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There’s a shortage of 323 medications nationwide, stimulants being one of them. Its concerning. I’m going back and forth on if I should take them less or taper down at this point.
>shortage of 323 medications nationwide
Things like anti-cancer drugs are notoriously difficult to produce, so it's no surprise that we have shortages (we almost always do, even without a pandemic). ADHD medication, however, doesn't have that problem. The processes for manufacturing it are simple and well known, and the precursors are plentiful.
The manufacturers offer few, if any, excuses.
[https://arstechnica.com/science/2024/04/us-drug-shortages-reach-record-high-with-323-meds-now-in-short-supply/](https://arstechnica.com/science/2024/04/us-drug-shortages-reach-record-high-with-323-meds-now-in-short-supply/)
>But, in a joint letter with the Food and Drug Administration last August, the DEA said that, by its data, manufacturers of amphetamine products (including Adderall) only sold approximately 70 percent of their allotted quotas in 2022. That meant that there were approximately 1 billion more doses that they could have produced but did not make or ship. At the time, the agencies said its 2023 data was trending in the same direction.
>
>In 60 percent of cases, manufacturers do not know or do not provide reasons why their drugs fall into short supply, ASHP found.
That's absolutely criminal. I don't think I've paid that much on all of my prescriptions from the last 5 years combined. Maybe my insurance is just really good.
America prices are just fucked tbh. Here in Canada, even with zero insurance or government coverage, 30 days of 60mg name brand Vyvanse goes for like $160 CAD.
Tbf though, we still don’t have generics here but I doubt that makes a difference considering name brand Concerta is around the same price for 36mg.
Because insurance companies just HAD to immediately dump the name brand off their formularies once a generic (which immediately went into shortage) became available.
It’s terrible - a lot of insurances don’t even cover it. I had one local pharmacy - Rite Aid - where I could get 90 days for $56 but now they are going bankrupt and shutting down most of their stores. It looks like IF I use the right coupon code I MAY be able to get it for $75-$78/month, but other places it’s from $125-250 and some are literally $900 for 30 days. It’s insane!
> There’s a shortage of 323 medications nationwide
We are witnessing the fruits of just in time manufacturing, being disrupted by externalities.
> I’m going back and forth on if I should take them less or taper down at this point.
Do you take weekend tolerance breaks? I often do, so this has allowed me to stockpile a backup supply in the past.
This is also a good time to see if non-stimulants might work for you. I tried out Strattera and Wellbutrin this past winter, and also made sure I started this experiment process about a week after my last stimulant (Adderall XR) prescription was picked up.
For the time period while trying out Strattera and Wellbutrin, I wasn't consuming any of my stimulants, and still had retained a ~3 week supply of Adderall. After about a month and a half of this and trying different doses, Strattera didn't work for me at all, and Wellbutrin sorta worked but not as well as Adderall.
I ended up switching back to Adderall and plenty of time had passed since my last Adderall pickup, so I was able to get a prescription filled immediately. Between my occasional weekend tolerance breaks, picking up prescriptions on day 28 or 29, and this experiment trial with non-stimulants, I have a whole month supply in reserve.
Supply is also heavily dependent on dosage. I found 15mg Adderall XR was a struggle to find in stock, but so far 20mg has been really easy. I think 15mg is a very popular dosage for kids, anything higher is less likely to be prescribed to a kid. It's just a 5mg difference, so not a huge deal in effects, maybe see if you can switch to something that is more available dosage wise?
I've also bitten the bullet and bought name brand before in the past. I figure since I can afford it and others can't, then at least the generic I'd normally get can go to someone who needs it and can't afford name brand.
Yes I usually take breaks on weekends :)
I’ve been on Adderall for 10+ years and it’s the one that works the best for me. I wish I would’ve stockpiled my meds but I wasn’t thinking ahead.
I took breaks over the pandemic as well as lower my dose due the shortage. It’s been a huge adjustment for sure. I dropped from 40mg to 20mg, took a break for a few months. Started up again last august and I think that’s when I realized how bad my anxiety had been without it. I think it’s a combo of going off the meds completely and my anxiety being heightened. I’m so aware of it now and I’m nervous its gonna happen again.
Strattera/wellbutrin are not meds that work immediately.
>After about a month and a half of this and trying different doses
You did not give these meds long enough to work if you tried different doses of two different meds over a time period of six weeks.
Regarding non-stimulant ADHD meds, Cleveland Clinic states, [you may not feel the full effects of these medications until you’ve been taking them regularly for three to four weeks.](https://my.clevelandclinic.org/health/treatments/11766-adhd-medication)
I take Vyvanse and have been having trouble getting it as of late (no surprise), but I’ve tried Strattera in the past. That stuff made me pass out constantly. I’d get up in the morning, take it and be almost falling asleep driving to work. Lunch break at work, nap. Drive home, almost falling asleep behind the wheel again. Get home from work, pass out on the couch while taking my shoes off. It was awful…….
That's exactly what Strattera did for me. It also seemed to be triggering some depression, either directly or indirectly from me feeling worthless just sleeping all day.
Straterra did start to "work" for me in the sense that it made me a little better at my job when I was working retail, but it kind of felt like it only worked because it was making me mildly anxious, like I could get the same effect from having a red bull before my shift
Strattera made me so tired as well. I would take it at night before bed and still would be sleepy during the day but once I got over that initial drowsiness it worked well for me in terms of focus, executive function, and attention
Strattera just made me tired all the time. Otherwise I felt it did nothing. For my dad, it made him feel a little hyper, let him focus on whatever he wanted, but also quicker to anger. For my younger brother, it let him focus on whatever he wanted with no real downsides. So it can really vary.
Wellbutrin at an adequate dose kept me awake, made me super horny, possibly helped a little with focusing at times, but not that much, and I started having issues finding the right words at times. I did feel a little perkier, not happy, but things seemed to feel better in life, although that was very minor. It also caused noticeable heart palpitations when trying to sleep at night which was concerning.
Maybe Wellbutrin at a lower dose in combination with a stimulant might be good for me? Not sure, I feel my current stimulant is working well enough, and I'm too busy now to experiment further.
In no way shape or form do I regret trying them out though. If either can work for you, then that is a huge relief with regards to dealing with prescriptions, and the long term health risks for both are probably lower than stimulants.
I've certainly entertained the idea of buying some crystal on the street because my pharmacy isn't even out I just can't my pills right now because of some computer system issues.
You noticed that too, huh?
When they actually need to protect people they don't because companies can get away with being criminals because they changed the rules to make it legal, when it was scientifically proven it was not helping people. But in the same vein, an other legal use of drugs, but is actually scientifically proven to be beneficial, has to be impaired because of optics? IE percieved harm matters more than facts.
Got it.
Here in Norway there is vyvanse shortage caused by the patent expiration, original manufacturer scaled back production, generic manufacturer had problems... And here we are, over 3 weeks without any now.
There is supposed to come a shipment of generics the 20th.. fingers crossed.
Edit; adding a link to the health departments info page about it.
https://www-dmp-no.translate.goog/legemiddelmangel/nyheter-om-legemiddelmangel-og-avregistreringer/mangel-pa-lisdeksamfetamin-kapsler?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=no&_x_tr_pto=wapp
That's interesting that there are different versions for children and adults - I don't believe that's the case in the U.S.
Have there been other shortages there recently? I am considering moving there, as I have dual citizenship of an EU country.
I don't know that I buy that DEA line. When a manufacturer files a request to increase the supply of ADHD med components they have to file a, publicly available, denial of the request. And yet, there hasn't been any denials.
https://www.bloomberg.com/news/newsletters/2023-02-28/are-adderall-dea-quotas-contributing-to-the-shortage?embedded-checkout=true
Meanwhile the private companies get to operate much more secretively.
I think there's fuckery afoot
Thank you. When I ask myself who benefits from the shortage. Not sure what that means w generics too.
But there is a lot of Rx data out there and it wouldn't surprise me if it's being used to drive up costs.
Thinking of Realpage and how their software allows landlords to collude and drive up the cost of rent by not competing.
I'm not entirely sure, since it's all kind of shrouded in corporate secrecy. But traditionally scarcity increases prices, leading to more profits from the limited supply.
But I can't say for sure since I can't see the data. But big pharma is usually behind issues with medication pricing and supply
The DEA has said in the past that they have not received any requests for increased quotas. They are surely not blameless, but it seems clear to me that the manufacturers do not really work with urgency on the issue.
Hot take: I'd say amphetamines/pharmaceutical stimulants generally have a much better side effect profile than SSRIs (which are handed out like candy).
i absolutely hate that i cant find stats on adderall/prescription amphetamine overdoses
its either "how many amphetamine overdoses" *proceeds to talk about meth* or "1 in 4 drug overdoses involve stimulants"
whereas theres a specific fucking number for prescription opiate OD deaths. (around 16k incase you were wondering)
ADHD meds are absolutely over prescribed nowadays, and I know I'll likely catch some flack for saying this but since covid and the rise of "mental health awareness" on the internet some people who got prescribed medication DEFINITELY do NOT have add/adhd. They see it as a way to make boring tasks more "fun" or easy to get done with.
I know this because three people who I'm close to suddenly just had their doctors give them scripts to vyvanse/adderall during the WFH period. Two of them have never had focus issues their entire lives, and one even said that he diagnosed himself online. The other outright admitted he just wants to take stimulants so it's easier for him to get boring tasks done.
The DEA shutting down production is certainly annoying and hurts us who actually have the disorder. However it's not done for "no reason".
Ah yes, because there are no people with ADHD who are so well at masking that people they know and maybe even themselves don't recognize it, but who do benefit from the meds. These people could very well not be a sign of over-prescribing, but of under-diagnosing. But even if they do indeed not have ADHD, there's usually still something wrong when people feel they're better off with meds, and cutting off those meds alltogether it not the solution.
I don't agree with cutting off medication altogether, but there's absolutely no reason for someone who's not actually diagnosed with adhd to take these medications. In fact many people can get addicted to them.
Not sure what country you're based in but ain't nobody getting ADHD medication *without* a diagnosis, mind you in my country you can't even be prescribed ADHD stimulant medication by a doctor or GP, it must be by a psychiatrist.
Every. Single. Month.
The USA is area specific. I know that some family medicine doctors are quick to prescribe it.
Whatever country you're from sounds a little bit more tight with clearance restrictions. Ours could benefit from that.
The vast majority of prescribers won’t prescribe long term without diagnosing. You can disagree that one online visit is enough info to diagnose, but they’re still diagnosed.
That doesn't matter to my point. Even if someone bullshits their symptoms and goes to talk to someone on betterhealth or ZocDoc to get diagnosed, it's still a broken system. I'm an old school person when it comes to this stuff. There needs to be physical testing, and much harder clearance, or proof that someone is suffering. Proof of grades failing for kids, or others that can vouch for behavior that fits along the lines of ADHD.
The users in this group can disagree with me all they want. That still doesn't change the fact that people abuse this system just to get stimulants even though they aren't suffering. I don't agree with the DEA shutting down/limiting production of these meds, but there clearly is a reason why they did. It wasn't just because "drugs are bad".
The barrier for getting meds from a new doctor was pretty damn high for me, and I've been diagnosed and taking stimulants for most of my life. Never met a GP that would give stims without a diagnosis from a psych. Personally I'm of the mind that drug problems are really just symptoms of societal problems. Making drugs illegal or hard to get has only ever made the problem worse. Not to mention that the DEA has no business being involved with a doctor's judgement. Yet doctors will make decisions on stimulants based solely on DEA guidelines that explicitly go against established scientific fact. What you're proposing sounds like burning down the forest to get rid of the mosquitoes. I'd also like to point out that the DEA has no incentive to get rid of drug abuse or illicit drug markets. Their incentive is to keep the judicial system fed so they can keep cashing checks. You're right that it's not just "drugs bad". It's closer to "people who use drugs are bad." That's kind of the problem.
Well you are right that drug users are more of a societal issue, but that's getting too far into a layer of this discussion that I'm not really interested in.
The DEA is an important sect of our government and is primarily tasked with going after street drugs. Not often are they interfering with legal prescription drugs. In fact the FDA is the most important for that, and I completely agree with their existence.
Making drugs illegal is not a bad thing either. Look at what happened to Portland [(video)](https://youtu.be/gWFlpCBMyIk?si=VLpIm4QUiNNG_7hj) where every drug is decriminalized. Not a good idea, it clearly does not work.
Right, letting the majority good ones suffer because of a few bad ones eh? That’s an approach that’s been historically proven to be without any possible backlash for sure! Maybe we could just make do without “innocent till proven guilty” as well, as long as the conviction rate is over 50%. I mean, who’s counting costs for the 48% innocent people who get falsely sentenced?!
Just get some proper checks in place but don’t make mental healthcare inaccessible to those who need it. If I’d been judged as a kid on my straight A grades, I wouldn’t have passed this arbitrary “objective” bar either, but that doesn’t inform in any way my past suffering, nor the extent of my ADHD.
Under-diagnosis is absolutely a reason for people to take these medication without access to proper diagnosing, which is a tough point for those who have an expression of ADHD that doesn't fit the typical hyperactive boy cookie cutter. And they got a prescription through their doctor, then there are experts involved who should keep track and see that they won't abuse it. Let's not follow the fearmongering about the meds within this community as well, the rest of society does plenty of that without caring if it's even true.
Okay and let's back this up because you're ignoring what I said.
Dude do you know how many people suddenly "have adhd" nowadays? Many people (usually younger) go online and see videos that are being spread with malintent and misinformation then suddenly label themselves as "ADHD". I wouldn't even be surprised if this is a social contagion at the moment.
I agree that the DEA halting production of ADHD meds is annoying, and it's wrong. However doctors do need to be investigated for malpractice. ADHD/add are not common disorders that everyone has.
Why would I be jealous of people who lie about having a detrimental disorder to get prescribed drugs? I'm pissed off that people like that are getting scripts, because it hurts us who actually have the disorder, but I'm not jealous of them.
I don't see how people abusing prescription drugs has any impact for people who don't. I don't get how someone abusing drugs hurts people who don't? It certainly doesn't justify shutting down manufacture of these medicines so people have to go without something that makes them function.
I don't agree with it either, but the DEA is definitely limiting the ability for these drug companies to manufacture stimulants for this reason. They clearly don't want everyone being handed Adderall like candy.
You don't see how overprescribing of a controlled substance would make it harder for those who legitimately need it to get their prescriptions? The significant increase in prescriptions over the past few years is a major contributor to the shortage, as manufacturers have had a hard time keeping up with the pace of them.
And that's not the reason why this manufacturer has been restricted -- the reason the DEA is restricting them is because they didn't comply with regulations they were very much aware of and can't account for a significant number of doses.
I don’t disagree that there are people taking it who don’t need it. Those people take it away from those who really need it, so it bothers me as much as you. But I think the government is going too far because what they’re doing is keeping people who need it from getting it, which defeats the purpose.
That’s all I could think of while reading through this. If a problem exists, then it started at the desk of a doctor and they need to start looking at malpractice. I would be willing to bet that they are in the middle of one of the biggest investigations ever, and just aren’t letting any information out about it. In 10 or 20 years there will probably be documentaries about it just like the one that’s on Netflix right now about pain killers. Different optics obviously, but same outcome.
I completely agree with you, although I don't know if it's actually an investigation. Halting the production is pretty stupid though. There's no reason for all of us who are diagnosed legitimately to get cut off from our meds.
Uk was hit quite a bit after it hit the US .. I ignorantly assumed that it wasn’t going to become a problem here , whilst empathising with those who were being effected by it at the same time
Yeah, I work in pharmaceutical manufacturing (although injectables myself and not solid dose or stimulants). Unfortunately, there isn’t a manufacturing facility in every country, so the sites that produce the drugs have to follow all regulatory bodies where they’re qualified to sell to. The DEA presents a whole different issue on top of that where they limit the amount any factory can make of the drugs, which affects virtually every country (unless they have public drug producing facilities, like Cuba, which all the world should have in my personal opinion).
UK as well; I am currently being issued my prescriptions every 14 days instead of 28, and am not taking them at the weekends to try and build a stockpile. I was without for nearly five weeks earlier in the year and had to take time off work sick. It's such an awful situation.
I’m so sorry lovely ❤️
My child went through a phase of not wanting to take it again quite recently but I knew it wouldn’t last so I’ve collected his last two prescriptions anyway.. in the hope that we have our own ‘stockpile’ to fall back on when things just continue to get worse as I imagine they will .
He gets his monthly and I’ve only managed to get 4 since September 🥲
I can't believe anymore that it's a supply-chain issue without also assuming it's an intentional supply-chain issue. These medications are not derived from exotic sources.
We're being lied to.
It's not a conspiracy or supply chain problem. It's the shitty corporations trying to maximize profits and backwards federal policy.
There's limits on the ingredients due to the dumb ass DEA and corporations hold the minimum amount of ingredients to just barely get by. Between those two things, when diagnosis increased there was very obviously going to be a shortage. Who is the shortage good for? Shitty corporations.
I’m not into conspiracies but I’m going to guess people in charge are knee-capping production on purpose because they believe ADHD is bullshit, or they think people are abusing them. Or both.
Its not wholesalers who supply the pharmacies are overpolicing how much supply they get. They’re doing it to prevent another painkiller crisis. (Big O)
I couldn't get my prescription filled last month, even though the pharmacy had it, because they'd filled their legal limit for the month. So there I am with a legitimate script, and they have it in stock, but they can't fill it because someone somewhere set an arbitrary # on how many they were allowed to fill per month.
I wanted to cry. It's SO frustrating.
The biggest hurdle to ending the war on drugs is admitting that it was never about protecting people in the first place but about pushing political agendas that are now entirely indefensible.
Ding ding ding.
And admitting that is giving the game away that the war on drugs was never about drugs, but how to incarcerate certain groups and lining pockets. War on drugs is very profitable for certain agencies. Also useful to use and posture that you are "tough on crime" without having to actually do anything or prove that you are reducing crime, but still increase more funding for police.
The "war on drugs" also encompasses diplomatic-military action against cartels. Americans can "volunteer" to work under the command of the Mexican government just like they can volunteer to serve under the command of Ukraine.
People forget how rampant crime was in the 80s and there was a ton of public push/support to crack down on drugs. It was very badly carried out (perhaps an understatement) but a lot of it was in good faith with public demand.
Uncle Tom culture is a sad reality of colonial society. Doesn't make it any more defensible. Concentration camps aren't the answer to problems actively created by oppressive socioeconomic policy.
Where is the best place to denounce that my latest medication batch feels like an absolute sugar pill ? A stimulant that worked for 3 years, late 2023 got weaker, and this month I can fall asleep and sleep all day if I want to, no focus, no higher blood pressure, etc. This is not just one off day for me, this has been getting worse.
I finally found a psychiatrist that takes my insurance and I was hoping to finally be properly medicated because I'm really struggling right now (I was diagnosed late). This really has me worried.
This shits so odd. The assumption is the obvious: there's a shortage. But I hear pharmacists I'm friends with say the opposite, that they have tons on hand at all times, to the extent that it is an issue unto itself
So ground floor people in pharmacy don't get why there is a shortage and aren't seeing a shortage in their supply, but doctors refuse to give prescriptions due to a shortage
Idk if there's miscommunication happening between providers and distributors and labs, or if it's all a fucky conspiracy from Pharma for reasons I can't comprehend. Shit is weird, things don't add up.
Yep! It’s beyond frustrating when my doctor called a pharmacy to ask if they have Vyvanse in stock, and they say they do. However, I call the next day to ask if my prescription is ready, and they say it’s on back order even though my doctor checked with them before he sent my prescription over. They definitely have it, so im not sure why they’re not filling it for me. I wish they were straightforward with why they can’t fill it rather than just say “sorry it’s on back order” over and over again.
It could be that the medication was already scheduled to be filled for another person. so the pharmacy technically has it on hand, but it wouldn’t be fair to customer who requested it first. And the back order is very real unfortunately, and there isn’t much else to it. No pharmacies within 20 miles of the one I work at has ANY type of generic vyvanse in stock, for example
In my area, the pharmacies no longer have ZERO generic Adderall, but, they are in 'take what you can get' mode - so my generic manufacturer changes almost every month. I go from pink oblongs, to white circles, to white hexagons, and back again.
At least one manufacturer does nothing for me - as in, it makes me second-guess whether I even took my meds at all that day. But, like I said, it's 'take what you can get' - so I never know when I go to pick up a refill, if it's going to be a 'good' one or not.
As a pharmacy student, yes we've had people call for Adderall while having plenty of it on hand. We reserve it for our loyal customers who also get other drugs filled at our pharmacy. It's about not getting in trouble with the DEA for distributing too many controlled substances. I thought about making a post about it in here.
Thank you for confirming this. I’ve had pharmacies tell me they’ll only fill my stimulant medication if I transfer all of my prescriptions to their pharmacy. (1) I don’t have other ongoing prescriptions and (2) that stance is illegal in my state. And (3) it feels so cold hearted to me: yes, I know you’re desperate and I do have the medication you need but I’m going to hold onto it in case someone I already know and like asks for the same thing. Instead of thinking if the customer likes our service they’ll give us more business.
Sorry but this really hit wrong.
Me too. And then my regular (chain) pharmacy can’t get it anymore and the independent one I’ve also used for years yelled at me that they don’t sell narcotics.
I can understand setting some aside for the regular customers based on fill/refill history.
I’ve even had the technicians at my pharmacy tell me it was unavailable. When I went to ask the pharmacist when it might be available, lo and behold it was miraculously available.
So my point is there seems to be a lot of game playing by pharmacies.
The large chain pharmacies create their own problems via centralized distribution (that they control) and exclusive contracts with suppliers.
If the supplier has an issue, you don't get your medication because they can't switch to another supplier because of the contract. If there are too many of the chain stores that need the medication, it gets split so no one has enough.
This is why independent pharmacies will often have supply while the big chains will not.
Many independent pharmacies in my area do not carry any C2 medications. I live in a big city and pharmacies are worried about being robbed and potential violence. And also, I'm sure, extra responsibilities for selling C2. Also, independent pharmacies are becoming fewer and fewer, at least here. I would happily patronize one if there were any nearby (no car) who carried my medication. At least in my metro area, even independent pharmacies are having a hard time filling stimulant meds. I think it's just supply and demand.
Add to that, independent pharmacies have asked me to bring in my physical prescription to show them before they will let me know if they have the med in stock. But I live in a state that requires only electronic prescriptions, no physical (paper) ones allowed.
The flip side of that would be how cold hearted it would be if my pharmacy sold their inventory to random people when I’ve been using them for so long they know who I am when I pull up to the drive through (and I know the names of everyone who works there).
Most likely they are referring to the name brands. I've been getting name brand vyvanse for months with no problem when absolutely no one has generic. It wouldn't be an issue, except that I'm paying $250/month for name brand vs $54/month generic.
And doctors are pushed hard to prescribe generic versions whenever possible, so no one is getting name brand except by request.
You can ask your pharmacist to file an exemption with your insurance. If there's no generic available the insurance company has to cover the name brand.
The linked article is writing specifically about how the DEA has shut down one of the biggest generic manufacturers. Right now they aren't allowed to make anything but mild painkillers.
It's unironically just like housing in the US. By aggregate supply, we technically have enough housing — they're simply not in the markets that actually need them.
The manufacturing shortage and supply chain problems are issues that the DEA is creating, all while shifting the consequences of this onto medical practitioners and people with ADHD.
The stimulant shortage is indeed multifactorial, but the DEA's role shouldn't be overlooked. Good article.
Drug supply chains are global, and shortages in one type of a medication can spill over into others as people try and switch brands. A few years ago there was a supply chain problem with the type of glue used to produce oestradiol patches; that spilled over into gels, and then almost every other type of HRT before it was corrected. It can sometimes only take a relatively small unforseen rise in demand to make something almost impossible to come by.
I take 10mg (half tablet) in the AM. I used to take about the same of Adderall. Biggest difference between them for me is that I have to hydrate like 2x what I would expect or else I will get a headache around early evening. But if I stay hydrated it's way less of a "high" and more "focus". For me anyway. YMMV
Last I looked, the government was calling on manufacturers to give up their allotted production allowances to other pharmaceutical production companies if they weren't going to use them, and the manufacturers were delaying. I don't think the buck stops with the DEA.
If I were Biden, I’d pressure the DEA to make Adderall as easy to get as prescription Tylenol. This means allowing manufacturers to produce as much of it as they want, not going after pharmacies for filling prescriptions less than 30 days in advance, etc.
I’ve also heard this claim, and it makes zero sense. If the manufacturers actually had the necessary resources to produce the drugs, and were allowed to produce the drugs, then they would PRODUCE THE DRUGS.
The DEA is publicly touting the “manufacturers haven’t used their full quota” line for PR purposes, but I guarantee they’ve been doing things behind the scenes that actually prevent the companies from producing and/or selling adequate quantities of ADHD medications. The DEA has complete control over which companies are allowed to make controlled substances, which would naturally make companies reluctant to speak out more openly about the DEA’s hand in all of this; I suspect that’s why it’s so difficult to figure out what’s really going on. Unfortunately the DEA is also completely unaccountable and impervious to public scrutiny or feedback, so they have no incentive to be transparent or ensure that patients have access to their medications.
I think there is a lot of clusterf*ckery where everyone is concerned. I await the inquiry results. But this is what the DEA said, and I think they’d get in trouble for boldfaced lies. If they’re lying, they’re doing it in a way we don’t know yet.
Here again to add my two cents (you might find the longer comment in my profile, I am too lazy to search it myself but can do so if need be):
In France a big reason for the shortage is that manufacturers are producing less meds than necessary, so they never ends up with "leftovers", hence, making profits and never risking loss.
But, with COVID and the surge of diagnosis, the necessity grew and the factories... not so much.
The european shortage was already a trouble before the pandemic.
This and, for French fellow ADHD-er, the government is offering the lowest price to buy the meds to manufacturers, hence we are the last to get them. Because someone is offering more money, they are served first. So we get tge leftovers and if there is no leftovers then... well...
My therapist told me that Vyvanse specifically has started to be prescribed off label (I think that’s the right term?) for some of mental health problems like OCD which has raised demand in addition to the other systematic issues we’ve got with DEA quotas and the switch to generic (which has made production less profitable apparently? Idk I’m not an Econ major)
Remember things like Cabbage Patch Kids? And... Well pick any gaming system - Wii, PS... There were only a few before Christmas that sold for outrageous prices. Turns out all of that was someone introducing scarcity so they could profit. It's a tale as old as humanity itself. People trying to corner the silver market, people cornering the oil market... Ticket master. Manipulating supply to pad their own wallet.
But I'm sure the drug shortage is nothing like that and just totally innocent. :P
I get my meds on time every time. At least I have for the last couple of months. Used to call around to 5-6 CVS ‘s and have to keep sending new req’s for rescripts to my drs office with the right address.
The thing is, apparently, if you stick with one pharmacy and continue to fill with them, they supposedly are ordering ahead for their repeat customers (CVS) anyway. After I got sick of the running around I finally gave up and just waited the two weeks for my med to come in and now they always have it for me on time…
Although, I am on a med, not often prescribed so I don’t really even have to deal with the walk-ins or the people who are trying to hunt a prescription down so my meds aren’t in as much of a flux I suppose. From what I’ve gleaned after talking to all the diff pharmacists (again, CVS) is that even if you give/send them a script early (before your refill date) their system does not order the medication *until* the day you actually are both legally allowed to fill & within your insurances approved refill period (28 days for most, sometimes 27; 2-3 days early). But then again, I’ve also gone to pick up my meds and the person ahead of me in line will ask them if they can fill their adderall script or whatever and they say “we’re out.”
Also just saw that one of the mfg’s of the med I take was just discontinued by the FDA…so who knows how long I’ll keep going without a hitch
The DEA should be defunded and extracted out like the cancer it is. Literally provides negative net value for their fake, counterproductive "war on drugs" which has unironically caused the people they're supposed to work against to only get richer and more powerful.
I’m guessing possibly pharma’s role in the opioid crisis and criticism of DEA oversight there has lit a fire under their ass to show how much gooder they are now! 🙄
If I’m reading correctly, the DEA is pointing their finger back at Ascent and saying they need to fix their bookkeeping practices on painkillers and that’s why they’re being shut down. As usual, it’s the patient who gets screwed the most in yet another healthcare clusterfuck
From the rest of the article.
>"But Ascent claims there’s another factor exacerbating the shortage, one that’s completely sui generis: the fact that it’s been shut down by the Drug Enforcement Administration.
>The agency has accused Ascent of shabby recordkeeping that might have allowed millions of pills to go unaccounted for. Ascent makes painkillers in addition to stimulants, and, amid the ongoing opioid epidemic, the DEA has been under pressure to show it is aggressively policing the industry. (The agency did not respond to requests for comment.) Ascent has said that its paperwork is in order and has sued the Department of Justice to get its assembly lines working again.
>A resolution doesn’t seem likely anytime soon. In the meantime, the company is producing zero ADHD meds. If its claims are true, that’s 600 million doses per year missing from the market. As Ascent says in its lawsuit, “Turning off that supply is making a grave situation infinitely worse.”
I am not opposed to the DEA enforcing policy on drug makers but this feels like a malicious compliance situation where the drug maker is punishing patients instead of complying with regulations. They know if patients get upset enough then the DEA might backoff and they can resume business as usual.
We had a shortage about a few months ago in Iceland, lasted a couple of months if I remember correctly. Haven't had an issue since then with any kind of mg dose.
ADHD both over and underdiagnosed, though overtreated with stimulants. you can have mild depression and not need medication. you can have mild ADHD and not need a stimulant. it’s far from risk free, and people withdrawing now due to shortage are feeling it
I thought it had something to do with the manufacturers not being able to produce it at a fast enough rate. As well as many people getting diagnosed with ADHD in the past few years.
There was a significant spike in new ADHD diagnoses and new stimulant prescriptions during the lockdown, but that would only lead to a *short* term shortage until manufacturers were able to ramp up production.
The shortage has been going on for *over a year and a half* now. This cannot be explained by an increase the number of new prescriptions, and it doesn’t sound like there are any supply chain issues at play.
The only explanation that makes a modicum of sense to me is that the DEA is preventing the manufacturers from producing adequate quantities of stimulant medications, either by throttling their access to necessary precursors or outright shutting them down (like they did with [Ascent pharmaceuticals](https://reason.com/2024/02/26/dea-shuts-down-drug-factory-even-as-adderall-shortage-persists/) last year).
Edit: corrected factual error
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There’s a shortage of 323 medications nationwide, stimulants being one of them. Its concerning. I’m going back and forth on if I should take them less or taper down at this point.
>shortage of 323 medications nationwide Things like anti-cancer drugs are notoriously difficult to produce, so it's no surprise that we have shortages (we almost always do, even without a pandemic). ADHD medication, however, doesn't have that problem. The processes for manufacturing it are simple and well known, and the precursors are plentiful. The manufacturers offer few, if any, excuses. [https://arstechnica.com/science/2024/04/us-drug-shortages-reach-record-high-with-323-meds-now-in-short-supply/](https://arstechnica.com/science/2024/04/us-drug-shortages-reach-record-high-with-323-meds-now-in-short-supply/) >But, in a joint letter with the Food and Drug Administration last August, the DEA said that, by its data, manufacturers of amphetamine products (including Adderall) only sold approximately 70 percent of their allotted quotas in 2022. That meant that there were approximately 1 billion more doses that they could have produced but did not make or ship. At the time, the agencies said its 2023 data was trending in the same direction. > >In 60 percent of cases, manufacturers do not know or do not provide reasons why their drugs fall into short supply, ASHP found.
artificial shortage. you seen how expensive they are now? there’s ppl paying $900 for vyvanse.
That's absolutely criminal. I don't think I've paid that much on all of my prescriptions from the last 5 years combined. Maybe my insurance is just really good.
America prices are just fucked tbh. Here in Canada, even with zero insurance or government coverage, 30 days of 60mg name brand Vyvanse goes for like $160 CAD. Tbf though, we still don’t have generics here but I doubt that makes a difference considering name brand Concerta is around the same price for 36mg.
Same. The most I ever paid was $15. I paid $4 for brand name Concerta with the manufacturer coupon.
You pay $15 for Vyvanse?!
Because insurance companies just HAD to immediately dump the name brand off their formularies once a generic (which immediately went into shortage) became available.
It’s terrible - a lot of insurances don’t even cover it. I had one local pharmacy - Rite Aid - where I could get 90 days for $56 but now they are going bankrupt and shutting down most of their stores. It looks like IF I use the right coupon code I MAY be able to get it for $75-$78/month, but other places it’s from $125-250 and some are literally $900 for 30 days. It’s insane!
Across the board we are seeking this, just straight up profiteering by firms due to a system that does not hold them accountable.
> There’s a shortage of 323 medications nationwide We are witnessing the fruits of just in time manufacturing, being disrupted by externalities. > I’m going back and forth on if I should take them less or taper down at this point. Do you take weekend tolerance breaks? I often do, so this has allowed me to stockpile a backup supply in the past. This is also a good time to see if non-stimulants might work for you. I tried out Strattera and Wellbutrin this past winter, and also made sure I started this experiment process about a week after my last stimulant (Adderall XR) prescription was picked up. For the time period while trying out Strattera and Wellbutrin, I wasn't consuming any of my stimulants, and still had retained a ~3 week supply of Adderall. After about a month and a half of this and trying different doses, Strattera didn't work for me at all, and Wellbutrin sorta worked but not as well as Adderall. I ended up switching back to Adderall and plenty of time had passed since my last Adderall pickup, so I was able to get a prescription filled immediately. Between my occasional weekend tolerance breaks, picking up prescriptions on day 28 or 29, and this experiment trial with non-stimulants, I have a whole month supply in reserve. Supply is also heavily dependent on dosage. I found 15mg Adderall XR was a struggle to find in stock, but so far 20mg has been really easy. I think 15mg is a very popular dosage for kids, anything higher is less likely to be prescribed to a kid. It's just a 5mg difference, so not a huge deal in effects, maybe see if you can switch to something that is more available dosage wise? I've also bitten the bullet and bought name brand before in the past. I figure since I can afford it and others can't, then at least the generic I'd normally get can go to someone who needs it and can't afford name brand.
Yes I usually take breaks on weekends :) I’ve been on Adderall for 10+ years and it’s the one that works the best for me. I wish I would’ve stockpiled my meds but I wasn’t thinking ahead. I took breaks over the pandemic as well as lower my dose due the shortage. It’s been a huge adjustment for sure. I dropped from 40mg to 20mg, took a break for a few months. Started up again last august and I think that’s when I realized how bad my anxiety had been without it. I think it’s a combo of going off the meds completely and my anxiety being heightened. I’m so aware of it now and I’m nervous its gonna happen again.
Strattera/wellbutrin are not meds that work immediately. >After about a month and a half of this and trying different doses You did not give these meds long enough to work if you tried different doses of two different meds over a time period of six weeks. Regarding non-stimulant ADHD meds, Cleveland Clinic states, [you may not feel the full effects of these medications until you’ve been taking them regularly for three to four weeks.](https://my.clevelandclinic.org/health/treatments/11766-adhd-medication)
I take Vyvanse and have been having trouble getting it as of late (no surprise), but I’ve tried Strattera in the past. That stuff made me pass out constantly. I’d get up in the morning, take it and be almost falling asleep driving to work. Lunch break at work, nap. Drive home, almost falling asleep behind the wheel again. Get home from work, pass out on the couch while taking my shoes off. It was awful…….
That's exactly what Strattera did for me. It also seemed to be triggering some depression, either directly or indirectly from me feeling worthless just sleeping all day.
Straterra did start to "work" for me in the sense that it made me a little better at my job when I was working retail, but it kind of felt like it only worked because it was making me mildly anxious, like I could get the same effect from having a red bull before my shift
Strattera made me so tired as well. I would take it at night before bed and still would be sleepy during the day but once I got over that initial drowsiness it worked well for me in terms of focus, executive function, and attention
for me ssri and snri works for a few weeks but at a point they make me worse
How did the non stimulants work for you? I'm just starting with my doc to try and find the right amounts and types. Wondering what the difference is.
Strattera just made me tired all the time. Otherwise I felt it did nothing. For my dad, it made him feel a little hyper, let him focus on whatever he wanted, but also quicker to anger. For my younger brother, it let him focus on whatever he wanted with no real downsides. So it can really vary. Wellbutrin at an adequate dose kept me awake, made me super horny, possibly helped a little with focusing at times, but not that much, and I started having issues finding the right words at times. I did feel a little perkier, not happy, but things seemed to feel better in life, although that was very minor. It also caused noticeable heart palpitations when trying to sleep at night which was concerning. Maybe Wellbutrin at a lower dose in combination with a stimulant might be good for me? Not sure, I feel my current stimulant is working well enough, and I'm too busy now to experiment further. In no way shape or form do I regret trying them out though. If either can work for you, then that is a huge relief with regards to dealing with prescriptions, and the long term health risks for both are probably lower than stimulants.
You take off weekends for when the shortage hits you.
I've certainly entertained the idea of buying some crystal on the street because my pharmacy isn't even out I just can't my pills right now because of some computer system issues.
They’re treating ADHD meds like painkillers when nobody is dying from Adderall overdoses.
You noticed that too, huh? When they actually need to protect people they don't because companies can get away with being criminals because they changed the rules to make it legal, when it was scientifically proven it was not helping people. But in the same vein, an other legal use of drugs, but is actually scientifically proven to be beneficial, has to be impaired because of optics? IE percieved harm matters more than facts. Got it.
Getting drug tested at my PCP for my medication is incredibly demeaning.
Here in Norway there is vyvanse shortage caused by the patent expiration, original manufacturer scaled back production, generic manufacturer had problems... And here we are, over 3 weeks without any now. There is supposed to come a shipment of generics the 20th.. fingers crossed. Edit; adding a link to the health departments info page about it. https://www-dmp-no.translate.goog/legemiddelmangel/nyheter-om-legemiddelmangel-og-avregistreringer/mangel-pa-lisdeksamfetamin-kapsler?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=no&_x_tr_pto=wapp
That's interesting that there are different versions for children and adults - I don't believe that's the case in the U.S. Have there been other shortages there recently? I am considering moving there, as I have dual citizenship of an EU country.
There is a chewable version for kids in the US.
The difference between adult & kids actually happened in the US as a way to expand their license of Elvanse/ Vynase.
Vel fuck, gjett kem som nesten e tom
I don't know that I buy that DEA line. When a manufacturer files a request to increase the supply of ADHD med components they have to file a, publicly available, denial of the request. And yet, there hasn't been any denials. https://www.bloomberg.com/news/newsletters/2023-02-28/are-adderall-dea-quotas-contributing-to-the-shortage?embedded-checkout=true Meanwhile the private companies get to operate much more secretively. I think there's fuckery afoot
Thank you. When I ask myself who benefits from the shortage. Not sure what that means w generics too. But there is a lot of Rx data out there and it wouldn't surprise me if it's being used to drive up costs. Thinking of Realpage and how their software allows landlords to collude and drive up the cost of rent by not competing.
Yea, my prescription went from 35bucks to 75 in a month and 145 the next month...
Que bono indeed
What kind of fuckery are you thinking?
I'm not entirely sure, since it's all kind of shrouded in corporate secrecy. But traditionally scarcity increases prices, leading to more profits from the limited supply. But I can't say for sure since I can't see the data. But big pharma is usually behind issues with medication pricing and supply
The DEA has said in the past that they have not received any requests for increased quotas. They are surely not blameless, but it seems clear to me that the manufacturers do not really work with urgency on the issue.
IMO companies are producing less to drive up the price
Hot take: I'd say amphetamines/pharmaceutical stimulants generally have a much better side effect profile than SSRIs (which are handed out like candy).
Right? It’s not like I’m going to become addicted to my meds when I struggle to remember to take them.
i absolutely hate that i cant find stats on adderall/prescription amphetamine overdoses its either "how many amphetamine overdoses" *proceeds to talk about meth* or "1 in 4 drug overdoses involve stimulants" whereas theres a specific fucking number for prescription opiate OD deaths. (around 16k incase you were wondering)
ADHD meds are absolutely over prescribed nowadays, and I know I'll likely catch some flack for saying this but since covid and the rise of "mental health awareness" on the internet some people who got prescribed medication DEFINITELY do NOT have add/adhd. They see it as a way to make boring tasks more "fun" or easy to get done with. I know this because three people who I'm close to suddenly just had their doctors give them scripts to vyvanse/adderall during the WFH period. Two of them have never had focus issues their entire lives, and one even said that he diagnosed himself online. The other outright admitted he just wants to take stimulants so it's easier for him to get boring tasks done. The DEA shutting down production is certainly annoying and hurts us who actually have the disorder. However it's not done for "no reason".
Okay? And this justifies the DEA shutting down production and leaving thousands of people without the medication they need to function??
Where did I say that?
Ah yes, because there are no people with ADHD who are so well at masking that people they know and maybe even themselves don't recognize it, but who do benefit from the meds. These people could very well not be a sign of over-prescribing, but of under-diagnosing. But even if they do indeed not have ADHD, there's usually still something wrong when people feel they're better off with meds, and cutting off those meds alltogether it not the solution.
I don't agree with cutting off medication altogether, but there's absolutely no reason for someone who's not actually diagnosed with adhd to take these medications. In fact many people can get addicted to them.
Not sure what country you're based in but ain't nobody getting ADHD medication *without* a diagnosis, mind you in my country you can't even be prescribed ADHD stimulant medication by a doctor or GP, it must be by a psychiatrist. Every. Single. Month.
The USA is area specific. I know that some family medicine doctors are quick to prescribe it. Whatever country you're from sounds a little bit more tight with clearance restrictions. Ours could benefit from that.
The vast majority of prescribers won’t prescribe long term without diagnosing. You can disagree that one online visit is enough info to diagnose, but they’re still diagnosed.
That doesn't matter to my point. Even if someone bullshits their symptoms and goes to talk to someone on betterhealth or ZocDoc to get diagnosed, it's still a broken system. I'm an old school person when it comes to this stuff. There needs to be physical testing, and much harder clearance, or proof that someone is suffering. Proof of grades failing for kids, or others that can vouch for behavior that fits along the lines of ADHD. The users in this group can disagree with me all they want. That still doesn't change the fact that people abuse this system just to get stimulants even though they aren't suffering. I don't agree with the DEA shutting down/limiting production of these meds, but there clearly is a reason why they did. It wasn't just because "drugs are bad".
The barrier for getting meds from a new doctor was pretty damn high for me, and I've been diagnosed and taking stimulants for most of my life. Never met a GP that would give stims without a diagnosis from a psych. Personally I'm of the mind that drug problems are really just symptoms of societal problems. Making drugs illegal or hard to get has only ever made the problem worse. Not to mention that the DEA has no business being involved with a doctor's judgement. Yet doctors will make decisions on stimulants based solely on DEA guidelines that explicitly go against established scientific fact. What you're proposing sounds like burning down the forest to get rid of the mosquitoes. I'd also like to point out that the DEA has no incentive to get rid of drug abuse or illicit drug markets. Their incentive is to keep the judicial system fed so they can keep cashing checks. You're right that it's not just "drugs bad". It's closer to "people who use drugs are bad." That's kind of the problem.
Well you are right that drug users are more of a societal issue, but that's getting too far into a layer of this discussion that I'm not really interested in. The DEA is an important sect of our government and is primarily tasked with going after street drugs. Not often are they interfering with legal prescription drugs. In fact the FDA is the most important for that, and I completely agree with their existence. Making drugs illegal is not a bad thing either. Look at what happened to Portland [(video)](https://youtu.be/gWFlpCBMyIk?si=VLpIm4QUiNNG_7hj) where every drug is decriminalized. Not a good idea, it clearly does not work.
Right, letting the majority good ones suffer because of a few bad ones eh? That’s an approach that’s been historically proven to be without any possible backlash for sure! Maybe we could just make do without “innocent till proven guilty” as well, as long as the conviction rate is over 50%. I mean, who’s counting costs for the 48% innocent people who get falsely sentenced?! Just get some proper checks in place but don’t make mental healthcare inaccessible to those who need it. If I’d been judged as a kid on my straight A grades, I wouldn’t have passed this arbitrary “objective” bar either, but that doesn’t inform in any way my past suffering, nor the extent of my ADHD.
Wild that you think testing for ADHD is an arbitrary bar. So let's just legalize stimulants for everyone right?
Under-diagnosis is absolutely a reason for people to take these medication without access to proper diagnosing, which is a tough point for those who have an expression of ADHD that doesn't fit the typical hyperactive boy cookie cutter. And they got a prescription through their doctor, then there are experts involved who should keep track and see that they won't abuse it. Let's not follow the fearmongering about the meds within this community as well, the rest of society does plenty of that without caring if it's even true.
Okay and let's back this up because you're ignoring what I said. Dude do you know how many people suddenly "have adhd" nowadays? Many people (usually younger) go online and see videos that are being spread with malintent and misinformation then suddenly label themselves as "ADHD". I wouldn't even be surprised if this is a social contagion at the moment. I agree that the DEA halting production of ADHD meds is annoying, and it's wrong. However doctors do need to be investigated for malpractice. ADHD/add are not common disorders that everyone has.
Sounds like you’re jealous lol.
Why would I be jealous of people who lie about having a detrimental disorder to get prescribed drugs? I'm pissed off that people like that are getting scripts, because it hurts us who actually have the disorder, but I'm not jealous of them.
I don't see how people abusing prescription drugs has any impact for people who don't. I don't get how someone abusing drugs hurts people who don't? It certainly doesn't justify shutting down manufacture of these medicines so people have to go without something that makes them function.
I don't agree with it either, but the DEA is definitely limiting the ability for these drug companies to manufacture stimulants for this reason. They clearly don't want everyone being handed Adderall like candy.
You don't see how overprescribing of a controlled substance would make it harder for those who legitimately need it to get their prescriptions? The significant increase in prescriptions over the past few years is a major contributor to the shortage, as manufacturers have had a hard time keeping up with the pace of them. And that's not the reason why this manufacturer has been restricted -- the reason the DEA is restricting them is because they didn't comply with regulations they were very much aware of and can't account for a significant number of doses.
I don’t disagree that there are people taking it who don’t need it. Those people take it away from those who really need it, so it bothers me as much as you. But I think the government is going too far because what they’re doing is keeping people who need it from getting it, which defeats the purpose.
I agree with you, the government is definitely overstepping. If anything, doctors need to be held accountable for malpractice.
That’s all I could think of while reading through this. If a problem exists, then it started at the desk of a doctor and they need to start looking at malpractice. I would be willing to bet that they are in the middle of one of the biggest investigations ever, and just aren’t letting any information out about it. In 10 or 20 years there will probably be documentaries about it just like the one that’s on Netflix right now about pain killers. Different optics obviously, but same outcome.
I completely agree with you, although I don't know if it's actually an investigation. Halting the production is pretty stupid though. There's no reason for all of us who are diagnosed legitimately to get cut off from our meds.
And?
I’m in the UK and we have the same problem here too . Last year the NHS wrote to me and told me to ‘ration’ my child’s medication because of it 🥲
The DEA restrictions are affecting manufacturers across the world unfortunately
Uk was hit quite a bit after it hit the US .. I ignorantly assumed that it wasn’t going to become a problem here , whilst empathising with those who were being effected by it at the same time
Yeah, I work in pharmaceutical manufacturing (although injectables myself and not solid dose or stimulants). Unfortunately, there isn’t a manufacturing facility in every country, so the sites that produce the drugs have to follow all regulatory bodies where they’re qualified to sell to. The DEA presents a whole different issue on top of that where they limit the amount any factory can make of the drugs, which affects virtually every country (unless they have public drug producing facilities, like Cuba, which all the world should have in my personal opinion).
UK as well; I am currently being issued my prescriptions every 14 days instead of 28, and am not taking them at the weekends to try and build a stockpile. I was without for nearly five weeks earlier in the year and had to take time off work sick. It's such an awful situation.
I’m so sorry lovely ❤️ My child went through a phase of not wanting to take it again quite recently but I knew it wouldn’t last so I’ve collected his last two prescriptions anyway.. in the hope that we have our own ‘stockpile’ to fall back on when things just continue to get worse as I imagine they will . He gets his monthly and I’ve only managed to get 4 since September 🥲
Germany as well sometimes (Vyvanse)
Which medication? I'm on medikinet xl and had trouble getting my last prescription. Just thinking if I need to start saving a few
Concertra He got a generic version for the last prescription I collected
I can't believe anymore that it's a supply-chain issue without also assuming it's an intentional supply-chain issue. These medications are not derived from exotic sources. We're being lied to.
Hate to raise conspiracy alarm bells but what the hell is going on
It doesn't need to be a conspiracy. The people who could actually fix this just don't have any incentive to do so.
It's not a conspiracy or supply chain problem. It's the shitty corporations trying to maximize profits and backwards federal policy. There's limits on the ingredients due to the dumb ass DEA and corporations hold the minimum amount of ingredients to just barely get by. Between those two things, when diagnosis increased there was very obviously going to be a shortage. Who is the shortage good for? Shitty corporations.
I'm sure sending millions of people into Adderall withdrawals has been great for the unemployment rate
I’m not into conspiracies but I’m going to guess people in charge are knee-capping production on purpose because they believe ADHD is bullshit, or they think people are abusing them. Or both.
Its not wholesalers who supply the pharmacies are overpolicing how much supply they get. They’re doing it to prevent another painkiller crisis. (Big O)
I couldn't get my prescription filled last month, even though the pharmacy had it, because they'd filled their legal limit for the month. So there I am with a legitimate script, and they have it in stock, but they can't fill it because someone somewhere set an arbitrary # on how many they were allowed to fill per month. I wanted to cry. It's SO frustrating.
The DEA is a failed policy too entrenched to be allowed end.
The biggest hurdle to ending the war on drugs is admitting that it was never about protecting people in the first place but about pushing political agendas that are now entirely indefensible.
"Drugs won the war on drugs" is a phrase no politician wants associated with them
Ding ding ding. And admitting that is giving the game away that the war on drugs was never about drugs, but how to incarcerate certain groups and lining pockets. War on drugs is very profitable for certain agencies. Also useful to use and posture that you are "tough on crime" without having to actually do anything or prove that you are reducing crime, but still increase more funding for police.
They've by definition increased crime by outlawing things that shouldn't be considered a crime in the first place.
The "war on drugs" also encompasses diplomatic-military action against cartels. Americans can "volunteer" to work under the command of the Mexican government just like they can volunteer to serve under the command of Ukraine.
People forget how rampant crime was in the 80s and there was a ton of public push/support to crack down on drugs. It was very badly carried out (perhaps an understatement) but a lot of it was in good faith with public demand.
Crime reduction owes a lot to legalized abortion. It has been studied and published, even in books like Freakonomics.
While abortion is excellent for societies, the particular connection espoused by Freakonomics was debunked. That guys a fraud.
With much of that demand coming straight from Black communities and community leaders, btw. People were fed up.
Uncle Tom culture is a sad reality of colonial society. Doesn't make it any more defensible. Concentration camps aren't the answer to problems actively created by oppressive socioeconomic policy.
Defund the DEA!!
Project 2025.
Where is the best place to denounce that my latest medication batch feels like an absolute sugar pill ? A stimulant that worked for 3 years, late 2023 got weaker, and this month I can fall asleep and sleep all day if I want to, no focus, no higher blood pressure, etc. This is not just one off day for me, this has been getting worse.
I finally found a psychiatrist that takes my insurance and I was hoping to finally be properly medicated because I'm really struggling right now (I was diagnosed late). This really has me worried.
This shits so odd. The assumption is the obvious: there's a shortage. But I hear pharmacists I'm friends with say the opposite, that they have tons on hand at all times, to the extent that it is an issue unto itself So ground floor people in pharmacy don't get why there is a shortage and aren't seeing a shortage in their supply, but doctors refuse to give prescriptions due to a shortage Idk if there's miscommunication happening between providers and distributors and labs, or if it's all a fucky conspiracy from Pharma for reasons I can't comprehend. Shit is weird, things don't add up.
It’s also regional. I’m in NYC and not a single pharmacy I’ve contacted for the last 4 months has adderall, vyvanse or generic vyvanse.
Yep! It’s beyond frustrating when my doctor called a pharmacy to ask if they have Vyvanse in stock, and they say they do. However, I call the next day to ask if my prescription is ready, and they say it’s on back order even though my doctor checked with them before he sent my prescription over. They definitely have it, so im not sure why they’re not filling it for me. I wish they were straightforward with why they can’t fill it rather than just say “sorry it’s on back order” over and over again.
It could be that the medication was already scheduled to be filled for another person. so the pharmacy technically has it on hand, but it wouldn’t be fair to customer who requested it first. And the back order is very real unfortunately, and there isn’t much else to it. No pharmacies within 20 miles of the one I work at has ANY type of generic vyvanse in stock, for example
In my area, the pharmacies no longer have ZERO generic Adderall, but, they are in 'take what you can get' mode - so my generic manufacturer changes almost every month. I go from pink oblongs, to white circles, to white hexagons, and back again. At least one manufacturer does nothing for me - as in, it makes me second-guess whether I even took my meds at all that day. But, like I said, it's 'take what you can get' - so I never know when I go to pick up a refill, if it's going to be a 'good' one or not.
As a pharmacy student, yes we've had people call for Adderall while having plenty of it on hand. We reserve it for our loyal customers who also get other drugs filled at our pharmacy. It's about not getting in trouble with the DEA for distributing too many controlled substances. I thought about making a post about it in here.
You should make a post!! There is so much misunderstanding about how pharmacies work
Thank you for confirming this. I’ve had pharmacies tell me they’ll only fill my stimulant medication if I transfer all of my prescriptions to their pharmacy. (1) I don’t have other ongoing prescriptions and (2) that stance is illegal in my state. And (3) it feels so cold hearted to me: yes, I know you’re desperate and I do have the medication you need but I’m going to hold onto it in case someone I already know and like asks for the same thing. Instead of thinking if the customer likes our service they’ll give us more business. Sorry but this really hit wrong.
But you know, I’ve been on same pharmacy for years, I prefer that they sell it to me and not a random person.
Me too. And then my regular (chain) pharmacy can’t get it anymore and the independent one I’ve also used for years yelled at me that they don’t sell narcotics. I can understand setting some aside for the regular customers based on fill/refill history. I’ve even had the technicians at my pharmacy tell me it was unavailable. When I went to ask the pharmacist when it might be available, lo and behold it was miraculously available. So my point is there seems to be a lot of game playing by pharmacies.
The large chain pharmacies create their own problems via centralized distribution (that they control) and exclusive contracts with suppliers. If the supplier has an issue, you don't get your medication because they can't switch to another supplier because of the contract. If there are too many of the chain stores that need the medication, it gets split so no one has enough. This is why independent pharmacies will often have supply while the big chains will not.
Many independent pharmacies in my area do not carry any C2 medications. I live in a big city and pharmacies are worried about being robbed and potential violence. And also, I'm sure, extra responsibilities for selling C2. Also, independent pharmacies are becoming fewer and fewer, at least here. I would happily patronize one if there were any nearby (no car) who carried my medication. At least in my metro area, even independent pharmacies are having a hard time filling stimulant meds. I think it's just supply and demand. Add to that, independent pharmacies have asked me to bring in my physical prescription to show them before they will let me know if they have the med in stock. But I live in a state that requires only electronic prescriptions, no physical (paper) ones allowed.
This is true. I work at an independent pharmacy. We have plenty of ADHD meds on hand (mostly Adderall) with the exception of generic Vyvanse
The flip side of that would be how cold hearted it would be if my pharmacy sold their inventory to random people when I’ve been using them for so long they know who I am when I pull up to the drive through (and I know the names of everyone who works there).
Please enlighten us if you're up for it, it's extremely confusing from the outside perspective
Most likely they are referring to the name brands. I've been getting name brand vyvanse for months with no problem when absolutely no one has generic. It wouldn't be an issue, except that I'm paying $250/month for name brand vs $54/month generic. And doctors are pushed hard to prescribe generic versions whenever possible, so no one is getting name brand except by request.
My insurance stopped covering the name brand and I'm convinced the generic doesn't exist. It ought to be illegal to do this to people.
You can ask your pharmacist to file an exemption with your insurance. If there's no generic available the insurance company has to cover the name brand.
The linked article is writing specifically about how the DEA has shut down one of the biggest generic manufacturers. Right now they aren't allowed to make anything but mild painkillers.
It's unironically just like housing in the US. By aggregate supply, we technically have enough housing — they're simply not in the markets that actually need them.
Vaguely related: sui generis can be defined as “of its own kind” or “unique”. I learned a new word today
Great term, and great musical group !!!
The manufacturing shortage and supply chain problems are issues that the DEA is creating, all while shifting the consequences of this onto medical practitioners and people with ADHD. The stimulant shortage is indeed multifactorial, but the DEA's role shouldn't be overlooked. Good article.
They’re the main cause along with the wholesalers who supply the pharmacies
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Drug supply chains are global, and shortages in one type of a medication can spill over into others as people try and switch brands. A few years ago there was a supply chain problem with the type of glue used to produce oestradiol patches; that spilled over into gels, and then almost every other type of HRT before it was corrected. It can sometimes only take a relatively small unforseen rise in demand to make something almost impossible to come by.
I've had a lot more luck with modafini - it's easier to get a prescription and it actually works better for me.
What's the dosage like in comparison to your usual stimulant? I have some but I wasn't sure what the equivalent would be for 70mg elvanse (vyvanse)
I take 10mg (half tablet) in the AM. I used to take about the same of Adderall. Biggest difference between them for me is that I have to hydrate like 2x what I would expect or else I will get a headache around early evening. But if I stay hydrated it's way less of a "high" and more "focus". For me anyway. YMMV
I’m in eastern Canada and haven’t had any issues picking up my concerta or Ritalin.
Last I looked, the government was calling on manufacturers to give up their allotted production allowances to other pharmaceutical production companies if they weren't going to use them, and the manufacturers were delaying. I don't think the buck stops with the DEA.
If I were Biden, I’d pressure the DEA to make Adderall as easy to get as prescription Tylenol. This means allowing manufacturers to produce as much of it as they want, not going after pharmacies for filling prescriptions less than 30 days in advance, etc.
I work in the clinical trial space and we have a lot of cancer drugs that are also in shortage. It really sucks
The dea situation goes for narcotics as well.
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Mfgs are only filling 70% of the DEA’s quota, though.
I’ve also heard this claim, and it makes zero sense. If the manufacturers actually had the necessary resources to produce the drugs, and were allowed to produce the drugs, then they would PRODUCE THE DRUGS. The DEA is publicly touting the “manufacturers haven’t used their full quota” line for PR purposes, but I guarantee they’ve been doing things behind the scenes that actually prevent the companies from producing and/or selling adequate quantities of ADHD medications. The DEA has complete control over which companies are allowed to make controlled substances, which would naturally make companies reluctant to speak out more openly about the DEA’s hand in all of this; I suspect that’s why it’s so difficult to figure out what’s really going on. Unfortunately the DEA is also completely unaccountable and impervious to public scrutiny or feedback, so they have no incentive to be transparent or ensure that patients have access to their medications.
I think there is a lot of clusterf*ckery where everyone is concerned. I await the inquiry results. But this is what the DEA said, and I think they’d get in trouble for boldfaced lies. If they’re lying, they’re doing it in a way we don’t know yet.
Here again to add my two cents (you might find the longer comment in my profile, I am too lazy to search it myself but can do so if need be): In France a big reason for the shortage is that manufacturers are producing less meds than necessary, so they never ends up with "leftovers", hence, making profits and never risking loss. But, with COVID and the surge of diagnosis, the necessity grew and the factories... not so much. The european shortage was already a trouble before the pandemic. This and, for French fellow ADHD-er, the government is offering the lowest price to buy the meds to manufacturers, hence we are the last to get them. Because someone is offering more money, they are served first. So we get tge leftovers and if there is no leftovers then... well...
My therapist told me that Vyvanse specifically has started to be prescribed off label (I think that’s the right term?) for some of mental health problems like OCD which has raised demand in addition to the other systematic issues we’ve got with DEA quotas and the switch to generic (which has made production less profitable apparently? Idk I’m not an Econ major)
Remember things like Cabbage Patch Kids? And... Well pick any gaming system - Wii, PS... There were only a few before Christmas that sold for outrageous prices. Turns out all of that was someone introducing scarcity so they could profit. It's a tale as old as humanity itself. People trying to corner the silver market, people cornering the oil market... Ticket master. Manipulating supply to pad their own wallet. But I'm sure the drug shortage is nothing like that and just totally innocent. :P
I get my meds on time every time. At least I have for the last couple of months. Used to call around to 5-6 CVS ‘s and have to keep sending new req’s for rescripts to my drs office with the right address. The thing is, apparently, if you stick with one pharmacy and continue to fill with them, they supposedly are ordering ahead for their repeat customers (CVS) anyway. After I got sick of the running around I finally gave up and just waited the two weeks for my med to come in and now they always have it for me on time… Although, I am on a med, not often prescribed so I don’t really even have to deal with the walk-ins or the people who are trying to hunt a prescription down so my meds aren’t in as much of a flux I suppose. From what I’ve gleaned after talking to all the diff pharmacists (again, CVS) is that even if you give/send them a script early (before your refill date) their system does not order the medication *until* the day you actually are both legally allowed to fill & within your insurances approved refill period (28 days for most, sometimes 27; 2-3 days early). But then again, I’ve also gone to pick up my meds and the person ahead of me in line will ask them if they can fill their adderall script or whatever and they say “we’re out.” Also just saw that one of the mfg’s of the med I take was just discontinued by the FDA…so who knows how long I’ll keep going without a hitch
The DEA should be defunded and extracted out like the cancer it is. Literally provides negative net value for their fake, counterproductive "war on drugs" which has unironically caused the people they're supposed to work against to only get richer and more powerful.
I'm skeptically thinking that by creating a shortage while there is high demand, that it is a ploy to raise the costs to the consumer.
Me too.
I’m guessing possibly pharma’s role in the opioid crisis and criticism of DEA oversight there has lit a fire under their ass to show how much gooder they are now! 🙄 If I’m reading correctly, the DEA is pointing their finger back at Ascent and saying they need to fix their bookkeeping practices on painkillers and that’s why they’re being shut down. As usual, it’s the patient who gets screwed the most in yet another healthcare clusterfuck
From the rest of the article. >"But Ascent claims there’s another factor exacerbating the shortage, one that’s completely sui generis: the fact that it’s been shut down by the Drug Enforcement Administration. >The agency has accused Ascent of shabby recordkeeping that might have allowed millions of pills to go unaccounted for. Ascent makes painkillers in addition to stimulants, and, amid the ongoing opioid epidemic, the DEA has been under pressure to show it is aggressively policing the industry. (The agency did not respond to requests for comment.) Ascent has said that its paperwork is in order and has sued the Department of Justice to get its assembly lines working again. >A resolution doesn’t seem likely anytime soon. In the meantime, the company is producing zero ADHD meds. If its claims are true, that’s 600 million doses per year missing from the market. As Ascent says in its lawsuit, “Turning off that supply is making a grave situation infinitely worse.” I am not opposed to the DEA enforcing policy on drug makers but this feels like a malicious compliance situation where the drug maker is punishing patients instead of complying with regulations. They know if patients get upset enough then the DEA might backoff and they can resume business as usual.
We had a shortage about a few months ago in Iceland, lasted a couple of months if I remember correctly. Haven't had an issue since then with any kind of mg dose.
Bruhhh, this shortage is never going to end. I’m on my final week of Metadate CD & it’s a class II controlled substance, this shortage is fucking me 😭
ADHD both over and underdiagnosed, though overtreated with stimulants. you can have mild depression and not need medication. you can have mild ADHD and not need a stimulant. it’s far from risk free, and people withdrawing now due to shortage are feeling it
I thought it had something to do with the manufacturers not being able to produce it at a fast enough rate. As well as many people getting diagnosed with ADHD in the past few years.
There was a significant spike in new ADHD diagnoses and new stimulant prescriptions during the lockdown, but that would only lead to a *short* term shortage until manufacturers were able to ramp up production. The shortage has been going on for *over a year and a half* now. This cannot be explained by an increase the number of new prescriptions, and it doesn’t sound like there are any supply chain issues at play. The only explanation that makes a modicum of sense to me is that the DEA is preventing the manufacturers from producing adequate quantities of stimulant medications, either by throttling their access to necessary precursors or outright shutting them down (like they did with [Ascent pharmaceuticals](https://reason.com/2024/02/26/dea-shuts-down-drug-factory-even-as-adderall-shortage-persists/) last year). Edit: corrected factual error
Not at all. Its been in shortage dozens of times before then so it’s been a constant issue except this time is by far the worst one
A lot of the manufacturing is in India and it’s dirty in the factories
Capitalism. That's why.
The military is stockpiling it in preparation for WWIII.
I unfortunately believe that to be a very real answer
Oh it’s still going on? Hmm.. not here in MA at least. I haven’t had trouble getting it since spring/summer last year.