The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle. It's a risk for them to prescribe a stimulant, but zero risk to tell you to eff off.
As many have said in this thread, most doctors will tell you to go away or give you Welbutrin (which works poorly, if at all). I feel for your struggle.
I literally did the thing you’re not supposed to do.
my psych kept giving me everything by Adderall. So I went to one of those online doctors and got Adderall through her.
Then I just told my psychiatrist that I have Adderall prescription and she took it over.
For the record, she’s actually really reasonable and I like her but very conservative about the stimulants. Which when I finally got them were a revelation. Medication that actually works.
The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse.
Your psychiatrist is trying to deal with the DEA monitoring, and doesn't want to be the one who first puts you on it, but continuing an existing Rx is not treated the same by the DEA, as I understand it. So the online doc is putting her license more at risk to a DEA investigation, but your in-person doctor is less exposed.
N.B. this is how I understand the things that my wife has said to me. She is actually a pharmacist who has to deal with these things, and I might have garbled something.
Probably that it's basically a weaker form of meth. I mean they're chemically similar, they have the same effects, adderall is potentially addictive, nobody wants to end up dealing with something similar to America's meth epidemic. That's not to say you can't manufacture and prescribe this drug safely, but a lot more people are going to have a lot more reservations about it than if you want to crank out a generic Tylenol or something.
I'm currently addicted to Adderall. I also have a prescription for it and I have ADHD, but I'm still absolutely addicted. Without it I would suffer, and I would seek it out through illegal means if I could not get it legally.
Maybe it's just that the cost to set up the production elsewhere is too much for the expected market. The shortage of the drugs doesn't mean there will be enough buyer to cover the cost (and make enough profit).
> the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse.
I know that I process Adderall differently having ADHD, but I still struggle to see how it's used recreationally. I took it somewhat consistently for over a year for ADHD treatment until I missed an appointment and couldn't get around to scheduling another before my prescription ran out. After that getting back on became more trouble than it was worth. Not once did I ever feel a high from Adderall. My best naps were on Adderall. Not once after dropping it did I ever feel withdrawals or the urge to take more. The only thing I felt while taking it was constant dry mouth and my brain no longer constantly jumped between topics outside of my control.
My brother abuses controlled substances. When I told him I was taking Adderall he warned me to be careful and talked about his issues with it and I just couldn't relate at all. I'm no stranger to addiction. I'm an alcoholic and am addicted to nicotine via fruity vapes. But Adderall? Nothing at all.
My doc says the best diagnostic for whether you have ADHD is to prescribe Adderall and see what happens. Those with ADHD react very, VERY differently to the drug than the rest of the population.
i dont think thats true. I have ADHD and get amphetamine as medication. I gave it some friends and it had similiar effect as with me. they where hyper focused and aware. I think its what amphetamine does with every human. Regular humans have more focus and adhd people have suddenly focus but netherless same.
the euphoric high also happens in those with ADHD but only when they first start taking it. I would assume if you took it recreationally and not consistently you would have the same effect
My problem is I forget to take my Adderall. I've also experienced shortages in my area for 3+ months. When I eventually start back on my meds after a long hiatus, it seems to work just like it did when I stopped.
I could use some more euphoria in my life, sadly Adderall does not provide it (for me.)
One neurotypical I know who took 20mg of Adderall IR ended up going into a hyperfocused ‘can’t look away from the road’ 12+ hour road trip without stopping and couldn’t sleep for 3 days afterwards.
An ADHD’er I know who did the same thing, took a nap instead, and then actually started their taxes.
Not doubting you but… how? Adderall leaves your system in like 4 hours. The half life is crazy short and it’s extremely noticeable when it happens. I don’t understand how someone would fail to sleep for 3 days, or even hyper focus for 12 hours, when the drug is going to be completely gone from their system and not affecting them a fraction of the time into that period. Are you sure it wasn’t something else or they didn’t take more doses or other things?
Drug responses can be weird. Plus if you’ve been told this will make you manic and hyperfocused, your body will respond accordingly even if biochemically that doesn’t make a lot of sense.
Extended release. Those fucking things would keep me up for 3 days. If I take a the same dose of instant release, it'll be worn off at the end of the day and I'll sleep like a log. They say it wears off in 4 hours, but a single dose keeps working all day for me. Depends on how you metabolize it.
thats where i have to disagree. if I give anyone 5mg dexteoamphetamin they would be less hyperactive and more focused on one thing.
If you do too much it doesnt matter if you are regular brain or not. 80mg of dextroamphetamin would make everyone look like a speed freak.
If it would make people hyperactive it wouldnt be used for learning and sitting there 16h hyperfocused.
IMHO
edit: to explain better. imagine a adhd brain having dopamin swings between -1 and +1. While there are those swings people cant execute their plans and cant focus on one goal.
when you give them adderal or similar they get a powerboost to blasting +2 dopamin lvl and can keep that for hours.
so if you give a regular human beeing the same amount of adderall it will blast its brain on +2lvl dopamin also.
so adhd people and regular people behave the samw on adderall.
the thing with adhd it is not a lack of dopamin but an iregular flow of dopamin that is the problem. The solution is to hypercharge the brain with dopamin to get constant lvl.
> I still struggle to see how it's used recreationally.
- Adderall keeps you awake. Some people use that to be awake for very long periods of time. Long drives, marathons, etc.
- Adderall can make boring tasks seem engaging, so it can be used, for example, to help a student study. Combining that with no need to sleep that night, can become a bit of an unfair advantage.
- Adderall can cause a high, even though I've only ever experienced that with pure dextroamphetamine. For me it caused everything to feel warm and pleasurable somehow, the first couple weeks I was taking it.
Now I feel nothing except the wakefulness, although when I stop taking it for a while and then start taking it again, sometimes I will spontaneously do every chore that's been building up over the past months in a single day. That's just how it goes for me apparently.
Governments treat their citizens like children to be watched over, not like adults capable of making decisions. Until that changes, expect to be pissed off.
For many (not all) ADHD'ers, amphetamine or caffeine makes them sleepy.
> Adderall can make boring tasks seem engaging
This is true
> so it can be used, for example, to help a student study ... can become a bit of an unfair advantage
Unfair? This isn't sports. Nobody is being cheated by a study-enhancing drug.
> Adderall can cause a high, even though I've only ever experienced that with pure dextroamphetamine. For me it caused everything to feel warm and pleasurable somehow, the first couple weeks I was taking it.
Interesting. FYI ADHD people feel none of that. If anything, the opposite: on stimulants ADHD people feel relaxed and normal, bringing them down from hyperactivity and allowing them to focus on their life.
> For many (not all) ADHD'ers, amphetamine or caffeine makes them sleepy.
You're right, I was mainly speaking about people without ADHD using stimulants.
> Unfair? This isn't sports. Nobody is being cheated by a study-enhancing drug.
No, but it can lead to bad health effects for the student, and bad habits like dependence.
> Interesting. FYI ADHD people feel none of that.
I guess my ADHD diagnosis must be mistaken then? And my executive dysfunction must come from somewhere else...
ADHD is not a single neurotype. As even the most basic example, multiple different expressions of autism can each have ADHD.
> on stimulants ADHD people feel relaxed and normal, bringing them down from hyperactivity and allowing them to focus on their life.
Stimulants still help me regulate my sleep cycle and focus, but I don't think I experience hyperactivity from not being on them. (anymore at least; when I was younger I almost couldn't sleep without melatonin. That resolved itself before I ever touched stimulants, though.)
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I have heard of people with undiagnosed ADHD self-medicating with meth. Slightly different than people without ADHD using stimulants recreationally. I personally hope to never touch meth because I heard it can ruin one's relationship with other stimulants, and I don't want my medication to become any sort of recreational thing because I need to depend on it and not seek highs, but I feel like self-medication can be perfectly valid if someone knows what they are doing. Big if though.
My blanket statement was perhaps too broad. There are less than 10% of ADHD people whom do not demonstrate the paradoxical response to stimulants. That said, the percentage of misdiagnosis is at least that high, which makes one wonder. Mild bipolar is often misdiagnosed as ADHD, for example, and often discovered exactly because stimulants don't work as expected.
I missed on first read that you said the stimulants only had that high for the first few weeks though. That sounds different from what I understand to be the neurotypical response.
> Stimulants still help me regulate my sleep cycle and focus, but I don't think I experience hyperactivity from not being on them.
You may have the distracted variation rather than hyperactive.
Please don't speak for a whole group of people when you don't know what you're talking about. Euphoria is very common when people with ADHD first start taking amphetamines, it just goes away after a week or so.
> Interesting. FYI ADHD people feel none of that. If anything, the opposite: on stimulants ADHD people feel relaxed and normal, bringing them down from hyperactivity and allowing them to focus on their life.
That is common myth. It's a matter of dosage over time. If one takes 120mg of Adderall in one go, then I can assure you they will not be calm nor relaxed. The relaxed feeling comes with a build of tolerance over time and with the lowest therapeutic dosage possible.
I won't deny that people with ADHD might perceive more benefits from stimulants than those without ADHD. I person with poor vision probably would perceive more benefit from eyeglass than I do with 20/20 vision. The glasses work the same for both of us, I just don't benefit from the effects. Also, stimulants do not work for about 10%-30% of people with ADHD, and if the reactions were truly that different, then there would be no controversy about testing for ADHD. It'd be as simple as just examining the effects of a pill.
In the beginning, I felt euphoric from stimulants and I am ADHD as they come. On the rare occasion, I still might get hit with a glimpse of it. Though that is typically after I take a break from medication for some time.
Back when I was in college, I cannot tell you how many people I knew with legitimate ADHD that used to rail Adderall and Adderall XR pills (yes, the XR are just as easy to abuse).
Check out this subreddit if you care. Search for the term "ADHD" and you will see how the medication affects a portion of the ADHD population:
There’s a lot of myth in this myth-correcting post. I’ve doubled dosed by accident and although I felt like my heart was going to explode (and was very anxious over that), I still felt absolutely nothing resembling a euphoric high.
If you have good vision you do not benefit from glasses. In fact it makes things worse, as those with good vision are able to use their eye muscles to adjust focus but the glasses make that harder.
> I’ve doubled dosed by accident and although I felt like my heart was going to explode (and was very anxious over that), I still felt absolutely nothing resembling a euphoric high.
Doubling one's dosage does not mean much without stating the prescribed dosage. 5mg => 10mg is much different than 60mg => 120mg.
Also, the euphoric high tends to become lessened the longer one is on stimulants, even if the dosage is increased, due to neuroadaptation, i.e., a decrease in dopamine receptor availability and changes to downstream signaling effects of dopamine transmission.
Increasing the dosage on the second day of medication vs second year of medication may likely have significantly different effects in regards to the presence of euphoria.
That's wildly inaccurate. A brain is a complex system with emergent properties that result in us. The basic effect is an increase in Norepinephrine interactions but the effect that has on people with ADHD is obviously very different.
It's like saying that engines with fuel and engines with no fuel respond the same way to adding fuel: it increases the length of time they will run.
Stop adding fuel and the resulting system behaviour will be quite different.
> The basic effect is an increase in Norepinephrine interactions but the effect that has on people with ADHD is obviously very different.
I've heard it described as a difference in magnitude. If a person with ADHD has an arbitrary "focus" score of 5/10, and a normal person has a focus score of 8/10. If a stimulant brings them both up to a score of 9/10, then the effects may appear more noticeable in the ADHD person because a 4 point jump is typically far more apparent than a 1 point jump.
I’ve seen friends with stimulant and can say with full confidence they are not reacting to them the way I am. They’re « high », ideas everywhere and nowhere, acting like their overstimulated, full of energy… when I’m quieter, energy level normal, can think at one thing at a time without switching… and sleeping under the effect is not an issue. I a have great nap.
So no. Maybe if I try a récréative drug will I have my adhd multiplied, but here it’s not.
I think it should have been fun while younger discovering that amphetamine could quiet me when everyone was dancing under the influence.
It’s not perfect. No medication are. If you abuse it, take it without need… yeah it can be abused. Don’t try heart medication either. Or lithium for kicks. Or…
> I’ve seen friends with stimulant and can say with full confidence they are not reacting to them the way I am.
That means very little. Do you think all people react the same way to all medications? If someone takes an SSRI and it doesn't work, then does that mean they do not have depression, anxiety, or whatever the medication is indicated for? Do opioids only work for people with chronic pain?
As someone with ADHD, it's extremely common for people with ADHD to think they are some sort of rare subspecies of humans where everything different in their life is due to ADHD. In all aspects of life, people with ADHD are far closer to normal than they might want to believe. It's why people even doubt the existence of ADHD at times. I've yet to see anyone seriously doubt the existence of Schizophrenia, for example.
All drugs affect everyone differently. Something that's ok with you can literally kill someone else - simple example - smoking weed with someone that has some lung disease.
That's why just having them illegal makes them 100x more dangerous. Through less knowledge among users, no guidance on packaging and difficult to identify the substance if someone had to be taken to the hospital.
> This isn't true, it affects everyone the same way.
Adderall causes me to be essentially unable to move or function. When I tried it, I was very hungry but I couldn't get myself out of bed to get food so I had to sleep it off! Pure dextroamphetamine works a treat for me though.
this is true. Regular people get hyperfocus and adhd people get focus.
real adhd is a neurologic disorder. its an instability in the flow of dopamin. so adderall puts dopamin flow on 200% and suddenly there is a steady flow for adhd people.
there are maybe 10% of people getting not focused and awake of adderal.
But "adhd brain reacts different then regular brain" is not true. For both its 20x dopamin release in 8 hours.
I wouldn’t be surprised if this study were funded by some pharmaceutical lobbying shell organization.
I was on various forms of prescribed amphetimines for years and developed paranoia. It took me a few years to somewhat recover. My family has PTSD about that period of my life. I can’t think or communicate well anymore. Fuck that industry.
> LZ is supported by ìShizu Matsumuraîs Donation (2024-02228) and KI Research Grants (024-02570). LL was supported by the Swedish Heart-Lung Foundation (20230452), the Söderström König Foundation, and Fredrik och Ingrid Thurings Stiftelse. BD was supported by a grant from the American Foundation for Suicide Prevention (AFSP). SC, National Institute for Health and Care Research (NIHR) research professor (NIHR303122), is funded by the NIHR for this research project.
It may be none of them. It may be all of them. There could be corruption. There could be subtle manipulation. You have no idea how much money there is in the industry. They make things happen.
Some in the medical profession believe that these abused drugs are safe for their patients. Others know better but they still prescribe them. Some pharmacists will tell you that they’re good for your brain because they increase blood flow, because that’s what they’ve been sold by the reps and the studies they’re fed.
The fear over a paper, which can be studied and evaluated, is much higher than it need be. It would be something else if it were a media release, advertisement, or an actual compound being lauded.
It doesn't matter who funds a study if it's properly designed. You see this kind of dismissal on /r/science all the time and it's always just evidence that they're not qualified to actually read the study.
I knew someone that worked for the tobacco industry where they had labs that constantly were looking for reasons that tobacco was good for you. It meets your qualifications for properly designed studies, but it was purely about trying to convince convinced others that a known addictive substance that caused emphysema and lung cancer was beneficial to your health.
Something similar happened in the weed industry, though it it’s proponents were initially just people that wanted pot to be free for anyone to grow, and then it got taken over by capitalists that didn’t mind using massive amounts of energy to fund vertical gardening, or genetically modify yeast to create THC, or to genetically modify the plant itself to produce an untested derivative of it that would meet the qualifications for hemp products, and then peddle it to teenagers at massive doses without control, pairing it with sugar-free sweeteners and causing serious health problems like uncontrollable vomit coughing, basically inventing a new disease from scratch.
> I knew someone that worked for the tobacco industry where they had labs that constantly were looking for reasons that tobacco was good for you.
If you're implying publication bias, that's addressed by preregistration, though you either have to be careful about looking it up or else rely on meta-analysis.
Otherwise if they're publishing true results then there you go. Nicotine does have some benefits; it's basically the only effective nootropic and it's pretty effective for schizophrenia which is why almost all schizophrenic people are smokers. Of course the problem is it's super addictive and all the ways of taking it give you cancer.
You're right, and the situation is a harm to those who need adderall. Besides, adderall is not nearly as dangerous as Opiods. Whoopty-doo if it's diet Coke. This is why, even though I don't like Adderall's side effects for my ADHD and don't use it often, I keep the prescription, because fuck the government trying to squeeze pharmacists and doctors.
So even though there's a shortage, you're keeping your prescription to "fuck the government" but actually only fucking someone who needs it and cannot get it?
Yep. No matter how long I've been taking my ADHD meds, I can just stop them at any time. I'll sleep for a while (I think my record is 25 hours of sleep), but that's it. No life-threatening withdrawals. No panic. No pain. Safer than any opioid (except perhaps naloxone?).
The DEA is a runaway paperclip maximizer[1]. Their directive is "prevent drug abuse", and they will continue to pursue that goal to the detriment of everything else. There is ZERO feedback loop here. You need to build that feedback loop of you want one. It's your government, shape it how you want it.
All abuse is bad. Some abuses are worse than others.
What abuse are they seeing with adderall? What I hear in casual conversations is that people are abusing it to learn things. Is that what the DEA was seeing too?
You aren’t really going to get addicted to therapeutic doses. Recreational doses are like 5-10x what a doctor would prescribe, with restrictive laws in the U.S. you can only get a months supply at a time.
Would be pretty dumb to use your months dosage for 3 days of partying
I think of this stuff when folks say “trust the science!”. It’s all trust the science until that science conflicts with some broader agenda of a federal agency or a doctor’s whims about risks to their license.
Medicine really has a bad problem with groupthink. To get the best healthcare you have to both trust physicians and be critical of them.
Then the DEA seems to consider stimulants as a moral failing.
I’ve been off Concerta for 3-4 years now because it was so difficult to keep my productivity up when the pharmacies near me ran out due to the unpublished extra-legal DEA caps on stimulants.
Luckily even have been on Concerta has helped me learn how to manage my ADHD a bit better. It also gave me the chance to heal some of the worst traumas due to undiagnosed ADHD.
I think "trust the science" is a stupid slogan anyway. Not all science is equally well proven. Who represents the "science" when scientific opinion i divided? Even when there is a consensus there are plenty of examples when a strong consensus has been wrong.
The end result is that i tends to make the public regard science as something that they are told by experts, so then it becomes a matter of which experts they trust. This ultimately undermines trust in science because some expert opinions turn out to be wrong.
We really need better science communication, which will not happen when the media want sensation, politicians want spin, and the public believe either the media or ChatGPT or some random nutcase on Tiktok.
> (which has no physical diagnosis criteria, just a subjective checklist),
An ADHD diagnosis is not just subjective checklist. There's little regulation, but in order to get federal ADA accommodations in gradschool I had to get a diagnosis that took weeks. First I had a professional IQ exam which took 6 hours and highlighted that certain sub-scores were low indicative of ADHD, in particular working memory. Then there was testing with reflexes and attention regulation via computer testing. Finally there wad several counseling sessions reviewing childhood patterns and history, life and work impacts, etc.
Also you can scan ADHD brains with fMRI and see the differences.
> Why in the world would anybody be motivated to suppress the widespread usage of adderall for ADHD
Similar reasons as to why you're throwing shade at ADHD diagnosis criteria and hinting at that ADHD is fake. Maybe it's just ableism or puritanical views against the idea of stimulants.
Perhaps moral aspersions on a group of people whose symptoms look like they're just lazy. This is the most common in my experience.
> Who would be bribing them?
Some of the worse oppressors are those who do it because they believe they're doing it for your good. Perhaps beaurocrats enjoying the power in their fiefdom.
> Do you think that the DEA gets to make decisions about drug policy,
Well yes, especially before the Chevron doctrine was overturned recently by the Supreme Court [1]. Even Congress doesn't know what the DEA set their quotas for schedule 2 drugs at [2].
> or that they all belong to some secret anti-adderall church?
> Maybe it's just ableism or puritanical views against the idea of stimulants
It was very widely abused in my college days. There was also a (IMHO justified) concern over whether it was being over-prescribed as a way to deal with problematic behavior in children, rather than actually putting in the effort as a parent or medical professional to get to the root of the issue.
With that said, I do know people who genuinely have either ADD or ADHD, and who struggle to function without some form of pharmacological help in addition to therapy. Limiting their access to stop others from abusing it is unethical, whatever a cost/ benefit analysis might say.
I found the stronger stimulants robbed me of joy in life, I became very productive though. A good worker. Wellbutrin prevents my catastrophic thinking and feelings of being overwhelmed. I still miss meetings and procrastinate, but I also still whistle a tune while watching the sunlight pass through the leaves of a tree. That stopped on the strong stuff. All that anectdata aside, some people need the strong stuff, but many more are using it to fit perfectly into a world that no one should have to fit into. Antidepressants cause a similar problem, where people put up with situations they shouldn't. Just because the stimulants allow you to handle a certain amount of stress or work, doesn't mean you should.
> There's little regulation, but in order to get federal ADA accommodations in gradschool I had to get a diagnosis that took weeks.
That's because you wanted to get something from via the ADA. If you just go to a website, do a questionnaire with _very_ leading questions (that you can do anonymously several times to make sure you get the desired result), book a meeting, and then you can walk out of your meeting with a prescription. Pending a mandatory drugs test, of course.
Ask me how I know. And I actually _do_ have clinically diagnosed ADHD, so I didn't need to fake anything.
There's absolutely people who don't believe in any psychiatric medication, either for religious or just pseudo-scientific reasons. Look at how harshly the United States has treated marijuana users compared to smokers and alcoholics. There's moral and social judgement associated with different substances which is contingent on history and not based in fact.
Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that.
> Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that.
There are a few providers out there. The DEA is cracking down on them (they call them "pill mills") and that crackdown is - depending on who you ask - partially/fully responsible for the stimulant shortages the past few years. The /r/ADHD sub has some good discussion(s) from time to time on the latest action(s) taken by the DEA.
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When I was seeing medical help to confirm or refine my suspected/self-diagnosed ADHD, it was a _pain_ to jump through all the hoops. I was nervous getting my first Rx filled but oh my god was it a night and day difference. Within 45 min, it was _clear_ that the medication was working ... exactly how it's supposed to for people with ADHD. That "validation" was my prize for attempting to navigate the american health care system.
If I could have replaced dozens of hours / 6+ months of phone-tag/paperwork/assessments for a monthly subscription and a 30 min video call, I'd have jumped at the chance.
> and that crackdown is - depending on who you ask - partially/fully responsible for the stimulant shortages the past few years.
Australia has been experiencing psychostimulant shortages in recent years, but they haven’t been due to the DEA (or Australian equivalent thereof-most of the DEA’s functions are state government responsibilities in Australia), they’ve been explained as due to manufacturing issues and growing demand - https://www1.racgp.org.au/newsgp/clinical/further-adhd-medic... - while I totally believe the US is facing additional issues due to its own regulatory regime, if Australia is having supply issues independent of that factor, why wouldn’t the US too?
Since last year, lisdexamfetamine sold in Australia has been manufactured in Germany (API) and Ireland (packaging). The DEA has zero jurisdiction over a drug manufactured in Germany/Ireland and then exported from there to Australia–US quotas do not apply, the relevant quotas are the German/Irish/Australian quotas set by their respective governments (which governments appear to take a much more flexible and responsive approach to doing so than the DEA does). Takeda said that GMP issues in the Irish plant were causing supply problems – and I don't see any reason to disbelieve them; GMP is a TGA/FDA/EMA issue not something the DEA has any authority over.
The biggest cause of Australia's lisdexamfetamine supply issues isn't the DEA, it is patent law – the US patent expired in 2023, the Australian patent doesn't expire until 2028, which gives Takeda a continuing near-monopoly on lisdexamfetamine in the Australian market – so if Takeda is having problems meeting the growing demand, it is legally very difficult for other firms to step in. The TGA did for a period allow emergency parallel import – but I don't know if that included generics, and my own experience was it wasn't clear how to even access it – my impression is that for most patients it was more of a theoretical allowance than something practically helpful to them.
I think the biggest thing the DEA is doing here is damaging the US' own pharmaceutical manufacturing industry by pushing controlled substances production out of the US and into friendlier countries in Europe and Asia. The DEA can't cause any lasting issues with controlled substances availability in Australia because their jurisdiction is legally limited to the United States. Even if we suppose the DEA may have temporarily contributed to supply issues in Australia – surely equal blame lies at Takeda for being too slow at moving manufacturing out of the US.
That document is quite confusing, at least when skimming it. There's actually a bullet point on one page that says, "The current interruption to supply is NOT related to any DEA production quotas or restrictions on API."
That may be technically true, or perhaps it's just a false assertion included in the document dump. But AFAIU the issue is that the DEA tightly controls production and distribution of bulk amphetamines. There's just not a global quota, but per manufacturer quotas as well as requirements for allocation for each product. For example, the DEA sets a supply quota for 40mg pill production separate from a 50mg prescription. So if a particular manufacturers supply for 40mg pills is exhausted but they have tons for 50mg pills, too bad unless and until you go through an onerous process with the DEA to reallocate. It gets even worse across manufacturers. If manufacturer A has to shut down their production facility for some reason, manufacturers B and C can't easily pick up the slack. That's because reallocation of amphetamine supply to another manufacturer not only requires navigating a bureaucracy (that the DEA may very well slow walk given their present attitude), but it requires manufacturer A to voluntarily relinquish their quota, which they never do as there's zero benefit to them.
TL;DR: Technically global supply is more than adequate, but DEA rules, which effectively operate extraterritorially, create huge distribution problems. So the DEA can technically claim quotas aren't the problem, but that's at best highly misleading. If manufacturer A has to shutdown production (which, from the document, seems to have been one of the issues with Takeda), the end result is less production even though other manufacturers could theoretically pick up the slack.
There is no global quota. There are national quotas set by every country's government. US law nominates the DEA as the agency which does that for the US. Each country's government reports their national quotas to a UN agency (the INCB), but the UN agency has no power over them – at the very worst, they might criticise your quotas, but probably not even that; and more powerful countries (not just the US, even middle powers like Australia) can ignore what UN bureaucrats think with impunity – some poor developing country it may be a different story, especially if aid decisions are tied to getting a "good report card" from those bureaucracies.
And while for the DEA, setting these quotas is part of some grand moral/ideological crusade, for EU governments and Australia it is just technocratic paperwork – so of course those governments approach the issue much more reasonably than the DEA does.
> but DEA rules, which effectively operate extraterritorially, create huge distribution problems.
I don't see how they do. Lisdexamfetamine sold in Australia is manufactured by Takeda in Germany and Ireland. The DEA lacks jurisdiction over what a Japanese company does in EU and Australia. Although the drug was originally developed in the US, the Australian patent is currently owned by the Japanese parent company, not its American subsidiary, while the American subsidiary owns the "Vyvanse" trademark in Australia; anyway, DEA jurisdiction is based on manufacture in the US or US import/export, not country of development or IP ownership.
> If manufacturer A has to shutdown production (which, from the document, seems to have been one of the issues with Takeda), the end result is less production even though other manufacturers could theoretically pick up the slack.
In Australia's case they can't because lisdexamfetamine is still under patent, so other manufacturers are illegal – not because of the DEA, because Takeda will sue them. Takeda could license other manufacturers voluntarily, but why would they do that? That might be great for patients, but probably not so great for their shareholders.
I'm no fan of the DEA, but blaming the DEA for something that happens in Australia appeals to people emotionally even if it isn't true, whereas blaming patent law and the business decisions of a Japanese corporation is more truthful but less emotionally satisfying.
Yeah, it's ridiculous. I've been taking medication for ADHD since the 3rd grade. Why in the good goddamn should I have to go in EVERY month for a refill for a medication I've been taking for over 20 years.
I was on a 90 day prescription for ten years (vyvanse) when I told my doctor I was traveling abroad.
Insurance doesn’t cover 90 day bottles so it was $300/mo but worth it.
Nowadays there’s generic Vyvanse which is much cheaper so it probably makes 90 day prescriptions financially viable?
I just moved back to the US and had to find a new local doctor who gives me 30 day scripts so I haven’t asked about 90 day yet. I imagine these pill mills are pretty stingy. It takes a lot of time and calling around to find docs who don’t treat you like a fiend in some way.
But we need to count our blessings. People on pain killers need to put up with crazy shit like getting randomly summoned to the office so they can count your remaining pills.
> I just moved back to the US and had to find a new local doctor who gives me 30 day scripts
You may have difficultly getting a 90 day, both the doc and pharmacist have to agree to do it - 3x30 day with 'fill on dates' is more likely.
When I had a long out of town trip I was able to get a 60 day script. When I came back the doc sent 60 day script again but the pharmacist wouldn't fill it and only allowed it because what ever code/note the doc added about long term travel. That was self pay so I wasn't even a risk for selling it. Some states won't allow more than 3x30 day.
I am surprised you got name brand vyvanse for $300/month, generic is ~$250/month without coupons/discount cards
Interesting. I got a 90-day bottle from a doc in my hometown until 2022. That's when I moved back to Texas but didn't want to drive all the way to my hometown anymore to see that doc.
Now I go to some "psychiatrist" pill mill where they made me take a BS $200 computer test to diagnose me with ADHD (CYA even though I've been taking this drug for 16 years) and they ask me the same goofy questions every televisit (probably more CYA).
Yeah, it was $1000-1200 for 90 pills of Vyvanse all that time. GoodRX only knocked it down $200 or so. And the website coupon only applies to 30-day.
Now with insurance, Vyvanse is $100 for 30 while generic is $10.
This is why a friend of mine lies about their dosage. They claim they take 10mg twice a day when in reality they break the tablet into fourths and take 5mg total a day. Now they have a stockpile that gets them through frequent shortages and long trips. If their doctor asks why they haven't visited in a month and a half they say they don't take it on the weekends sometimes.
Mail order pharmacies (though insurance companies) are more likely to fill a 90 day stimulant script in my experience, solely because they really want to send out 90 day supplies for everything for whatever reason.
I get 84-day supplies of Concerta through ExpressScripts. They send them signature-required (unlike other Rxs I get from them). It's a bit of a pain—I usually end up having to go to the post office to pick it up—but it's an order of magnitude easier than needing to get a refill at a retail pharmacy every month.
I regularly travel for 4-6 months at a time and I have several prescriptions that I must take daily for years/decades and they’re not even controlled substances. Getting >60 day supplies is like pulling teeth.
It’s the same thing for me and Klonopin and my psychosis. The Klonopin is the only thing that stops my psychosis yet they only give me 20 tablets at a time and since I’m homeless and driving around it’s really hard for me to get a new doctor and a new prescription. I’ve been taking it as needed for over nine years and they still can’t get it through their thick heads that I’m not gonna abuse it.
I was in the hospital after surgery and was being treated like an addict who was just there to get pills. It was madness. Like I willed by appendix to burst so I could get a little morphine or a xanax, that makes total sense.
Yes, I have schizoaffective disorder, Asperger‘s, and myofacial pain disorder they put me on disability about 22 years ago. I used to be able to handle living in apartments on my disability, but rent has gotten crazy so I ended up living in a van which actually ended up being kind of OK.
I have episodic psychosis. It’s not something that happens every day. And I’m seeming to manage it with some genetic and nutritional understanding I have of myself so it’s not that much of a problem anymore. I just have to be careful with Covid because both times I had Covid I had the worst psychosis of my life.
All my disorders are mostly due to a CBS Deficiency.
You have to go into a doctor every month and get a new paper prescription for hormonal birth control? In the US? 20 years ago, my wife was able to do an electronic prescription, and it automatically refilled at the pharmacy every month.
For stimulants, they can't do an electronic refill, so I literally had to go to my doctor, get a paper prescription, then drop it off at the pharmacy, then come back a few days later (because it's usually backordered) every 30 days.
Some doctors would write 3 prescriptions with a "not before" date, but others were not willing to do so.
Or how every month the brand changes or you get a slight variation or they give you half the pills but double the dosage, where all of these things requires a consultation with the pharmacist and it's always a 5 second conversation: "This again?" "yep. Any question?" "no" "Have a nice day"
For the last few years I think the actual medication I take changes every month. Is it just amphetamine? Just dextroamphetamine? Both (like Adderall)? These aren't the same and effectiveness is at different dosages. And then I got to figure out how to adjust to the specific version and batch as the manufacturing tolerance is within sensitivity range. Not to mention food interactions. And most of this is a solvable problem!
At least with time release now there's less of a problem of having to sneak to the nurse's office every day at lunch to take medication and have that brat from third period ask you why you're in the nurse's office and what you're taking.
> Since you may sell them if you get them more frequently. Now here's a pack of 30.
But it's already a C/II class medication so the name on the Rx has to match the name on the photo ID and the pharmacy has to keep the records / there are rules for how often C/II medications can be dispensed. If you have a 30d Rx, the soonest you can come back with an Rx for that same medication is ~25d.
Regardless, does it matter if I have to re-fill every 30d or every 90d? As long as I'm only in there every 80d to get my 90d supply topped up, how is that any different from a 2d Rx or a 30d Rx being filled every 1d or every 25d?
Sorry, I was being a little tongue in cheek. My wife is on Adderall for ADHD and the renewal thing is frustrating for sure. Our pharmacy would only let us refill her prescription the day of until our psychiatrist wrote one that said 30 tablets over 25 days. So I get the frustration, I just find it kinda silly that there's all these overblown controls, and then they give a "large" amount when all is said and done. Kinda like security theatre to me, it's just dumb and punishes people that already have a hard time keeping up on appointments and paperwork due to their health.
I'm pretty ignorant of how all this works, never having had to take medication, so I apologize in advance if this comes off the wrong way. But isn't the reticence of doctors a result of the over-prescription of opioids leading to the very serious opioid crisis?
Not sure what the correct solution is, but on the one hand we don't want doctors to overprescribe, but on the other hand we want doctors to liberally prescribe without re-checks to make it easier for those who need it to get their meds. That would seem to put providers in a bind.
This is why I stopped, when I was starting doing internship at my job I was earning "1000", to go to the psychiatrist to get a prescription it'd cost 250, and the 1 month of pills would cost another 250, half my salary in this bullshit... on top of having to go every month which on itself is a burden.
Nice joke really, even after I started earning more after the internship period ended it was just too annoying so I stopped entirely, instead since it was work from home I literally spent 24/7 trying to finish my work so basically, "working" (if you have adhd you know that while you procrastinate, you aren't actually "relaxed" enough to go play games or whatever so it'd basically still being in work mode mentally) 16 hours a day.
Yep. For a while there I was able to work with my doctor and pharmacist to get Adderall from my Kaiser health plan pharmacy in 90 day increments but that stopped with the med shortage. Now that the shortage is over they won't do it again. Neither my doctor nor pharmacist know if this is an actual regulation change due to the shortage or just a health plan policy change. If it's a reg change, it'll never go away. If it's a health plan policy, maybe there's hope.
The problem is that Schedule 3 meds can't be shipped and must be picked up in person at the pharmacy (where driver's license # must be entered in an extra procedure not required for other meds). Health plan pharmacies have lines, don't have drug store hours and aren't on every corner. The combo of "in person pickup" + "30 day limit", which were enacted by different people at different times for different reasons creates life disruption and a massive waste of time, energy and money (we're all paying for this in increased prices). I've been on these same meds like clockwork for decades. In such cases they should relax either "in person pickup" or "30 day limit" but, we all know, it won't happen.
And if I need to travel on a trip or vacation for a week or two, with the 30-day limit there's a 25-50% chance I'll run out of meds and getting special dispensation to refill early requires contacting and coordinating the doctor and pharmacist in a non-automated, out-of-band loop. There's a two day automatic grace period to account for the pharmacy being closed on weekends but when my 30-day window falls on a weekend, I now have to coordinate pickup on an exact day - like I don't have a life outside of this bullshit. All just to get the meds which help me function normally.
Being forced to deal with all this for years has made it so I understand the health plan's back-end IT system capabilities (and lack thereof) better than most of their employees. It's still inconvenient for me but I'm one of the lucky ones. My meds are dialed-in and working, I have a flexible schedule and can parse bureaucratic systems. I got diagnosed and stable on my meds back before every ADHD patient was automatically considered a suspected drug abuser - which is ironic because I've never even had a drink, much less used illicit drugs (ADHD and alcohol/rec drugs tend not to mix well and I was diagnosed as a child). Which makes it meta-ironic I'm required to have a drug screen blood test every year to verify I am taking my prescribed drugs and not selling them - as if I got diagnosed in 4th grade as the ultimate long con knowing these meds would become street drugs worth a buck a pill decades later. I can't imagine a new ADHD patient still struggling to find the right med and dosage trying to figure all this out without giving up.
Are we talking Adderall? I would be amazed if it still works at all on you. It seems research is showing that stimulants work for ADHD, until it doesn't. If it is Adderall, do you cycle on and off, or what's your protocol? (curious is all)
Yes I did. It doesn't hit like it did when I first took it, but that decline quickly leveled off. I think it also helps that I don't take it on the weekends.
I've heard it argued that ADHD diagnoses should come with a social worker.
Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. Three day weekends are the worst.
One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a drawer. You only ever withdraw when you've fucked up your re-order.
I'm of course not recommending or condoning this, but with instant release it's definitely possible to also get a higher dosage than you actually need and cut the pills up to take the lower dosage you need, and stash the rest to build up a surplus.
The extended release means you only have to remember to take the medication once a day instead of twice.
What we need is for these pills to be compounded the way they do opioids: the wax granules are arranged to attempt to keep you from getting a burst dose by crushing the pills. The same process that makes crushing work makes splitting not work. So if you make split pills still time release, no problem.
But not for saving pills. Some people are exquisitely sensitive to these medications and you need 25mg per day but it only comes in multiples of 10 up to 50. So you’d like to split a 50 and take 1/2 pill per day. Also the 40mg often costs only 30-40% more than the 20.
One thing to keep in mind that methylphenidate is contextual and metabolic related.
Hard focus work could make it work shorter, but also some have metabolism so quick that they burn through medication. That's controlled by doctors so no worries, but I know people who take IR forms every 2 hours, and for those XR forms don't work at all (as it's like 2 complete cycles with all side effects).
Vyvanse is biochemically rate-limited rather than mechanically, so it is ideal for this; there is not really an alteration to the absorption properties no matter what you do.
When I was taking ADHD stimulants I had my core dose (long release) and then a “top-up” dose (5mg instant release) every month. The guy who prescribed me initially may have been a bit of a quack (I had to leave him because my insurance dropped him) but when I switched to a super mainstream doctor she had no problem continuing it.
you can open the XR/LR capsules too, there's just a bunch of small "grains" inside, with different coatings, and thus they get digested at different rates, and basically it's like eating one instant release and one ~4 hour release capsule. (though there are fancy ones that have ~3 peaks, etc.)
you can simply measure the grains with a scale and separate some fraction.
> I've heard it argued that ADHD diagnoses should come with a social worker.
I know a few people with crippling ADHD that have managed to hire a "life coach" of sorts to help. Takes a bit of screening to find somebody that knows ADHD and how to help with it versus the more generic/useless skills you probably first thought of when you read 'life coach' :).
> Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that.
We all have to develop our own coping / survival tools and I'm sure you've heard "put it in your calendar" before. I've had really good luck with an electronic pill dispenser. They can get pricey but for ~ $100 you can get a device that'll keep track of 30 doses and even push alerts to your phone if you've missed a scheduled dose or are down to your last few. You can also DIY; micro controllers and eInk display panels are _cheap_ now. My current iteration is wired into my Home Automation system and that affords me several opportunities to nudge me towards medication when i'd have otherwise forgotten.
> One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a drawer. You only ever withdraw when you've fucked up your re-order.
Yep. +1 for this. The first prescribing psych that I had clued me into this. They explicitly asked me if I wanted a bump to my Rx for the month so I could start building a buffer. I was clueless but it was explained to me that there's a bunch of timers and rules around how/when you can re-fill and you might not always have a continuous supply unless you take matters into your own hands. Years later, I now live in an area where fire season is almost year-round and you can bet that I have ~ 2 weeks supply stashed away in my "go bag".
Oh yeah, and I didn’t even cover the problem of “I have eight pills left and want to go out of town for two weeks”. They will not let you refill scheduled substances ahead of time like that.
I was last researching this a few years ago and the one I had bookmarked is apparently no longer available on Amazon. Doing a quick search for electronic pill dispenser does show several, a few of which are similar in appearance to the one I had bookmarked.
this is also standard practice with insulin for diabetics. though the regulations are less onerous the risk of running out is a bit worse so the incentives end up about the same.
The analogy I've given is having an asthma clinic at the top of Mt. Everest. If I could freaking get there, I probably wouldn't need it.
A friend referred me to a telehealth clinic where I could get in quickly instead of waiting for 6 months. They're dialed in to their patient care, too: I get a string of email and text reminders that I have an upcoming appointment. And contrary to some of the horror stories, my doc spent a couple of hours with me on the first appointment before coming up with a treatment plan. It wasn't a 5 minute visit where they through pills at me, but an actual genuine doctor's appointment with someone doing due diligence and customizing a care plan specific to me, with alternatives to try if my insurance didn't cover the first line of meds.
I feel so lucky that I got connected with the right people, after a series of PCP visits and a psychiatrist referral who diagnosed me as having anxiety. Oh, you think? Yeah, I'm feeling pretty anxious that my boss is annoyed at me for having all the signs and symptoms of ADHD and how it affects my work.
This doesn't even account for the perma-drama due to the artificial shortage generated by the DEA. Getting your prescription filled, if you manage to wrangle one, often requires hours of calling around which pharmacy can fill said prescription.
And you get to do that every months. And you can't get a prescription earlier, you have to wait a full month. So, essentially: Right when you're forced off your medication that helps your executive function, you need to exercise large amounts of executive function.
The hoops I have to jump through for a prescription I’ve been on for multiple years is ridiculous. My insurance will wrongly think I’ve filled it at a CVS I sent the script to hoping they’d have it in stock and then I sometimes end up paying out of pocket because otherwise I am exhausted all day and have limited capacity to do tasks.
The meds themselves have dramatically improved my life by being more capable of getting tasks and work done. Main downside is the drop off around 8/9pm when I become really tired and unfocused.
> Main downside is the drop off around 8/9pm when I become really tired and unfocused.
Talk to your prescribing psych about this. More, but smaller, doses throughout the day may be a way around this. Diet and changing when I medicate helped me a ton. I got another few hours per day out of my meds just by splitting the medication up and administering every few hours, timed just before/after lunch.
You do still need to acknowledge / accept that the medication can't be a 24x7/forever cure though; that crash back to sub-optimal levels of function and abundant distractability is inevitable :(.
That's not what you want to hear I guess. But Adderall has a dirty crash, using pure Dextroamphetamine and not one of this mix pills makes the crash more bearable and less tiring
You maybe know this already, but there are a couple sites that will handle the calling around for you. It is kind of ridiculous I spend more on the site than on the actual meds, but I just don't see another way for now.
I did not know this indeed. But, of course, that means signing up and spreading your medical info even further. (Plus, in some cases, more money)
For folks who are also looking, the search term "adhd meds call around service" seems to work. I'd list URLs, but I haven't used any and don't want to endorse.
Off-topic but recently I found out about Sensitive Rejection Dysphoria, its not officially recognized as a thing but it is in active study now, and very related to ADHD, and tbh I wish I knew about it sooner
Before I had my ADHD diagnosis, I just assumed that I have social anxiety and tried to fix it myself by giving me exposure therapy. I would force myself to seek out any social interaction regardless on how I felt.
The result was that I got worse, so much worse because I was basically trained myself to disregard my emotions. Turns out being undiagnosed with ADHD is traumatizing. I did not imagine that people hated me for being different, I never had any phobia. It wasn't "just in my head". The truth is that I am different and lots of people will instinctively hate me for being neurodivergent. I just needed to learn to deal with that.
That is why a correct diagnosis is so important. I despise that people are given generic diagnosis like depression or anxiety instead of digging deeper and trying to find out what actually causes them.
Dang, that sounds kinda like me though I never heard of RSD until now.
I guess it's like ADHD in that way: I thought I was just a lazy sack of shit until I found out I have a condition that I can treat with a pill. Then I could merely accept that it's not something I have control over, and I could move on.
Funnily enough no matter how great my life is nor how confident I feel, every once in a while a catastrophic fear of rejection will leap into my chest and I suddenly feel like I'm that poor terrified 15-year-old me, and I have to shake it off. I have much better tools for dealing with it now that I don't see it as part of my identity, much like I don't see myself as lazy.
That's the weird thing about neurodivergence. I forced myself for a year to finally "come out of my shell" and socialize in the college. On the surface I succeeded, got a friend group, hanging out frequently. Nothing improved, at the end of the year I was dreading any social interaction more than ever.
Turns out I had AuDHD and I was masking (pretending to be neurotypical when around people).
Can't tell you how exhausting that is. I cut off all my friends and couldn't be happier since.
It's not officially recognized because it's just something a guy with a blog made up. It has a fancy sciencey sounding name to cover up that a guy with a blog made it up.
It doesn't seem to be particularly exclusive to ADHD; to me it sounds like it's just anxiety.
Note that the guy who made it up advocates a specific medication regime for it that you probably aren't taking.
It's nothing personal but I clicked your link enthusiastically and was greeted with nothing but clickbait thumbnails.
"THIS COMMON MEDICATION IS DANGEROUS FOR ADHD WOMEN!" & "THIS STRANGE HABIT IN PREGNANCY INCREASES THE RISK OF ADHD!" are just two examples.
I'm sure it's a good podcast but I find this practice distasteful at best and absolutely abhorrent when you're directly targeting mental health patients with poor impulse control and self-regulation issues.
(I want to emphasize that I know you mean well :-) )
Funnily enough, my journey here in Spain was almost the opposite.
I didn’t know until my thirties that certain issues with executive dysfunction could be caused by adhd, as it is not a widely known disorder particularly for adults.
After I contacted a professional however, and once the relevant testing and assessment was finished, my doctor strongly recommended trying medication as part of the therapy. The whole thing took about $200 for the assessments and medication is cheap. Absolute life changer btw.
TL;DR they believe the most responsible thing to do is to give everyone Adderall if they're seeking Adderall, with minimal gatekeeping, because the risk of not giving Adderall to someone who needs it far outweighs the concerns of giving Adderall to someone who doesn't need it.
Yeah, the journey to stimulants for me was long and painful, with a lot of procrastination on my part. And now even having them prescribed it is a pain dealing with the bureaucratic / expensive nightmare of USA health insurance.
I just go through GoodRx now, makes it like $20 per month for my prescription. You don't even need to make an account with them, it's like coupon you don't even need to print out. Just tell the pharmacist you are going to use GoodRx and you are done.
My work insurance seems to change all the time, and while going through GoodRx doesn't count towards my deductible, I prefer the price stability. Not fun when I'm randomly told it's $120 now at the pharmacy because my insurance doesn't cover it now for some fucking inane reason. A few phone calls can often resolve it, but it's the last thing I want to do when I'm a day away from withdrawals kicking in. Even more absurd is this is basically guaranteed to happen more than once a year, THERE IS ONLY 12 MONTHS IN A YEAR!
GoodRx is genuinely a good deal. There's a paid offering (called Gold, I think?) that makes things cheaper, but whether it pays for itself will depend on what you're filling.
Insurance often refuses to cover ADHD meds, so a lot of us our paying the full price. Which is garbage, and is very much to do with insurance and our system of it.
They issue licenses for making the drugs and getting the raw materials to make them. The process is inflexible at best and if manufacturer A hits their quota, they can’t get additional raw materials, even if manufacturer B has excess.
Like most things associated with drug criminality, the rules are stupid and capricious.
And this has nothing to do with insurance, but does have to do with government bureaucracy negatively impacting people getting treatment for an illness.
Health insurance prior authorization policy, approved medication lists, and network pharmacy policies complicate maintaining continuous access during the DEA-imposed artificial shortage by complicating transferring prescriptions to pharmacies that have supply available and transferring prescriptions to substantially-equivalent drugs sold by different manufacturers.
I like that you’re posting “check and mate the DEA doesn’t do health insurance” as a gotcha when nobody in this entire thread has at any point said that the DEA is directly involved in health insurance. It is like loudly claiming victory that you have established that doctors aren’t in charge of trimming the hedges in your neighborhood
No, I'm pointing out that people like yourself are unable to recognize (willfully) government interference resulting in negative outcomes with the government interference you champion. Does it hurt to have this level of cognitive dissonance?
"Yes, the government is responsible for these awful things. But if it was responsible for even more things, it would be different and good, because someone told me it would!"
> No, I'm pointing out that people like yourself are unable to recognize (willfully) government interference resulting in negative outcomes with the government interference you champion.
No you’re not. You’re not doing that at all.
You’re just posting “Hey, you know that thing nobody said? What if you believed this thing I just made up? Even though I know you did not, you would surely look pretty silly if you also came up with this wrong thing that I thought of in my head. Just picture what a buffoon you would be if you said something completely different than what you said. I am imagining you doing that and it is very pleasing to me. You look quite the fool and I quite the razor-sharp wit in this scenario that never happened but I am envisioning anyway”
It is nonsense, quite literally gibberish. “What if we had an argument and I was right and you were wrong how would that feel” isn’t an argument or a point. It is a dream that you’ve decided to volunteer unprompted that you fantasize about.
It is like someone bringing up a new pair of running shoes and you interjecting with your thoughts about the eroticism of feet.
This is actually less of an issue for technically inclined folks, since we can get our initial fix from the darknet using cryptocurrency, and then getting more consistent at planning and sticking to routine becomes cognitively easier. This also has the advantage of the fact that researching darknet is actually quite fun and stimulating, sort of like a difficult video game with lots of little tricks and secrets.
There are non-stimulant ADHD meds as well. Most of us don't get a chance to try all of them.
In fact, I was surprised to learn that Adderall is highly illegal in many countries, including Japan and South Korea(), both of which have a higher standard of healthcare, and a much longer life expectancy, than the US does. In other words, they're not anti-health.
() In theory, you can bring Adderall into South Korea with your American prescription. In practice, not really.
I agree, except I've been much happier with Wellbutrin. After getting through the initial insomnia a few years ago and switching to normal release, not extended, I have good focus and don't have tremors or back pain like I did with stimulants.
I got gate-kept with a massive ten page plus questionaire to fill out. Got half way through the laborious free form text responses. Came back the next day and none of my work was saved.
funnily, i had zero issue getting vyvanse after a nearly 20 year medication gap, and being hugely successful by most metrics. i went to a psych, did an eval, and got medication. i know there are issues, but it’s interesting how different people’s outcomes are
And most people who claim to have ADHD don’t have ADHD. But apparently thinking you have ADHD makes you feel better about doing things you don’t enjoy.
Only if you myopically assume all drugs have equal abuse potential, addiction potential, and negative consequences of abuse. The US federal drug schedule is a clown show.
As many have said in this thread, most doctors will tell you to go away or give you Welbutrin (which works poorly, if at all). I feel for your struggle.