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While I agree that drugs like this shouldn't necessarily be handed out like candy (ignoring the lumping-together of amphetamines and opiates in the headline), it has been a real struggle to get legitimate stimulant prescriptions filled since at least October '22 in my experience. It's been an administrative challenge, which (ironically?) is one of the things ADHD types struggle with most, having to call ahead and try and get your order in before the prescription is due without coming off like a junkie. I feel grateful that I take d-amph "merely" for ADHD and not something like narcolepsy, which can be more acutely life threatening depending on the circumstance.

I suppose what I'm saying is that while I understand the need or desire to regulate powerful drugs, I fear further zealous overreach by the DEA et al that has already made it difficult for responsible users to access important medications.

In the same boat. I've been off it for months now and it's been the worst time I've had in a while. I lost my job pretty quickly and just can't keep track of time all day.

It's so tough to stay on top of making the phone calls every 30 days to fill it, and now figuring out what meds are actually available and what would work for me that I've pretty much given up at this point.

It’s disgusting that psychiatric medication is lumped in with opiates by the DEA and subject to many of the same hamfisted policies.
Opiates are incredibly effective at treating debilitating pain. Not headaches, not toothaches, but overwhelming “please just kill me” pain. I take adderall with a prescription but I am not going to pretend that my psychological needs are somehow more worthy of medication than another’s pain.

You want to get real angry? Cannabis and psilocybin are both schedule I drugs while cocaine is schedule II. I know cocaine has medical uses and is unfairly maligned, but still.

You do yourself and others a disservice by treating physical pain as “more real” than the psychological pain that can be caused by simply not functioning the way one wants and knowing a restricted pill could help.

Comparing one’s pain to another is meaningless, if the pain of both can be treated.

Pain isn’t necessary. It is enforced.

>>I suppose what I'm saying is that while I understand the need or desire to regulate powerful drugs

I dont. We have now almost 60 years of drug prohibition, and increasing levels of criminality of abuse of drugs with nothing really to show for it except billions, or trillions in wasted resources, the millions of destroyed lives with little or no evidence that any of the criminalization has done anything to curb abuse of drugs

If nothing else is clear, one thing for sure is.. the DEA is the most ineffective federal agency ever created bar none.

>>I fear further zealous overreach by the DEA et al that has already made it difficult for responsible users to access important medications.

It absolutely has, and likely has increased overdose's and death at the same time.

Not just ineffective, incompetent.

They've ignored pursuing policies that focus across the spectrum of illicit drug use and instead implement hamfisted solutions to problems only when they've grown so bad that legislators have to intervene. Often thier approach, purely from a law enforcement perspective, is interdiction and supression. To them drug abuse is a criminal problem which can only be solved by aggressive policing, confiscations, and arrests.

Now I hear that dealers in the US are cutting opioids sold to PWID with Xylazine which is highly destructive to tissue. There is no healthcare system to speak of available to the addicts so they don't end up in healthcare until their wounds have become gangrenous. It's no wonder an enforcement agency fails in this area because their mission is not to provide care and rehabilitation to criminals. Drug trafficking is supply and demand, maybe they should realize focusing on only half the problem isn't going to be a comprehensive solution.

> I suppose what I'm saying is that while I understand the need or desire to regulate powerful drugs, I fear further zealous overreach by the DEA et al that has already made it difficult for responsible users to access important medications.

This shouldn’t impact patients with an existing doctor and prescription. It only applies to initial visits.

This rolls back a COVID exception that allowed internet companies to remotely prescribe Schedule II drugs after a cursory call. Companies were using it to create Adderall subscriptions as a service. In fact, the rampant overprescribing might be why you’re seeing shortages right now.

It already is affecting patients with existing prescriptions. Every time I move I have to jump through a series of hoops to get my doctor comfortable enough to prescribe, and I've been on the stuff for well over a decade.

For a while, having the receipts for previous scripts was enough. Then they started needing medical records, which is like, okay fine. This most recent move has my new physician demanding I get rediagnosed (in an area where the next available appointment with a psych taking new patients is in, like, July). Because "this is a family practice, my license is on the line".

The gradual ratcheting of pressure by the nanny-state DEA has doctors spooked.

Never mind that the more beurocratic hoops you put in front of someone with an executive function disorder, the closer to impossible you make it for them.

And the shortage is because of the dea. They placed arbitrary limits on what any one producer is allowed to make, so when one of them has supply chain issues, no one can cover for them.

Disband the DEA.

The Constitution protects citizens' Equal Liberty to Pursuit of Happiness.

It says "Equal Justice Under Law" on the front of which building?

Isn't the prescription system an illegally discriminatory protection racket? How can the state grant rights on the basis of medical status as determined by a physician that the citizen must pay?

"You may only legally risk [juggling chainsaws in the privacy of your Lawrence v home] if you have a qualifying disability as determined by a physician you must pay?"

Physicians can self-prescribe controlled substances.

Patients can risk unintentional self-harm by choosing to participate in a Clinical Trial of a wholly-untested treatment; they do have such Equal Liberty as is necessary to pursue Happiness.

Do pharmacies have the right to deny service? Per the more recently fraudulently-packed Supreme Court ("Where's his birth certificate,[ tax return, arrest records, and level of foreign debt]"), You don't have to serve a gay cake to a gay wedding.

The UNDHR (UN Declaration of Human Rights) specifies "Equal Protection" of "Equal Rights" as fundamental rights.

Shouldn't a US Constitutional Amendment be necessary to unequally deny rights on the basis of medical status (under the guise of authorization of right to regulate substantial affectation of Interstate Commerce), if an amendment was necessary to (also unequally) prohibit alcohol?

How can we work together on our shared objectives: maximize compliance with the Constitution, provide for the national defense, minimize self-harm and physician liability, and secure the blessings of Liberty?

How and why is there a profit margin in pharmaceutical resale without a license? What is the comparative cost of the pharmaceutical generic?

We could give people a discount - equally - for speaking with a physician. There should be a financial incentive to work with a physician on what works and isn't working.

https://is-this-valid.github.io/liberty/

> The gradual ratcheting of pressure by the nanny-state DEA has doctors spooked.

The specific regulations referenced here aren’t new. They were only granted a temporary exemption during COVID, and now that is expiring.

The DEA literally loosened their regulations during this period, and now that is expiring.

I do suppose I'm generalizing past what is, strictly speaking, the scope of the story.

The fact is, 10 years ago, it was a lot easier to get these meds. More recently, I've had to deal with piss tests, scared physicians, and other formats of bullshit. Because why? It's some grave social ill that some people like adderall and don't need it? Cut us a break.

What about people who are physically disabled or live in very rural areas? At one time my pharmacy was 10 minutes away but my psychologist was 90 minutes. You can't reasonably expect people to make a day trip into town every 30 days for the same meds they've been taking for years.
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First time prescription only
They keep doubling down on failed drug policies as if they didn't have decades of statistics showing what they're doing right now doesn't work. Kill off oxy? Well now you have very cheap fentanyl all over the place, which is much more likely to kill people. Legalize and regulate and stop making everything that is victimless (aside from the dummy who is addicted) a crime.
Legalize and regulate to what extent? Most drugs are certainly not victimless.
What exactly do you mean when you say "victimless"?
I literally wish I knew what the ruckus is. I go in for surgeries every year or so and get sent home with a handful. No fun, i.e. no high for me, AFAIK. Not very good at pain control either. From my perspective all they do is act as the perfect sleeping pill.

I used to regard myself as an honorary drug addict/alcoholic because I’m morbidly obese. My whole family were addicts, inspiring me to never try alcohol or illicit drugs. In my declining years I actually sort of hope I will get some fun out of legal drugs like this, but it hasn’t worked out that way. My life expectancy is low and I am mildly considering trying some illegal drugs

> I literally wish I knew what the ruckus is. I go in for surgeries every year or so and get sent home with a handful. No fun, i.e. no high for me, AFAIK.

If you’re in pain following surgery, the prescribed medication isn’t expected to feel “fun” or produce a recreational high.

Note that this does not mean that you are immune to addiction or recreational effects. In fact, this exact mindset is a common story underlying many addiction stories: A belief that the person’s response is in some way unique or less than average, leading to cavalier engagement with drugs.

Don’t go down this path.

I can't speak to painkillers but this makes no sense at all for ADHD patients and is literally just an artificial barrier -- not because it's impossible to see a doctor in person but because finding someone local qualified to formally diagnose ADHD is a huge pain.

My therapist was like, "you obviously have ADHD but I can't diagnose you, you should talk to your primary." My primary was like, "you obviously have ADHD but I can't prescribe anything -- not because I'm not allowed but because I need to cover my ass. You need to see a psychologist or psychiatrist and get a letter. Then I can manage your medication." You know how many psychologists in my area do evaluations like this -- none.

ADHD clinics are the new pain clinics. With Covid and the rule changes allowing virtual visits for controlled substances, we ended up with start-ups like Cerebral Inc.
I’m not sure why doctors still prescribe any of this stuff.

Straterra for ADHD.

Tramadol, ibuprofen, Tylenol 3, and gabapentin for pain.

Nothing stronger than hydroxyzine and clonipin for breakthrough anxiety.

Everything else should be dealt with by mature coping mechanisms. Europe does it just fine - but not here in USA.

I guess providers get rated by customers and we’re capitalists so addicts are the byproduct.

Even people in this thread say they make sure to call every month for refills. That behavior is definitely noticed by physicians. Patients won’t do that for other drugs of far greater importance to their health. They’re very sticky for the fun stuff no matter the friction put in place.

I am downvoting this comment for referring to medication as “the fun stuff.” Job loss is not uncommon and a powerful motivator.
That’s OK, thank you for your dv. I don’t expect all users to have insight into their conditions. Like I said, there’s straterra, which is a non-amphetamine alternative and effective. But there’s some barriers. Initial constipation is a problem to do tolerance of the GI tract to amphetamine. Another barrier is the loss of “adderolling” which users enjoy.
I threw up heavily and daily on straterra. Just because it doesn’t have the same suffix as meth doesn’t mean it’s a panacea. Doctors should have the ability to prescribe what is best for their patients
You don't know what the fuck you're talking about, and you're condescending about it to boot.
Seriously. I don’t understand proud ignorance contributes anything.
Klonopin is a very powerful benzodiazepine, whereas hydroxyzine is a more akin to Benadryl. You undercut your point when you prepend your point with easily falsifiable information.
Its a long acting benzo and less prone to abuse than xanax. When used appropriately for break through anxiety it works well in combination with atarax.
Well Stevie Nicks might disagree that it is less prone to abuse.
The effect size and response of Atomoextine stacks quite badly against stimulants, which are first line treatments. It also targets noradrenaline mostly, with relatively minor effect in dopamine.

If it works for you, great, but for many including myself it was a waste of time.

I'm not from the US or Europe btw, but if you want a sound complaint against the status quo in the US, I'd argue against the popularity of the Adderall mixture of L and D-amp over LDX (Vyvanse), which seems more effective (only D-amp) and less addictive.

Vyvanse, at least for me, tends to amplify aggressive tendencies to the point I've had my partner comment I scare her. This includes shortening my fuse with people during training, and tolerance for other people making a mistake. All while getting 8 hours or more of sleep a night, actually gaining weight, and having subjectively higher QoL on my end. So no "Adderolling" as @Pigalowda is so fond of criticizing. I get jack and shit out of Straterra in terms of objective therapeutic benefit.

Adderall, I have no such aggression amplification problems with, at the cost of needing a substantially higher dose. I'm much more patient and tolerant of frustration, have many fewer ANT's (Automatic Negative Thoughts), and I don't need to take regular breaks to cool off.

While Vyvanse undeniably worked for me in terms of increasing my capability to pay attention throughout the day, and as a consequence, get tons done, not only in terms of work, but living a normal life with hobbies; that price tag of inducing eggshell walking among those I love was just too damn high.

So I'm back on Adderall... Learning new coping strategies... trying to just get by. Point being, please abstain from painting in broad strokes and assuming just because you may have some pet theory down, that that translates without loss in practice. It doesn't. Not by a long shot.

I know there are subtle effect differences between the preparations, sorry that I came across that way.

In fact what you describe I also experienced with Vyvanse for years and it just toned down in the recent years by staying at a lower dose and then adding an SSRI (which pretty much removed all those 'triggers' I had of berating people, yet not the 'stim look' that people have on their eyes when on stimulants, that only fades out after the 8-12 hours when you become human again)

One time I tried Bupropion instead, I got immediately super short fuse, berating people and so on. Reminded me of a boss I hated so much that would grill me over small things on my PRs for hours, rather than moving on quickly. I didn't want to become anything close to that guy so I just stopped.

My point is, the studied outcomes are usually just one variable, that ignores a lot of the extra behavioral effects we as patients get in practice, but it's a good pointer in guiding where to aim treatment first for most. And it seems now LDX is being tried first, before Adderall over there in some practices, with the added convenience of making refills easier.

Good luck with your journey pal, I only wish it'd be easier for all of us.

Appreciated, and $DEITY bless in your direction as well. Life is hard enough as is for everyone without throwing Schedule II's on top of it, and dealing with all that nonsense.
You sir/madam/whatever your pronoun, need to mind thine own beeswax.

You are not the sufferer of the malady in question. You have not mastered the art of walking around in someone else's bag o'flesh for 30+ on years, and you have zero place to be lecturing others or opining without having lived with someone whose ADHD isn't responsive to Straterra. Of having to put up with the crippling disorganization; with having to endure the frustration of both the sufferer themselves, and that of those around them.

When it gets to the point I have to drop 10+ years of medical records onto a practitioners desk, and STILL get handwringing and whining about "you need a rediagnosis" which requires ceasing treatment and unloading, and results in massive disruption of my, and my loved one's lives, and my ability to work and hold down a job, and my ability to pick up the pieces once everyone ends up going "Welp, yup, that one's a hell of a case of ADHD. Just like they said the first five times they were diagnosed”; which by the way, is fundamentally inflicting diagnostic harm on me; your regulatory regime has gotten out of hand.

You think I like this? You think Schedule II is fun to be on the receiving end of? You think I haven't accounted for all the lost time, opportunity, and spend on the drug? You think I like having to fight with insurers for continuity of mental existence? I wouldn't wish it on anyone.

And you have the gall to sit here and leave this stain of a bird dropping of a post, pitching

>They’re very sticky for the fun stuff no matter the friction put in place.

...as some sort of indicator that "Oh it's because they're a druggie."

No, it's because if I don't, the world will be subject to the deleterious consequences of an adult human, tuned to maintain operation with pharmacological assistance, suddenly operating in the abscence thereof in a highly degraded state.

Good Lord. Find some bloody perspective. There's about three types of people I can't stand, period; and sanctimonius people that think they can apply one size fits all treatments to others are one of them.

The negative externalities of our pharmaceutical industry and its rampant over prescription of amphetamine and opioids aren’t worth it in my opinion. I would gladly get rid of all of it. The homeless users I see walking from Pioneer Square to Harborview Hospital didn’t start off injecting heroin/fentanyl and smoking meth. They almost certainly all started with pills, whether prescribed or illegally obtained.

Your argument that it helps you just doesn’t move the needle for me. I see dead 20 year olds nearly every day from fentanyl or hypertensive brain hemorrhages from meth users. That’s just in Seattle - I’m sure it’s similar in every major US city. There’s no

So while you describe this benefit to you, I think of it analogously as gun ownership. There are people who use guns appropriately for self defense, hunting, etc - but thousands of people die from them every year due to inappropriate and illegal use. And yet there’s no constitutional protection for amphetamine and opioids - but here the US is today, in a drug crisis of its own making.

That’s my perspective. I see the end of one extreme every single day. This is a population level problem and you want me to contextualize it to a single individual. I guess my response to that is that I have contextualized it and reject it. I might be some sanctimonious wind bag to you (who you can’t stand) but you don’t have to see the dead all the time. And this trail of mayhem begins at our irresponsible pharmaceutical industry. The high functioning cheerleading users have 0 perspective and want me to lose sight of the forest. No thank you, I’ll stick to the one size fits all treatments. No opioids or amphetamines.

So... now if you need an adderall prescription now costs you hundreds of dollars a month: you need a day off during the work week to see a doctor, who is likely a out of network psychiatrist (because afaict most aren't in any network), and you have to pay the $1-200 that they charge for each appointment.

It's almost like once a bunch of congress folk lost their payouts from the Sacklers (who recall essentially got away with mass manslaughter) they've decided it's time to be hard on drugs by punishing people with legitimate needs.

This is for the initial establishment of patient care.

It’s not targeting the average doctor. It’s targeting the pill mills that were setup to prescribe Adderall as a subscription service. You paid a monthly fee to get Adderall prescriptions and the doctors would rush through a token “visit” to get through as many patients as possible in a day.

Sounds like a better and leaner service than what doctors offer, which is mostly a bunch of theatrics to justify the rents they earn from each adderall prescription, prescription adjustment, or renewal. Nobody would use doctors as their dealers if the DEA and co didn’t force everybody to cut them in.
Most doctors I have had prescribing things have been annoyed when they’re having to talk to me just to renew the same prescription. Obviously there are sketch ones as well, but I assume honest doctors have to deal with people moving to cheaper doctors because the cheaper doctors are just churning prescription renewals to be profitable so can charge less. Again: the alternative to these appointments is simply having auto renew prescriptions, as most recurrent ones are.
To be clear the _only_ reason that service exists is because the government passed a law that required adderal be represcribed continuously rather than having an automatic refill as you would with every other prescription.

People who need adderall prescriptions don’t spontaneously get better.

Imagine the outcry if diabetes, or heart diseases, etc drugs started needing you to get a dr sign off every month: how long do you think before the same service would exist for those?

This is very simple: congress consists largely of untrained people looking for “hard on crime” sound bites, and as long as they’re just targeting generics that aren’t super profitable it doesn’t hurt their pay days.

Americans are just a bunch of drug addicts aided by fake experts. For them, every natural body function is a disease that needs repeated and continual drug use.
Thanks DEA for forcing people doctors literally call disabled to ritually trek to a doctor every few months to plead once again for drugs.

What a racket. Entire thing is a farce, you can’t test for a mental disorder through observation to begin with and research proves how easily one can get an ADHD diagnosis by putting on a performance. It’s not as if these check and balances do shit.

My understanding is that you only have to see the doctor in person once, and then can do telemedicine after that. Still a pain, but not as bad.