[HN Gopher] Xanax and Adderall Access Is Being Blocked by Secret...
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Xanax and Adderall Access Is Being Blocked by Secret Drug Limits
Author : mfiguiere
Score : 55 points
Date : 2023-04-03 20:40 UTC (2 hours ago)
(HTM) web link (www.bloomberg.com)
(TXT) w3m dump (www.bloomberg.com)
| neonate wrote:
| https://archive.ph/Fdtyx
| IAmGraydon wrote:
| The DEA has likely done more damage to this country than any
| other three letter agency, and that's saying something.
| psathrowaway wrote:
| [dead]
| gnicholas wrote:
| I've wondered if Adderall could be popular in part because it can
| lead to weight loss. This wouldn't be why people would go on the
| medication, but why they would hesitate going off it. I know some
| people continued smoking after they wanted to stop because they
| feared gaining weight when they did.
| samtho wrote:
| Adderall is not prescribed for weight loss, it would be an off-
| label use as well. There are stimulant medications like
| adderall that are prescribed and work much better at appetite
| reduction than Adderall.
| prepend wrote:
| Adderall is prescribed for weight loss, according my my
| psychiatrist, but it's not approved to treat weight loss.
| Although similar drugs like vyvanse are approved for binge
| eating disorder. I think adderall is prescribed when patients
| can't afford vyvanse. Although vyvanse is going generic this
| year.
| gnicholas wrote:
| Yeah, I added the second sentence to clarify. I'm sure people
| don't go on it primarily to lose weight, but I could see how
| it would become a one-way ratchet if going off it causes
| weight gain.
| operatingthetan wrote:
| Probably more so because even at therapeutic doses it gives a
| mild high and is addictive.
| pyuser583 wrote:
| I've struggled with weight and ADHD.
|
| Adderall is an appetite suppressant, but that doesn't always
| translate to weight loss.
|
| I've forgotten to eat for an entire day, but made up for it
| (and then some) the next.
| PlotCitizen wrote:
| Unpaywalled http://archive.today/Fdtyx
| Overtonwindow wrote:
| This seems just a little bit of a conspiracy theory but, giving
| it credence I would say that it might be because the drugs are
| ridiculously overprescribed. Particularly for those who just
| don't need it. In the case of ADD, once there was a medication
| for it the diagnosis took off like a rocket. Sort of like
| oxycodone..
| EngManagerIsMe wrote:
| Left handedness used to be about 2% of the US population. Now
| it's about 12%.
|
| While it could be that somehow we've got an epidemic of left-
| handedness that blossomed in the 1920s, what's much more likely
| is that we've gotten more accommodating and understanding of
| left handed people, so there was less incentive to fit the mold
| of right handed folks.
|
| I'm _sure_ there were people who were alarmed at that rise, who
| felt that we didn 't really need left handed tools and
| accommodations for the "2% of people who are left handed", but
| when you made those things available, we stabilized at about
| 12%.
|
| Antidepressants and ADHD meds are, imo, in a similar place --
| we've increased our understanding, we've increased our
| accommodations, we no longer force the people who experience
| those maladies into the stress of acting 'normal'.
|
| Once you remove demonization, of course diagnosis are going to
| skyrocket. When it's no longer a scary thing to admit
| depression, ADHD, or autism, it becomes easier to get evaluated
| and care for them. I experience depression, I am on an SSRI, it
| helps me a TON. Historically, I might have been involuntarily
| committed or been told to "deal with it". I guarantee you I
| would not be as successful as I am now if I didn't have the
| support I do.
|
| (Similarly, I expect you see a lot more people being "out" in
| the LGBTQ+ community as a result of a similar phenomena. Once
| it's no longer criminal or "get lynched" territory, we see
| numbers of gay and trans folks increase.)
|
| These things seem like fads. They usually aren't, they are
| usually the case of a particular mode of people being pressured
| to be silent and invisible. When you remove that negative
| stigma, the revert to the mean can be dramatic, but it will
| stabilize at a new normal level.
| notch898a wrote:
| I've also noticed family members benefit greatly from SSRIs.
| The main skeptic point I have is I've also seen them
| absolutely get wrecked by what appears to them as supply
| chain failures (usually because they're unable to get a
| meeting with a physician in time for refills and no physician
| will grant them a "bridge" to the next appointment). Of
| course as we saw during COVID, supply chain failures of all
| sorts are possible even when society has not collapsed.
|
| From the outside one of the biggest concerns I have is one of
| these supply chain failures will put them in even worse place
| than had they never taken them, as I've personally seen their
| withdrawal symptoms look far worse than their unmedicated
| baseline. It seems to be a "better day to day" with the added
| risk of extreme withdrawal and associated risks during these
| few in a lifetime supply failures.
| sieabahlpark wrote:
| [dead]
| OkayPhysicist wrote:
| Isn't that to be expected, though? There's plenty of people who
| wouldn't subject themselves to the ordeal of going to the
| doctors to pursue a diagnosis of an untreatable disease. You
| just suffer through it. In contrast, if there's a known
| treatment for it, then the reward (not having ADD symptoms)
| dramatically outweighs the cost (of drudging through doctors
| appointments).
|
| I'd bet the number of surgeries significantly increased after
| we discovered anesthesia and sanitation. Not because more
| people were needing it, but because the outcomes were suddenly
| much better.
| Overtonwindow wrote:
| You underestimate college students because that is exactly
| what we did in college. People went to their doctor, faked
| hyperactivity, and were given adderall which they then sold
| to other students. I'm sure your ADD is horrible but try
| telling someone taking these drugs to stop. They won't. They
| depend on it too much and it's become part of their
| personality, and their belief that it is what they need.
|
| Just. Like. Oxy.
| BoorishBears wrote:
| Sounds "Just. Like. Oxy." in that people who have no idea
| what they're talking about go based on their gut feelings
| as if science and medicine should yield to their
| imagination:
|
| I mean I'm sure your diabetes is horrible but try telling
| someone taking insulin to stop. They won't. They depend on
| not being in a diabetic coma too much! And not slipping
| into a diabetic coma becomes a part of their personality.
|
| -
|
| ADHD doesn't mean hyperactivity despite hyperactivity being
| in the name. For me _not_ taking ADHD medication results in
| what your proclivity for drug abuse was gaining you: the
| super human ability to focus on one thing for hours and
| hours at a time.
|
| The difference is when the drugs you were abusing wore off,
| you'd go back to being able to do other things. I'd just
| keep being prisoner of whatever I'm doing indefinitely.
| It's an awful feeling to know you _have_ to do something
| else, you really need to switch tasks _right now_ , but
| it's like you're a prisoner in your own mind, just _stuck_.
|
| So subjecting myself to that isn't really something I'd
| willingly... is that surprising?
|
| I mean I've personally requested lower doses of
| medications, leaned towards less "intrusive" delivery
| methods like metabolized extended release versions, and
| stopped when I was injured and unable to do much (being
| stuck mentally wasn't a big deal when I was physically
| stuck)
|
| But even if someone else dealing with this doesn't want to
| do that, I don't blame them. It's an awful disease that
| deserves proper treatment. Some dumb drug abusing kid isn't
| going to change that.
| zamnos wrote:
| That's only true if you squint real hard. Might as well say
| people are addicted to oxygen or food if you're going to
| oversimplify that far. Plenty of people are able to learn
| meaningful coping strategies for their ADHD and choose to
| go off medication (especially those medicated from a young
| age), or at least off of stimulant medication, choosing
| instead to treat their disease with non-stimulant options.
| You'd also have to ignore the fact that they're, umm,
| different drugs, and do different things. The pain relief
| granted by opiates, along with them being chemically
| addictive and the marketing put forth by Perdue Pharma
| leading to addiction, for which they've paid billion of
| dollars in fines. There have been no such issues for
| AmerisourceBergen Corp., Cardinal Health Inc. and McKesson
| Corp.
|
| The thing about the drugs being different is the results on
| people's lives. Off medication and unmanaged, people
| suffering from ADHD go into depressive slumps of executive
| dysfunction and are unable to perform their EDLs (EveryDay
| Living activities; showering, putting on clothes, feeding
| one's self, using the bathroom, exercising), never mind
| things like cleaning, holding down a job or paying rent.
| Most are able to keep at the same dosage for the majority
| of their lives.
|
| That's not what people happens to people chemically
| addicted to Oxy. They need more and more to get the same
| effect, and chase after it to the point that many have
| become hooked on heroin, absent a prescribed supply of
| Oxycontin. While _on_ the drug their lives turn to
| shambles, getting fired from work and losing their jobs and
| then their housing and end up living on the street.
|
| That difference is entirely material to the discussion. If
| people are able to make _more_ of themselves on a
| particular medication, society is able to accept that a
| medication is _good_ , rather than bad. That may be a tough
| pill for some to swallow, especially those that want to
| reject traditional societal norms for judging a person's
| life. Another tough pill is that the idea that Adderall
| blunts a person should really be considered a fringe belief
| these days, given how many people use Adderall to better
| their lives.
|
| Are their people that abuse Adderall? Sure. Are their many
| more people that don't, and live much richer lives thanks
| to prescribed medication from a doctor? Absolutely.
| notch898a wrote:
| I'm not interested in protecting the people that game their
| doctor. They decided on their own they wanted the drug and
| dishonestly represented themselves to obtain it. That's
| their own prerogative, if that causes problems then that
| should not result in punishment for those acting with
| honesty.
|
| This is not "just. like. Oxy." in so many cases. Many of
| these were people in pain management with zero deceit
| involved on the side of the patient.
| peyton wrote:
| ADHD is an ADA-recognized disability. I doubt you'd support
| secret limits on mobility scooter orders because college
| kids sometimes steal golf carts. Why is this different?
| showdeddd wrote:
| Because Adderall is 100% pure speed. A handful of
| Adderalls is more fun than a bag of cocaine (which is
| going to be more like 5% purity and adulterated with god
| knows what).
| kevviiinn wrote:
| Mobility scooters can also be abused for a good time
| BoorishBears wrote:
| Maybe if you stop taking Adderall for fun you won't need
| to compare it to your bags of cocaine.
| OkayPhysicist wrote:
| Don't talk out of your ass. Cocaine comes with a much,
| much bigger euphoric rush than even methamphetamine,
| which has a much bigger rush than amphetamine. If your
| coke is less fun than some focus enhancement, it's
| because somebody sold you a gram of baking powder.
|
| Basically all stimulants can be categorized by a level of
| euphoric rush, and a level of focus they provide.
| Caffeine sucks at both, methamphetamine rocks at both,
| cocaine's good for a body rush but isn't very good for
| focus, and amphetamine comes with relatively little
| euphoria for a methamphetamine-comparable level of focus.
| symlinkk wrote:
| What's the big deal? The definition of ADHD is extremely
| fuzzy anyway. Why not just let whoever take them that wants
| them?
| SeanAnderson wrote:
| Well, IMO, it puts everyone into a mental arms-race
| reminiscent of steroid use in bodybuilding competitions.
|
| If you told me I was going to take a standardized test
| where only the top 10% make the cut, and everyone serious
| about winning is taking a mental PED, then yeah I am
| going to feel intrinsic pressure to step-up and also
| engage in that mental arms race. I would've been just as
| happy to not do that if I were given a more level playing
| field.
|
| It's no secret that there is a war going on to
| commoditize attention. I want to live in a world where
| people hone their ability to push back against having
| their attention leeched not one where everyone raises
| their baseline to cope temporarily.
|
| I also have to think that, long term, it's kind of
| disrespectful to those with ADHD. If expectations of
| attention rise due to uptake in mental PEDs then where
| does that leave those who were originally disadvantaged?
| They lose their ability to exist on a more level playing
| field.
|
| Bit of a tangent, but many years ago when I was wrapping
| up college, I was in a Calc III class over summer. The
| course was being taught at an advanced pace and basically
| everyone in the class was struggling after the first
| exam. The professor addressed the class about the poor
| performance and then called out a student in the front
| row. The professor said, "You! You did well on the exam.
| What was your secret to studying?" and, not missing a
| beat, the student responded, "Adderall!" I took the hint,
| bought some from a friend, and suddenly found myself
| passing the class with flying colors. It felt good in the
| moment, but honestly only because I wasn't being graded
| on a curve. It would've been wildly demoralizing if I'd
| been in direct competition with my peers.
|
| I know life isn't fair and it's a pipedream to clamber on
| about desiring a level playing field, but surely we can
| agree that physical fitness competitions are more
| interesting when they are separated between "natty" and
| "enhanced" competitors? And that if we eliminated that
| separation that those without PEDs are disadvantaged? I
| don't see society making that sort of separation for
| mental fitness and so I am concerned about letting
| stimulants loose on the population.
| Scalene2 wrote:
| A choice must be made. Either be more restrictive and
| controlling meaning that some people that need the drugs
| don't get them. Or be less restrictive and controlling
| meaning that some people you think shouldn't get the drugs
| get them.
| asdff wrote:
| There's other ways to realign incentives. A buy back
| program would do a lot honestly to restrict the supply. A
| lot of people who got them for legit purposes would still
| end up with a ton leftover when they would get their next
| prescription. If they were able to get more money
| returning them to the pharmacy or counting them towards
| their next prescription than selling them to other
| students, that's what they would do.
| westmeal wrote:
| I suppose, but anecdotally I was told I have ADD by my family
| physician and was prescribed various stimulants including
| adderall and ritalin. I only stopped and got on a patch based
| medication when I was losing weight because of the
| amphetamines destroying my appetite and I was already a
| skinny bastard. The only difference I felt on the medication
| is that I was methed up. This could have been a misdiagnosis
| but the tests I was given that led to my diagnosis were
| frankly bullshit. Looking back it seemed incredibly easy and
| 'hand wavy' for the doc to just shut up the parent and
| schools and write up a prescription to 'solve the problem'.
| In my eyes, the only problem I had is that I thought school
| was a meaningless chore. Should we make children take meth
| because they don't like the system they're in?
| callalex wrote:
| Adderall and Ritalin are not meth, and the fact that you
| consider them equivalent demonstrates your harmful lack of
| knowledge on this topic.
| fzzzy wrote:
| Good comment, but Adderall is Amphetamine, not
| Methamphetamine. Big difference.
| OkayPhysicist wrote:
| Methamphetamine can be prescribed for ADHD under the
| trade name Desoxyn, but it's less common because the side
| effects are worse.
| [deleted]
| eindiran wrote:
| Methamphetamine is a schedule 2 drug and prescribed in
| the US, though significantly more rarely than
| amphetamine. Is there a difference between oral
| consumption of amphetamine and methamphetamine dosed out
| in correct proportion to the salts in question? Maybe,
| but certainly not that "big" of a difference.
| a2dam wrote:
| The difference is one of chemistry, not law. A helpful
| analogy is to find another pair of drugs that people are
| more familiar with where the difference is a single
| methyl group: caffeine and theobromine (the stimulant in
| chocolate).
|
| Saying that appropriately dosed amphetamine and
| methamphetamine don't have a "big" difference is like
| saying appropriately dosed chocolate and coffee don't
| have a "big" difference. The difference is clearly
| massive.
| OkayPhysicist wrote:
| It's a pretty huge difference. Desoxyn's focus
| improvement comes with a full-body euphoric rush, which
| while fun and all, dramatically increases its abuse
| potential and addictiveness. Amphetamine, in contrast, is
| just makes it easier to focus. Properly dosed, there's no
| rush, no euphoria, just slanted walls on the sides of
| your train of thought.
| caslon wrote:
| It's actually a big difference. One feels downright
| euphoric, according to Desoxyn users. The other is a
| boring study drug.
|
| https://slatestarcodex.com/2017/12/28/adderall-risks-
| much-mo...
| operatingthetan wrote:
| >The other is a boring study drug
|
| That's quite the mischaracterization. Stimulants even at
| low doses increase the dopamine in the brain and lead to
| a mild high. I don't think I've ever heard anyone ever
| call Adderall "boring" before either. That's like calling
| alcohol boring, maybe someone may not like the
| experience, but they both have immediate and noticeable
| effects and it's not just "I love studying" either.
|
| Even Scott's article has examples of this, here's a story
| of a little girl becoming very high from a prescription
| stimulant:
|
| "A spontaneous report from the manufacturer of Strattera
| (atomoxetine) described a 7-year-old girl who received 18
| mg daily of atomoxetine for the treatment of ADHD. Within
| hours of taking the first dose, the patient started
| talking nonstop and stated that she was happy. The next
| morning the child was still elated."
| IIAOPSW wrote:
| >Looking back it seemed incredibly easy and 'hand wavy' for
| the doc to just shut up the parent and schools and write up
| a prescription to 'solve the problem'
|
| Exactly. The diagnosis is a tool for the system to give it
| a veneer of scientific legitimacy. There is no truth only
| power. In living memory, being gay was a diagnoseable
| disorder. In some countries political dissidents would be
| deemed insane and committed to institutions. Psychiatrists
| used to hand out lobotomies and electric shocks to anyone
| they felt like.
| giraffe_lady wrote:
| The biggest flaw in this line of reasoning is that these
| drugs aren't inherently calming or causing docility. They
| are pretty powerful stimulants!
|
| It's quite obvious when a troublesome kid has been
| misdiagnosed: they act as you would expect a child on
| stimulants to act. The behavior changes are mostly only
| useful if the child does have adhd. A non-adhd problem
| child on amphetamines is a powerful source of chaos.
| OkayPhysicist wrote:
| > Should we make children take meth because they don't like
| the system they're in?
|
| The flip side of this is that being unable to thrive in the
| system they're in is effectively dooming them to a
| substandard, more difficult life. If you think the system
| is broken, fix it, but ripping off the bandage before you
| have any sutures on hand is the opposite of a solution.
|
| If I had started on medication younger, I undoubtedly would
| have done better in high school. If I had done better in
| high school, I would have gone to a better college, better
| college, better job etc. On the flip side, had I not gotten
| medicated in college, I very well could have flunked out.
|
| So, yeah, it's a fucked up that the system doesn't
| accommodate for people slightly outside neurotypical-ness,
| requiring stimulant use to thrive, just like it's fucked up
| that it doesn't accommodate deaf people, making cochlear
| implants an extremely valuable treatment. But so long as
| that system is in place, restricting access to harm
| mitigation from that system because the system is fucked is
| unquestionably wrong.
| iamdbtoo wrote:
| It sounds a little bit of a conspiracy because it's rooted in
| misinformation.
| epolanski wrote:
| I second this feeling, it seems like not only they are
| overprescribed but it's done at very young ages. Doctors just
| throw ADHD at signs of hyperactivity.
|
| The idea of creating generations after generations unable to
| function without drugs seems a social disaster.
|
| It's so odd, and also very specific to US.
| slapshot wrote:
| After the pharmacies got sued for filling opiate prescriptions
| (which were written by abusive doctors, but the pharmacies are
| the ones who got sued)[1], is it any surprise that Xanax and
| Adderall are being limited? If pharmacies are at risk for filling
| prescriptions that are more complex than antibiotics, the end
| result is that they make it harder to fill them.
|
| [1] https://www.fiercehealthcare.com/finance/federal-jury-
| holds-...
| runnerup wrote:
| > is it any surprise that Xanax and Adderall are being limited?
|
| That depends on who is doing the limiting -- if the pharmacy
| corporations are self-limiting then I would understand they are
| limiting their potential exposure/liability to whatever risk
| level they are comfortable with. I'll still be able to find my
| necessary drugs at another chain which doesn't limit.
|
| If the government is doing the limiting, then yes, that would
| be surprising. That seems to be the case here, and I think it's
| a very inappropriate response -- totally attacks the wrong part
| of the system.
| [deleted]
| zamnos wrote:
| The article goes to lengths to describe how the government,
| specifically the DEA are limiting supply by issuing edicts to
| pharmaceutical companies. Corporations don't generally defy
| government edicts, especially ones that lead to raids and
| jail time, so we really _can_ say it 's the government's
| doing here, rather than particularly self-limiting behavior
| on the part of the pharmaceutical companies.
|
| That the government is threatening defiance of edicts with
| fines and jail time and not using direct means to stop
| additional production is not a distinction worth making - the
| government is limiting the supply of these medications.
| kevviiinn wrote:
| The DEA needs to justify their existence somehow
| pyuser583 wrote:
| My understanding is that pharmacists are highly trained care
| providers. They aren't simply some retailer who fills a doctors
| order.
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