there are freakout posts every hour or so on r/adhd. desperate plans to amass a huge petition of signatures, or challenge it legally with a class act. lawsuit, but mostly a lot of despair and disbelief. also some blaming of the so-called undeserved adderall users that are allegedly the official reason for the shortage...and something about tiktok users.
it's bad and capitalism is certainly the reason why. i'd like to understand the nuance of it more though if anyone had some good leftist takes on it.
What I heard from my pharmacist:
Only a handful of companies are allowed to produce adderall because of the war on drugs. the main factory for one of these companies was temporarily shut down last year. This was apparently because of black mold contaminating a different production line (not adderall).
The working conditions there were also horrible, so the discovery of black mold set off a worker’s strike which has since been resolved.
Only so much adderall can be legally manufactured at a time. The US government is very slow to increase these limits so it can maintain control / limit amount of unused Adderall. It uses historical numbers to adjust, working off the RX number from previous years.
This typically benefits the pharma corps because it creates artificial scarcity + drives up cost, equalling higher profits. However those same companies are now behind the demand curve to such an extent there is a shortage. They are now losing money.
This has been combined with an uptick in people who were finally able to get diagnosed with adhd because telehealth became more accessible and the cost of being assessed went down.
The pharma companies cut corners to maximize profits, ate shit, and now the control mechanisms set in place by the war on drugs is making it so they can’t catch up.
TL;DR: it’s the US government and incompetent pharma corps, not individual people trying to get medication.
I stopped bothering to treat my ADHD with medication because of how much of a pain it is to get the stuff and its shitty side effects.
In my country, ADHD medication has to be prescribed by a psychiatrist. So that means every time I need a new prescription, I had to shell out $300 to see psych every time. They aren't open on the weekends either, so having to see a psych meant one day a month I'd have to take a day off work to see one. It ended up pissing off my boss and getting me fired. Ironically I was trying to treat my condition so I could do better at work. Lmao. Damned if you do, damned if you don't.
Here I was patting myself on the back for getting insurance so I could get a diagnosis:yea:
If you're prescribed extended release, Vyvanse, or some other form of medication you won't be nearly as impacted by the shortages. One step at a time though, it's good to get a better understand about yourself with the psychiatrist!
Could be it, I'm pretty low dose in a large city and haven't had any difficulty
that’s still worth doing and there are other adhd options. Adderall is just the most popular and historically the least expensive because it now has generic options. Dealing with this too and it sucks :soviet-heart:
I'm not sure, but I don't think this shortage is effecting strattera. Strattera/atomoxetine is a non-stimulant drug that can aleviate adhd symptoms. It's still worth pursuing a dianosis.
After a major shortage awhile ago, I got the doctor to increase the dosage to triple what is effective so I could stockpile, and went into a sort of permanent rationing mode.
‘Most ADHD medications fall into a class of controlled substances called central nervous system stimulants. Because the medications have a well-documented history of abuse and addiction, the FDA and Drug Enforcement Administration limit how many pills a pharmacy can dispense at once and how frequently patients can refill their prescriptions. The DEA also sets limits on the active ingredients pharmaceutical companies use to make these drugs each year.
“The DEA is involved if any manufacturers try to scale up production,” Ganio said. The DEA calculates how much of a given drug ingredient is needed to meet demand, then allocates that precise amount. The problem, according to Ganio, is how DEA uses historical data — meaning prescription numbers from previous years — to set these amounts.’
:wtyp: Source
“they used this shit to make bonobos do algebra, so it’s probably fine for me”
I'd never do a stimulant but I've done some LSD analogues before and they're pretty good.
Of course it's a crap-shoot because it just as easily could end up toxic which is just another reason why the war on drugs is big stinky.
There was a Ketamine analog that was fucking amazing but it got too popular and now there's no one in China producing it anymore along with bans in a lot of countries.
I have adult onset ADHD, I didn't have it at all until my early twenties, then all of a sudden it hit me. I can't read, and can barely even function tbh, without taking adderall. I've had trouble getting a refill several times in the past year, causing me to almost drop out of university twice, have the worst bout of depression I've had for years, and a host of other problems. My take is that they should get rid of ALL the restrictions on it. It's my medicine I need to take to function, no different from any other prescription I get. I just want my fucking medicine. I don't fucking care if that means people without an ADHD diagnosis take it - it makes you feel good, drugs are fun. If people are using it problematically, then address the addiction.
Is it just the instant release that is hard to get? I just started taking it and it works much better for me than the extended release.
I've only ever taken extender release, so I think its hard to get too. Although I take 60mg so that might have something to do with it. People I know who take 10-20mg of XR haven't had problems.
I'd advise you to read the book " Scattered minds: The origins and Healing of Attention Deficit Disorder " by Gabor Mate, because I recognise your way of talking about ADD and this book helped me immensely.
I dont think it’s capitalism specifically. It’s just American idiocy + capitalism = this shit
People from other countries aren’t having a shortage because their drug production isn’t dictated by a police organization
Step one: Prescribe thousands of children with adderall
Step two: Force the now-adults to have withdrawls
Capitalist "healthcare" torture time.
yep 100%
but what if it sent people into a big enough rage to start thinking a lot more about how we are in a class war? material conditions are definitely being affected because of it
I was diagnosed with ADHD late in my 20s and i decided not to get medication for it because I've done my whole life without it
I'm glad I'm not on it but i really do feel for everyone else, most of all that i feel like this is the government or DEA literally fuckin with people.
The feds always need a way to criminalize a community. For example like when they cut welfare or food stamps in order to kick up crime rates.
I feel like this is their gameplan
there are non stimulant ADHD meds you could try though, like Strattera, which is an SNRI, or things like Concerta/Ritalin which are IMO a lot less addictive than adderall (at least, for me, adderall = horny euphoria + energy and focus, the others were just the latter (but not as good))
Okay but a lot of people start taking meds later in life and realize they've been shackled by a million tons of disability the whole time. The only reason i don't take stimulants for adhd is it triggers my bipolar mania instantly. I do take strattera for it.
Adhd meds are a tool for relieving the burden of a serious disability causing condition.
As far as i know this is extremely simple - the DEA sets quotas to the pill on how much adhd medication can be manufactured each month. The drug companies are allowed to manufacture exactly that much and no more. No stockpiling for next month, no ramping up for increased demand.
And the numbers the DEA uses to estimate demand to set the quota come from previous tears. Adhd diagnosis went up during the pandemic, dea didn't give a shit, so now people get to suffer from the war on drugs in groovy new ways.
Effects of long-term treatment
[...] These studies suggest that altered brain activation patterns in children with ADHD are not due to the effects of long term stimulant treatment. The best design though that could examine the effects of long term stimulant treatment on brain function in ADHD would be one that includes both a treatment naïve sample and a sample that has received long term medication, alongside a healthy comparison group. Such a study was carried out by Pliszka and colleagues [38], using a response inhibition (stop) task. On almost all comparisons, they failed to find significant differences in brain activation or behaviour between drug naïve and long term treated ADHD groups (the latter were off medication during testing for a minimum of 24 hours). In the few cases where there were differences the ADHD group who had received long term treatment was closer to the healthy comparison group. Therefore, this study suggests that if there is any effect of long term stimulant treatment, it acts in the direction of normalising neural function.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763932/
Even people who should know better are still incredibly dismissive of adhd and repeat the "meth for kids" line.
People with ADHD who take stimulant medication have lower rates of drug abuse than people with ADHD who don't.
Why would people with adhd abuse adderall? I'm not even clear if we chemically can abuse adderall bc it effects us so differently from neurtypicals.
It's basically amphetamine-lite with all the abuse potential.
i don't really have a good take on it, but i've got a good conspiracy theory
the shortage is because of an increase in demand in the precursors and manufacturing chains for the military in Ukraine.
I don't really understand why so many people, particularly (but not exclusively) in the US, would need amphetamines to function 'properly'. I find it difficult to buy that there's a 'natural' reason and that it isn't just a kind of Brave New World socio-environmental issue causing a psychosomatic response in people that gets labelled as ADHD or similar. I don't mean to be callous or dismissive or imply there isn't an issue for people, but I know a few people with such a diagnosis and I'm pretty sure if I'd had their upbringing/life circumstances I'd find it difficult to concentrate too.
Not really sure what you are getting at, but of course there are socio-environmental factors with adhd. I don't think anyone is out there claiming there is anything natural about it. It's a conditions - conditioning feedback loop. If I wasn't forced to work 40 hours a week or become homeless, I wouldn't have found out I need to take amphetamines in order to hold a job. If my parents didn't both need to work all the time and could have afforded child-care, there's a good chance I wouldn't have so trouble functioning.
I don’t think anyone is out there claiming there is anything natural about it.
:I-was-saying:
ADHD, like autism, has a host of genetic and environmental causative factors, i.e. it's both nature and nurture.
Hmm, well I stand corrected and I'm glad I logged in to see this discussion my comment created. Not sure what I was even thinking because I knew it was partly genetic, but I was possibly referring to the treatment with amphetamines.
It was mostly an observation, but I suppose if I were getting at anything it'd be that if there's any possible way, even if greatly difficult, to avoid taking the substance and also avoiding homelessness then that'd be vastly preferable. Absent of any societal assistance in that, unfortunately and unfairly it requires the individual to attempt to find a way on their own or to attempt to organise such assistance. I'm not necessarily sure its a consequence or that there's a direct causative link with overworked absent parents though, since that has been a factor elsewhere/when seemingly without the solution being amphetamine prescription and usage.
edit: I would say that the doctors who diagnose and prescribe it are effectively claiming that there's something natural about it - its treated as a strictly physical condition with a physical solution in that case, with no attempt to address the cause(s) or enquire about them or alleviate them.
doctors who diagnose and prescribe it are effectively claiming that there’s something natural about it - its treated as a strictly physical condition with a physical solution in that case, with no attempt to address the cause(s) or enquire about them or alleviate them.
That's half true. AD(H)D is a developmental disorder, meaning that it isn't something you're born with (like for example some types of cancer that can "run in the family"), but it's caused by your surroundings during (early) childhood. Those surroundings make it so that the process of bonding with your caregivers is disturbed, which effects the development of your prefrontal cortex. The thing is: once you've got a prefrontal cortex which hasn't developped properly, you're stuck with it. It cannot be cured, but the effects can be remedied by taking medication.
I you want to adress the causes, you need to make sure that every child is brought up is a loving and caring environment, and that their parents all have the means to spend a lot of time with their children. If both parents work 40h a week, a lot of people's bonding proces during childhood goes awry, and you will have a lot of people developmental disorders simply because of the fact that developing children don't receive the attention and constant care that they intrinsically need. But even if you fix that, you'll still have shitty parents (for example: people who think that beating their children is sometimes permitted, people with anger issues, alcoholics and so forth) and the problem still isn't resolved entirely.
If you're really interested in the subject, I'd advise you to read " Scattered Minds" by Gabor Mate.
well that was very interesting and brand new information to me, so thank you. perhaps I will check out that book you've suggested.
thanks for the clarification. Is it really the case that a particular part of the brain can't change after the developmental period, or redevelop for want of a better term? That feels somewhat concerning in principle as a model for how our brains work, like doesn't it have implications for a whole range of societal and individual problems? I guess the ideas of lifelong education/learning and also rehabilitation are impacted by this structural issue presumably? I'm not disagreeing, I'm sure you know more than I do about this, but it is worrying if a bad childhood means lifelong substance use by necessity, if you see what I mean. Presumably good for drug manufacturers though!
Take this with a lot of salt. As far as i know the general consensus is that there is a strong biological component to adhd. They idea that it's a development disorder is fringe at best.
ADHD is highly heritable with around 76% of phenotypic variance accounted for by genetic influences [7] and molecular genetic studies have identified genetic variants within several genes involved in the regulation of neurotransmitter systems that are associated with increased risk for ADHD [8,9].
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763932/
That's interesting. Out of curiosity from this thread I found a more recent paper that seemingly had difficulty finding a genetic cause (but not association), and concluded that any cause was possibly environmental or possibly 'omnigenic'. Its this one: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477889/ if you want to have a look. Its interesting that heritability conclusions are different when relying on self-assessment vs parent or clinician assessments.
From the paper you linked, I checked to see what the classification was - because I was wondering if it was described as a developmental disorder or not:
"ADHD is a behavioural syndrome characterised by the presence of developmentally inappropriate levels of hyperactive, impulsive and inattentive behaviours"
That to me is a remarkable definition, I'm sure you'll understand better, but isn't it equivalent to saying ADHD is a description of somebody who acts younger than they are supposed to? I guess I'm asking, since you seem like somebody who might know, how is it concluded or determined that a person's activity levels, impulsivity, and attention span is 'inappropriate'?
I suppose from that and other definitions I've read it seems to me that you can say of ADHD sufferers - these people aren't acting grown up enough for wage slavery so we give them amphetamines to calm them down?
The diagnostic criteria and the "cutoff points" for most psychopathologies are subjective. It often comes down to the question of "is this behavior negatively impacting the person's life?" If the answer is "yes", then it's a mental illness which may benefit from treatment. If it's "no", then it isn't. Therefore I think it's entirely possible that some diagnoses would change if we significantly changed our way of life and work under full communism. However, many diagnoses would also not change, because ADHD affects more than just performance in school and work; it also affects hygiene, personal relationships, and even our ability to enjoy hobbies and leisure activities. I was put on ADHD medication because my girlfriend and best friend gave me an intervention, even though I was doing fine at work at the time.
Everything has a genetic component, but sometimes it is trivial to refer to it. Whether it is expressed or not is a consequence of environmental conditions.
it is worrying if a bad childhood means lifelong substance use by necessity
There certainly are people who manage to handle their AD(H)D symptoms without medication. But many can't and, if they're not diagnosed, it means a life of academic failure, being fired at every job and a resulting low self-esteem or depression. In general, I can't imagine how someone with AD(H)D manages to go trough college, or function at a job (which requires task-initiation and prolonged focus) without medication.
Idk what the causes are but people with adhd react to stimulants in a completely different way than people who don't have adhd. It's easy to measure, it's consistent. There are tons of funny annecdotes of people doing coke at parties and getting really calm and focused and thinking "oh i guess i have adhd"
It's not just "difficulty concentrating". It's a whole constellation of symptoms related to motivation, task initiation, executive function. Adhd doesn't make people " distracted" in some abstract way. Our brains aren't producing the right chemical responses to stimulus that allow normal people to sustain interest in a task.
ok, thanks for explaining. I said 'difficulty concentrating' because its another way of saying attention deficit. Isn't it to be expected that difficulty concentrating, or attention deficit, will necessarily involve issues with motivation, task initiation, and executive function since those things are all required for attention?
Personally, interacting with various people who have been diagnosed with ADHD, I find it very difficult to notice a difference between them and any other person except in that they're more socially expressive of how (understandably) bored they are by what I'm saying or what they're/we're doing. Of course I'm no expert in the criteria for such a diagnosis, this is just my subjective perception of these people.
if all you cowards just did actual speed or cocaine this wouldn't be an issue. But noooo you need your little fancy boy pharmacy amphetamine
