y ago

refurb 15y ago
Another great example of a gov't regulation that isn't in sync with the marketplace. If you are a company that produces product A and product B, and the gov't says you can only produce a limited amount of A+B, why wouldn't you automatically shift all of your production to the product with the highest profit margin. This is economics 101!
- pyre 15y ago
  Assuming that Shire has a patent on Vyvanse, then this is more like limit production of A+B and create product C that is more expensive and has an artificial monopoly (patent). This will then drive everyone that needs products A or B to your new product C. Profit!
  - refurb 15y ago
    I didn't get a sense from reading the article that Shire is limiting production of their branded amphetamine salts. However, you do have a point in that having more patients on a branded therapy makes a move to Vyvanse more likely.
    - pyre 15y ago
      I was going off of this: Luckily, Shire had magically possessed enough amphetamines from their DEA quota to produce plenty of their new ADHD medication, Vyvanse. In fact, Shire doubled its third quarter profits from 2010 to 2011, with most of that increase resulting from Vyvanse sales. During this time, coinciding nicely with the Adderall shortage, Shire hiked the price of Vyvanse.
    - eli 15y ago
      It makes sense to want everyone move to Vyvanse which is still protected by patent, but if you can game the system so that people are still forced to buy brand-name Adderall even though the patent is expired, that works too. (Worth noting that Shire makes money on all three -- including the generic version of Adderall. Which seems more than a little suspicious)
- mistercow 15y ago
  The thing is, there is reason to believe that these shortages are exactly what the DEA wants. Shire Pharmaceuticals has convinced the DEA that Vyvanse is the solution to the adderall abuse problem, and the DEA apparently doesn't understand that the American healthcare system simply doesn't allow everybody on generics to switch to an expensive name-brand medication. They're basically trying to manipulate the marketplace in order to force patients to switch to a drug that they expect to be easier to control. Of course, economics aside, Vyvanse is not a drop in replacement for adderall, and many people find it less effective or more prone to side effects. So it's also a good example of a government regulation that isn't in sync with medical science.
- Duff 15y ago
  "The marketplace" isn't a market at all -- it's a bunch of people, with and without a medical condition, who get a third party to purchase a medication for them. That infographic tells the story -- 50% more Iowan children need amphetamines to function as compared to New Yorkers? IMO, this is a case where the DEA is doing the right thing. Improve the guidance for prescribing this stuff, and the folks who need it will be fine.
  - mistercow 15y ago
    >That infographic tells the story -- 50% more Iowan children need amphetamines to function as compared to New Yorkers? Why assume that there is overdiagnosis in Iowa rather than underdiagnosis in NY? >and the folks who need it will be fine ...if they have health insurance and Vyvanse works for them.
    - Duff 15y ago
      Read the comment and think before posting a response that doesn't make sense. I assume there's an over-diagnosis because the abuse of these drugs is both blatant and widespread. Look at the infographic and you'll see that there is a very wide variance between states. NY and Iowa just two examples. If you have a medical condition that affects broad swaths of society and is being diagnosed so inconsistently that you have these huge variances, something is wrong. If doctors stopped supplying prescriptions to people who want speed, as opposed to people who need to treat a recognized medical condition, there would be no supply problem.
Game_Ender 15y ago
The government centrally controls the production of narcotics, and people are wondering why there are shortages? It is obvious the purpose of their central control is not working, people who need the drug can't get it, and people who want to "abuse" it are still able to acquire the drug. I doubt we will see the sane solution of just stopping control on the production of these drugs.
- eli 15y ago
  It's worth noting that the government clampdown on this drug also happens to be extremely advantageous to the pharmaceutical giant who makes these drugs. I don't think Shire is blameless here.
  - juiceandjuice 15y ago
    Shire doesn't make the generics, Barr does.
    - eli 15y ago
      Nope. It's called an "authorized generic. It's marketed by Barr, but it's still made by Shire. From Wikipedia on Adderall: "Authorized generics are exactly the same as the brand name product both in active and inactive ingredients—they go through exactly the same brand manufacturing line, yet different labels are put on at the end of the manufacturing process." There is only the illusion of competition. I'm honestly not sure how they get away with it.
- jrockway 15y ago
  Technically, "narcotic" means "opiate" (or more generally, a sleep-inducing drug), which Adderall is not. I think you meant "schedule II controlled substance", or something.
  - ahupp 15y ago
    The legal and medical definitions of narcotic are not the same, unfortunately.
AJ007 15y ago
I'm against drug prohibition. I'm also against telling people they have a medical disorder and need to take a recreational drug for it. And damn right Adderall is a recreational drug, it makes stuff that is boring fun. I've also watched people working while using it, they are easily distracted and then focus 100% of their attention on the distraction. Makes for a good illusion of productivity.
- deleted 15y ago
  [deleted]
- phillmv 15y ago
  I think a lot of people, for either environment or genetic reasons, just have crappy brain chemistry for succeeding in our modern, deep-focus oriented world. Back in the day, you work on the farm, you chat with people, you do your regular business. You didn't have to sit still in a large box for 70% of the day, and so it wasn't such a big deal if you were a little "light headed". I have a wee cousin who has ADHD and she's a problem child from hell. We know this 'cos her father was also a problem child from hell. She literally has an immense problem sitting still. Once she takes her meds though… it's hard to describe the feeling I had when I realized she had spent the last half an hour quietly colouring a book. So yeah. Some people pop it to do all nighters; for a lot of other people it's necessary in order for them to achieve the neuronormativity expected of them in say, an office job or 12 years of mandatory schooling.
  - jonhendry 15y ago
    "in order for them to achieve the neuronormativity expected of them in say, an office job or 12 years of mandatory schooling." And there are a lot of fields a person might want to enter, entirely on their own initiative (not teacher-imposed), that inherently require you to spend a lot of time doing 'boring' or repetitive things. And if you don't, you'll fail. Or give up painting/piano/whatever early out of frustration.
  - ramblerman 15y ago
    "a problem child from hell" It's not unnatural for kids to be all over the place, and subsequently require a lot of parental energy. I've always seen this as a drug for the parent's more so than for the kids, specially at such a young age.
funkah 15y ago
What a scam. People don't even understand how these drugs work in the first place, and now the government, insurance, and pharm industries combine to screw people out of the things they're convinced they need for their brains to work. Gross.
mindcreek 15y ago
I live in Turkey and I am using concerta for about 5 years now, if you have ADHD the drug calms you and makes focusing and completing tasks easy, it also unfortunately makes you immune to coffee no matter how much coffee you drink, you can still drink more :). When somone without ADHD uses the drug it causes tachycardia, high blood pressure, restlessness and sometimes paranoia, not all of them though, it migth be a recreational drug to someone but I need it to function in my daily life and I'm not using it to have fun in any way, I had periods ( at most 6 months) which, I had not taken any concerta of methylphenidate derivative and results were not good for my productivity. It is also a type II controlled substance here in Turkey You are prescribed one pill for one day and you cannot have more even if you want to, but we dont have any quotas on the precursors and drug use in Turkey is very low considering Europe and US.
- kristopolous 15y ago
  How much money is a 30 day supply?
  - mindcreek 15y ago
    85$
phren0logy 15y ago
This article ignores an important point about Vyvanse. It's a pro-drug: it's metabolized into one of the components of Adderall, but at a constant rate. That means you can't crush and snort it (well, you can, but the constant rate of conversion does not change). As such, it has less abuse potential than Adderall XR (though not zero abuse potential). In states like Florida where there has been more scrutiny on prescription of controlled substances, these details can be important.
vvpan 15y ago
Have any of you been diagnosed with ADHD? How dose it get diagnosed? I am really wondering how much is known about this ailment.
- tweak2live 15y ago
  Attention deficit is a conduct disorder, which means that its diagnosis relies entirely on assessment of patient's behavioural patterns. Since it's next to impossible to keep a patient under 24/7 observation, secondary sources have to be used. In most cases, the diagnostic process reduces to an "intake session" interview with a patient and a few multiple-choice diagnostic questionnaires. So an AD* diagnosis is trivial to hack. Moreover, it's impossible to design a diagnostic process that's not easily hackable because, ultimately, everything will boil down to a subjective assessment of patient's behaviour, i.e. a "doctor's call". Furthermore, the more you restrict prescriptions and tighten the diagnostic criteria, the more you increase the risk of denying medication to "legitimate" sufferers. Since the guiding philosophy of the medical community prioritizes "helping people" over "prescription security", the problem of how to keep people from getting "illegitimate" prescriptions is ultimately intractable.
- anigbrowl 15y ago
  Yes. you go to a psychiatrist who is familiar with the condition and are evaluated via a checklist, essentially - there is no blood test or technical diagnostic. Of course, it's not as simple as saying 'yes I am easily distracted, no I cannot concentrate, now gimme a prescription/disability parking sticker/get out of jail free card.' A good psychiatrist will look at the whole person's medical history and ask a lot of questions to check the consistency of the diagnosis, and may be slow to give a diagnosis immediately.Given our limited understanding of how the brain works, it's an inherently tricky process. Regarding the claims of the article, I would like to see a lot more supporting evidence. I take generic Adderall (instant release) and have noticed no systematic supply interruptions. Nor have my pharmacist or psychiatrist mentioned any difficulties with availability, although I am used to reviewing the branded vs. generic options and pricing. Mine is manufactured by a firm called Corepharma, which isn't even mentioned in the article. Apparently some people find this version of drug inferior due to side effects or inadequacy of primary effect and prefer not to use it. For me the side effects have been very marginal so I have not bothered to seek out competing products. I presume that for people who are sensitive to a particular ingredient or characteristic the version of the medication they take matters a good deal, but in my own experience it's like preferring a specific flavor of coffee - others don't taste as great as my favorite, but they're hardly undrinkable. The fact that other brands of the same generic drug go entirely unmentioned in the article makes me question the whole premise. If medication were simply unavailable as a result of manufacturing quotas that would certainly be a bad thing, but from here it sounds like 'it ain't coffee unless it tastes like Starbucks.'
noonespecial 15y ago
One of the greatest coups corporatism can pull in modern times is to get a patent on something and then get the government to mandate its use and restrict all substitutes. Its 100%, grade A, screw society, corporate win.
- nostromo 15y ago
  There are so many examples of this it's infuriating. Recent examples include patent holders for those automobile rear-view cameras lobbying to mandate they be added to all vehicles and Michael Chertoff lobbying to get his client's full body scanners in every airport in America.
- kristopolous 15y ago
  I'm curious as to the pricing structure in less corporatist countries, especially in places with public health care where (unlike the US), the government has the legal right to bargain prices and doesn't just satisfy any arbitrary price set by a manufacturer.
  - anigbrowl 15y ago
    It's flatter, but patients are given their medicine and told to take it rather than being invited to select from a menu. Pharmaceutical companies don't advertise direct to the public and doctors make all the decisions about which version of a drug patients should be taking, based on the clinical outcome (eg whether the side effects of a generic are well-tolerated or problematic). In the US you have to be a lot more knowledgeable about what you're taking and the information is much more available, so in that sense the patient has more control, and arguably more freedom; on the other hand most of us are not doctors and spending time becoming expert on the finer points of your meds is perhaps like becoming an expert on the difference between Coke and Pepsi - you may strongly prefer one over the other, but is it really making any difference to your nutritional outcome? In other countries the win for the drug companies is predictability; the government will negotiate far more aggressively but will then contract to purchase a certain amount for the next x years, providing the drug companies with a predictable revenue stream. Where public healthcare is the norm, the government also absorbs a lot of the insurance/liability costs; if a drug is approved for sale but later turns out to have problematic side-effects, the government will compensate or support the affected patients, on the theory that since it approved the medicine for sale it accepted the potential risks as well. Obviously, there are exceptions, such as if a manufacturer had data on clinical risks that it concealed to get approval, but those cases are a minority.
alexhaefner 15y ago
I find this absolutely startling: "It’s well known that many college students use Adderall to give themselves an extra edge for getting work done whether they’re prescribed or not ... Furthermore, a 2009 study on non-medical use (defined as use of a prescription drug without a doctor’s order) of Adderall among full-time college students showed that subjects aged 18 to 22 were twice as likely as their counterparts, who were not full-time college students, to have used Adderall." Along with: "Stephanie Lee found her freshman year of college unusually difficult. She had trouble adjusting to the levels of stress she encountered." And: "Without Adderall, you might feel bored by your math homework or unable to focus on the multiple steps needed to reach a solution, but on Adderall you might literally feel like you’re in love with math." So many people are taking this drug to deal with the fact that they cannot handle the type of work, or the stress. I find it fascinating that people have come to assume that the problem is with them because they find the work uninteresting, or they find school stressful, and not because that is how the systems (colleges) and the work (math, science) are designed. Instead of telling people how they are not designed properly for the work, perhaps we should take some time to reflect on how the work is repetitive and not creative, and not fulfilling, and that is perhaps the issue. Note: I do think math and science and intellectual work can be creative when at a high level. But at a learning level you're treated more like a machine designed to learn and repeat. I was recently chatting with another student about how classes here are just becoming increasingly demanding. In looking at computer science classes as an example, the complexity of even the basic computer science classes has grown with time, and nothing has been removed. Every one of our professors expects us to spend 10-15 hours per week just on their class. And it's obviously not possible. Instead of trying to find ways to optimize time, people are trying to optimize their minds to be something that is not creative, but rather very much like a machine. College is not designed around passionate work, it is designed to be a grind on you and force you to do a lot of work you hate. Every four months you take all the previous work you did and throw it out and start over. How is any part of that designed to be gratifying? I don't necessarily share entirely positive views of college. It's an institution designed to meld and mold people to fit into our economic model. I have spent some time thinking about this trend and have come to the conclusion that it could be a real damage to creativity and individuality when you can medicate your mind into a machine.
- 15y ago
NegativeOne 15y ago
Yet again the government tramples it's citizens freedom and desires and tells THEM how to live. Doesn't matter if this drug helps countless people across the country function in their day-to-day.

82 points by pier0 15y ago

Another great example of a gov't regulation that isn't in sync with the marketplace. If you are a company that produces product A and product B, and the gov't says you can only produce a limited amount of A+B, why wouldn't you automatically shift all of your production to the product with the highest profit margin. This is economics 101!

pyre 15y ago
Assuming that Shire has a patent on Vyvanse, then this is more like limit production of A+B and create product C that is more expensive and has an artificial monopoly (patent). This will then drive everyone that needs products A or B to your new product C. Profit!
- refurb 15y ago
  I didn't get a sense from reading the article that Shire is limiting production of their branded amphetamine salts. However, you do have a point in that having more patients on a branded therapy makes a move to Vyvanse more likely.
  - pyre 15y ago
    I was going off of this: Luckily, Shire had magically possessed enough amphetamines from their DEA quota to produce plenty of their new ADHD medication, Vyvanse. In fact, Shire doubled its third quarter profits from 2010 to 2011, with most of that increase resulting from Vyvanse sales. During this time, coinciding nicely with the Adderall shortage, Shire hiked the price of Vyvanse.
  - eli 15y ago
    It makes sense to want everyone move to Vyvanse which is still protected by patent, but if you can game the system so that people are still forced to buy brand-name Adderall even though the patent is expired, that works too. (Worth noting that Shire makes money on all three -- including the generic version of Adderall. Which seems more than a little suspicious)
mistercow 15y ago
The thing is, there is reason to believe that these shortages are exactly what the DEA wants. Shire Pharmaceuticals has convinced the DEA that Vyvanse is the solution to the adderall abuse problem, and the DEA apparently doesn't understand that the American healthcare system simply doesn't allow everybody on generics to switch to an expensive name-brand medication. They're basically trying to manipulate the marketplace in order to force patients to switch to a drug that they expect to be easier to control. Of course, economics aside, Vyvanse is not a drop in replacement for adderall, and many people find it less effective or more prone to side effects. So it's also a good example of a government regulation that isn't in sync with medical science.
Duff 15y ago
"The marketplace" isn't a market at all -- it's a bunch of people, with and without a medical condition, who get a third party to purchase a medication for them. That infographic tells the story -- 50% more Iowan children need amphetamines to function as compared to New Yorkers? IMO, this is a case where the DEA is doing the right thing. Improve the guidance for prescribing this stuff, and the folks who need it will be fine.
- mistercow 15y ago
  >That infographic tells the story -- 50% more Iowan children need amphetamines to function as compared to New Yorkers? Why assume that there is overdiagnosis in Iowa rather than underdiagnosis in NY? >and the folks who need it will be fine ...if they have health insurance and Vyvanse works for them.
  - Duff 15y ago
    Read the comment and think before posting a response that doesn't make sense. I assume there's an over-diagnosis because the abuse of these drugs is both blatant and widespread. Look at the infographic and you'll see that there is a very wide variance between states. NY and Iowa just two examples. If you have a medical condition that affects broad swaths of society and is being diagnosed so inconsistently that you have these huge variances, something is wrong. If doctors stopped supplying prescriptions to people who want speed, as opposed to people who need to treat a recognized medical condition, there would be no supply problem.

Game_Ender 15y ago

The government centrally controls the production of narcotics, and people are wondering why there are shortages? It is obvious the purpose of their central control is not working, people who need the drug can't get it, and people who want to "abuse" it are still able to acquire the drug. I doubt we will see the sane solution of just stopping control on the production of these drugs.

eli 15y ago
It's worth noting that the government clampdown on this drug also happens to be extremely advantageous to the pharmaceutical giant who makes these drugs. I don't think Shire is blameless here.
- juiceandjuice 15y ago
  Shire doesn't make the generics, Barr does.
  - eli 15y ago
    Nope. It's called an "authorized generic. It's marketed by Barr, but it's still made by Shire. From Wikipedia on Adderall: "Authorized generics are exactly the same as the brand name product both in active and inactive ingredients—they go through exactly the same brand manufacturing line, yet different labels are put on at the end of the manufacturing process." There is only the illusion of competition. I'm honestly not sure how they get away with it.
jrockway 15y ago
Technically, "narcotic" means "opiate" (or more generally, a sleep-inducing drug), which Adderall is not. I think you meant "schedule II controlled substance", or something.
- ahupp 15y ago
  The legal and medical definitions of narcotic are not the same, unfortunately.

AJ007 15y ago

I'm against drug prohibition. I'm also against telling people they have a medical disorder and need to take a recreational drug for it. And damn right Adderall is a recreational drug, it makes stuff that is boring fun. I've also watched people working while using it, they are easily distracted and then focus 100% of their attention on the distraction. Makes for a good illusion of productivity.

deleted 15y ago
[deleted]
phillmv 15y ago
I think a lot of people, for either environment or genetic reasons, just have crappy brain chemistry for succeeding in our modern, deep-focus oriented world. Back in the day, you work on the farm, you chat with people, you do your regular business. You didn't have to sit still in a large box for 70% of the day, and so it wasn't such a big deal if you were a little "light headed". I have a wee cousin who has ADHD and she's a problem child from hell. We know this 'cos her father was also a problem child from hell. She literally has an immense problem sitting still. Once she takes her meds though… it's hard to describe the feeling I had when I realized she had spent the last half an hour quietly colouring a book. So yeah. Some people pop it to do all nighters; for a lot of other people it's necessary in order for them to achieve the neuronormativity expected of them in say, an office job or 12 years of mandatory schooling.
- jonhendry 15y ago
  "in order for them to achieve the neuronormativity expected of them in say, an office job or 12 years of mandatory schooling." And there are a lot of fields a person might want to enter, entirely on their own initiative (not teacher-imposed), that inherently require you to spend a lot of time doing 'boring' or repetitive things. And if you don't, you'll fail. Or give up painting/piano/whatever early out of frustration.
- ramblerman 15y ago
  "a problem child from hell" It's not unnatural for kids to be all over the place, and subsequently require a lot of parental energy. I've always seen this as a drug for the parent's more so than for the kids, specially at such a young age.

funkah 15y ago

What a scam. People don't even understand how these drugs work in the first place, and now the government, insurance, and pharm industries combine to screw people out of the things they're convinced they need for their brains to work. Gross.

mindcreek 15y ago

I live in Turkey and I am using concerta for about 5 years now, if you have ADHD the drug calms you and makes focusing and completing tasks easy, it also unfortunately makes you immune to coffee no matter how much coffee you drink, you can still drink more :). When somone without ADHD uses the drug it causes tachycardia, high blood pressure, restlessness and sometimes paranoia, not all of them though, it migth be a recreational drug to someone but I need it to function in my daily life and I'm not using it to have fun in any way, I had periods ( at most 6 months) which, I had not taken any concerta of methylphenidate derivative and results were not good for my productivity. It is also a type II controlled substance here in Turkey You are prescribed one pill for one day and you cannot have more even if you want to, but we dont have any quotas on the precursors and drug use in Turkey is very low considering Europe and US.

kristopolous 15y ago
How much money is a 30 day supply?
- mindcreek 15y ago
  85$

phren0logy 15y ago

This article ignores an important point about Vyvanse. It's a pro-drug: it's metabolized into one of the components of Adderall, but at a constant rate. That means you can't crush and snort it (well, you can, but the constant rate of conversion does not change). As such, it has less abuse potential than Adderall XR (though not zero abuse potential). In states like Florida where there has been more scrutiny on prescription of controlled substances, these details can be important.

vvpan 15y ago

Have any of you been diagnosed with ADHD? How dose it get diagnosed? I am really wondering how much is known about this ailment.

tweak2live 15y ago
Attention deficit is a conduct disorder, which means that its diagnosis relies entirely on assessment of patient's behavioural patterns. Since it's next to impossible to keep a patient under 24/7 observation, secondary sources have to be used. In most cases, the diagnostic process reduces to an "intake session" interview with a patient and a few multiple-choice diagnostic questionnaires. So an AD* diagnosis is trivial to hack. Moreover, it's impossible to design a diagnostic process that's not easily hackable because, ultimately, everything will boil down to a subjective assessment of patient's behaviour, i.e. a "doctor's call". Furthermore, the more you restrict prescriptions and tighten the diagnostic criteria, the more you increase the risk of denying medication to "legitimate" sufferers. Since the guiding philosophy of the medical community prioritizes "helping people" over "prescription security", the problem of how to keep people from getting "illegitimate" prescriptions is ultimately intractable.
anigbrowl 15y ago
Yes. you go to a psychiatrist who is familiar with the condition and are evaluated via a checklist, essentially - there is no blood test or technical diagnostic. Of course, it's not as simple as saying 'yes I am easily distracted, no I cannot concentrate, now gimme a prescription/disability parking sticker/get out of jail free card.' A good psychiatrist will look at the whole person's medical history and ask a lot of questions to check the consistency of the diagnosis, and may be slow to give a diagnosis immediately.Given our limited understanding of how the brain works, it's an inherently tricky process. Regarding the claims of the article, I would like to see a lot more supporting evidence. I take generic Adderall (instant release) and have noticed no systematic supply interruptions. Nor have my pharmacist or psychiatrist mentioned any difficulties with availability, although I am used to reviewing the branded vs. generic options and pricing. Mine is manufactured by a firm called Corepharma, which isn't even mentioned in the article. Apparently some people find this version of drug inferior due to side effects or inadequacy of primary effect and prefer not to use it. For me the side effects have been very marginal so I have not bothered to seek out competing products. I presume that for people who are sensitive to a particular ingredient or characteristic the version of the medication they take matters a good deal, but in my own experience it's like preferring a specific flavor of coffee - others don't taste as great as my favorite, but they're hardly undrinkable. The fact that other brands of the same generic drug go entirely unmentioned in the article makes me question the whole premise. If medication were simply unavailable as a result of manufacturing quotas that would certainly be a bad thing, but from here it sounds like 'it ain't coffee unless it tastes like Starbucks.'

noonespecial 15y ago

One of the greatest coups corporatism can pull in modern times is to get a patent on something and then get the government to mandate its use and restrict all substitutes. Its 100%, grade A, screw society, corporate win.

nostromo 15y ago
There are so many examples of this it's infuriating. Recent examples include patent holders for those automobile rear-view cameras lobbying to mandate they be added to all vehicles and Michael Chertoff lobbying to get his client's full body scanners in every airport in America.
kristopolous 15y ago
I'm curious as to the pricing structure in less corporatist countries, especially in places with public health care where (unlike the US), the government has the legal right to bargain prices and doesn't just satisfy any arbitrary price set by a manufacturer.
- anigbrowl 15y ago
  It's flatter, but patients are given their medicine and told to take it rather than being invited to select from a menu. Pharmaceutical companies don't advertise direct to the public and doctors make all the decisions about which version of a drug patients should be taking, based on the clinical outcome (eg whether the side effects of a generic are well-tolerated or problematic). In the US you have to be a lot more knowledgeable about what you're taking and the information is much more available, so in that sense the patient has more control, and arguably more freedom; on the other hand most of us are not doctors and spending time becoming expert on the finer points of your meds is perhaps like becoming an expert on the difference between Coke and Pepsi - you may strongly prefer one over the other, but is it really making any difference to your nutritional outcome? In other countries the win for the drug companies is predictability; the government will negotiate far more aggressively but will then contract to purchase a certain amount for the next x years, providing the drug companies with a predictable revenue stream. Where public healthcare is the norm, the government also absorbs a lot of the insurance/liability costs; if a drug is approved for sale but later turns out to have problematic side-effects, the government will compensate or support the affected patients, on the theory that since it approved the medicine for sale it accepted the potential risks as well. Obviously, there are exceptions, such as if a manufacturer had data on clinical risks that it concealed to get approval, but those cases are a minority.

alexhaefner 15y ago

I find this absolutely startling: "It’s well known that many college students use Adderall to give themselves an extra edge for getting work done whether they’re prescribed or not ... Furthermore, a 2009 study on non-medical use (defined as use of a prescription drug without a doctor’s order) of Adderall among full-time college students showed that subjects aged 18 to 22 were twice as likely as their counterparts, who were not full-time college students, to have used Adderall." Along with: "Stephanie Lee found her freshman year of college unusually difficult. She had trouble adjusting to the levels of stress she encountered." And: "Without Adderall, you might feel bored by your math homework or unable to focus on the multiple steps needed to reach a solution, but on Adderall you might literally feel like you’re in love with math." So many people are taking this drug to deal with the fact that they cannot handle the type of work, or the stress. I find it fascinating that people have come to assume that the problem is with them because they find the work uninteresting, or they find school stressful, and not because that is how the systems (colleges) and the work (math, science) are designed. Instead of telling people how they are not designed properly for the work, perhaps we should take some time to reflect on how the work is repetitive and not creative, and not fulfilling, and that is perhaps the issue. Note: I do think math and science and intellectual work can be creative when at a high level. But at a learning level you're treated more like a machine designed to learn and repeat. I was recently chatting with another student about how classes here are just becoming increasingly demanding. In looking at computer science classes as an example, the complexity of even the basic computer science classes has grown with time, and nothing has been removed. Every one of our professors expects us to spend 10-15 hours per week just on their class. And it's obviously not possible. Instead of trying to find ways to optimize time, people are trying to optimize their minds to be something that is not creative, but rather very much like a machine. College is not designed around passionate work, it is designed to be a grind on you and force you to do a lot of work you hate. Every four months you take all the previous work you did and throw it out and start over. How is any part of that designed to be gratifying? I don't necessarily share entirely positive views of college. It's an institution designed to meld and mold people to fit into our economic model. I have spent some time thinking about this trend and have come to the conclusion that it could be a real damage to creativity and individuality when you can medicate your mind into a machine.

15y ago

NegativeOne 15y ago

Yet again the government tramples it's citizens freedom and desires and tells THEM how to live. Doesn't matter if this drug helps countless people across the country function in their day-to-day.