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Over-prescribed means people are receiving prescriptions who should not be, not that supply is artificially low. The caps were in place before the pandemic, so

Over-prescribed means people are receiving prescriptions who should not be, not that supply is artificially low. The caps were in place before the pandemic, so they are not a "fix". Did prescriptions skyrocket during the quarantine because we found a bunch of undiagnosed people, or because the relaxing of the rules made it very easy for companies to make a lot of money prescribing these medications to people who were struggling working from home? Probably a mix of the two.

gruez 2y ago
>Over-prescribed means people are receiving prescriptions who should not be, not that supply is artificially low. Refusing to increase the cap even though there's increased demand is arguably a conscious decision on the part of the government, and that makes them as responsible for the shortage as the telehealth companies, if not more so. A doctor could plausibly justify over-prescribing with a variety of reasons (eg. the dsm-v being super vague, wfh environment being more distracting, more awareness of adhd) but I can't think of how the government can justify keeping the cap the same, even if it thinks the drug is being over-prescribed.
- mpalmer 2y ago
  > that makes them as responsible for the shortage as the telehealth companies, if not more so Completely ridiculous. You might just as well say that the government is responsible for a lack of wage growth because they haven't decreased taxes to zero. Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise... The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed?
  - gruez 2y ago
    >Completely ridiculous. You might just as well say that the government is responsible for a lack of wage growth because they haven't decreased taxes to zero. 1. taxes aren't factored into wage growth figures 2. there's an obvious fiscal impact to lowering taxes. There's no fiscal impact to increasing the quota. 3. the government could plausibly be blamed for refusing to remove limits, even if there's plausible reasons for keeping the quota. eg. zoning restrictions to "preserve the character of the neighborhood" >Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise... Except that keeping the quota the same is a terrible way to curb over-use/over-prescription. It impacts "real" adhd users and "fake" adhd users alike. If anything it impacts people with actual adhd users more because once they're less able to navigate the bureaucracy and/or call up a dozen other pharmacies to get their supply. It's like trying to fix the obesity problem by keeping food production the same. >The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed? I'm not sure how you got the impression that I claimed Done's practices were legal. I was only claiming that there's plausible justifications for "over-prescribing" in general but no such justifications for keeping the quota the same. Even if the drugs were illegitimately prescribed, the solution can't be "let's keep the cap the same and let the "real" and "fake" adhd users fight it out"
    - mpalmer 2y ago
      I know you're sharp enough to pick up on imperfect analogies; picking mine apart doesn't really change the overall point. And the impact doesn't have to be fiscal, and I know you know this too. The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive. Increasing caps just because demand increases is the wrong action to take. Taking legal action against entities responsible for massive over-prescription of controlled substances is a step in the right direction.
      - gruez 2y ago
        >Increasing caps just because demand increases is the wrong action to take. Taking legal action against entities responsible for massive over-prescription of controlled substances is a step in the right direction. No, increasing caps is the right action to take because it makes no sense to subject legitimate users to grief (ie. jumping through hoops to obtain their supply and/or to go without it) in a misguided attempt to reduce abuse. By all means go after the people who are prescribing it incorrectly, but punishing legitimate and illegitimate users alike makes no sense, and that's what keeping the quotas the same does.
        mpalmer 2y ago
        To repeat > The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive And how do you account for the tons of raw material that manufacturers had on hand months into the shortage?
        gruez 2y ago
        > The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive Just to be clear you're claiming it's better to have a shortage (which affects both legitimate and illegitimate users) than to increase the quota and allow more illegitimate users to get their hands on the drugs? >And how do you account for the tons of raw material that manufacturers had on hand months into the shortage? https://nymag.com/intelligencer/article/adderall-shortage-adhd-medication-ascent-pharmaceuticals.html https://nymag.com/intelligencer/article/adderall-shortage-ad...

gruez 2y ago

>Over-prescribed means people are receiving prescriptions who should not be, not that supply is artificially low. Refusing to increase the cap even though there's increased demand is arguably a conscious decision on the part of the government, and that makes them as responsible for the shortage as the telehealth companies, if not more so. A doctor could plausibly justify over-prescribing with a variety of reasons (eg. the dsm-v being super vague, wfh environment being more distracting, more awareness of adhd) but I can't think of how the government can justify keeping the cap the same, even if it thinks the drug is being over-prescribed.

mpalmer 2y ago
> that makes them as responsible for the shortage as the telehealth companies, if not more so Completely ridiculous. You might just as well say that the government is responsible for a lack of wage growth because they haven't decreased taxes to zero. Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise... The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed?
- gruez 2y ago
  >Completely ridiculous. You might just as well say that the government is responsible for a lack of wage growth because they haven't decreased taxes to zero. 1. taxes aren't factored into wage growth figures 2. there's an obvious fiscal impact to lowering taxes. There's no fiscal impact to increasing the quota. 3. the government could plausibly be blamed for refusing to remove limits, even if there's plausible reasons for keeping the quota. eg. zoning restrictions to "preserve the character of the neighborhood" >Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise... Except that keeping the quota the same is a terrible way to curb over-use/over-prescription. It impacts "real" adhd users and "fake" adhd users alike. If anything it impacts people with actual adhd users more because once they're less able to navigate the bureaucracy and/or call up a dozen other pharmacies to get their supply. It's like trying to fix the obesity problem by keeping food production the same. >The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed? I'm not sure how you got the impression that I claimed Done's practices were legal. I was only claiming that there's plausible justifications for "over-prescribing" in general but no such justifications for keeping the quota the same. Even if the drugs were illegitimately prescribed, the solution can't be "let's keep the cap the same and let the "real" and "fake" adhd users fight it out"
  - mpalmer 2y ago
    I know you're sharp enough to pick up on imperfect analogies; picking mine apart doesn't really change the overall point. And the impact doesn't have to be fiscal, and I know you know this too. The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive. Increasing caps just because demand increases is the wrong action to take. Taking legal action against entities responsible for massive over-prescription of controlled substances is a step in the right direction.
    - gruez 2y ago
      >Increasing caps just because demand increases is the wrong action to take. Taking legal action against entities responsible for massive over-prescription of controlled substances is a step in the right direction. No, increasing caps is the right action to take because it makes no sense to subject legitimate users to grief (ie. jumping through hoops to obtain their supply and/or to go without it) in a misguided attempt to reduce abuse. By all means go after the people who are prescribing it incorrectly, but punishing legitimate and illegitimate users alike makes no sense, and that's what keeping the quotas the same does.
      - mpalmer 2y ago
        To repeat > The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive And how do you account for the tons of raw material that manufacturers had on hand months into the shortage?
        gruez 2y ago
        > The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive Just to be clear you're claiming it's better to have a shortage (which affects both legitimate and illegitimate users) than to increase the quota and allow more illegitimate users to get their hands on the drugs? >And how do you account for the tons of raw material that manufacturers had on hand months into the shortage? https://nymag.com/intelligencer/article/adderall-shortage-adhd-medication-ascent-pharmaceuticals.html https://nymag.com/intelligencer/article/adderall-shortage-ad...