Is anyone surprised? Everybody and their mother has a script for Adderall in the tech industry (wider I’m sure). In the city I’m from it’s common industry knowledge which guys to go see for an easy prescription.
I said this in another thread, but I predict overdiagnosis of ADHD (as a mechanism to get access to Adderall) will come to lights as one of the biggest scandals of our time.
As someone with pretty strong ADHD (who was extremely hyperactive as a kid) I truly cannot understand why anyone without ADHD would take these stimulants. They must want to torture themselves.
Last I checked, ~5% of the population suffers from ADHD.
I have the opposite reaction — I'm not surprised at all!
The short-term benefits seem really high. And ADHD sits at one end of a normal distribution — lots of people suffer from elements of it, particularly when doing solitary work which requires lots of concentration.
You bet. Relatively convenient[0] access to online docs is literally a lifesaver to me. The medicine is best described as “tolerable”. It lets me function normally so it’s well worth the minor adverse reactions. Damned if I’d take it if I didn’t need it, though.
[0]Mine requires regular video call checkins. As per law, we need to physically visit once a year or so. The original diagnostic visit was as thorough as I’d have expected from a traditional office visit. The main difference is that this doc was easy enough to book an appointment with that I could schedule one while dealing with ADHD. I might not have followed through if I had to wait 6 months and take an afternoon off to visit in person first.
I can't follow. It shoots your energy levels through the roof, makes even the hardest task a breeze and can be the difference between barely getting along and having a rockstar career
Can you expand on what you mean by energy levels? The stuff put me in an intolerable zombie not-tired-not-awake state when I was prescribed it. I think the technical term is somnolence? It’s a very common problem for people who take the medication for ADHD instead of recreation.
This sounds like standard reaction to ADHD medication for someone that has ADHD, and usually point where you fiddle with the dose and release-mechanism with your psych, untill you get best results with fewest drawbacks, modulo pareto efficiency and all that.
But if you managed to accomodate yourself to just be able to actually rest to a usable state ... more power to you, and I would like to hear more!
I do have a feeling that if I exercised daily, and slept well for 8 hours every night ... I might not need that boost from those meds. But the meds do keep me more organized so that I am actually managing at least the sleep thing? Unless I take them too late? Trade-offs everywhere :D
I take Ritalin which is not the same. Dosing is subjective obviously but a lower dose has been a game changer for me. Super-powered now.
But Adderall has significant downside right?
I've had a script for ADHD meds most of my life. Without them I daydream constantly. My parents thought I had a hearing problem because they would talk to me and I wouldn't know what they said because I was day dreaming.
I've had both adderall and ritalin scripts (both long and short term variations). I'm convinced that adderall is prescribe incorrectly. It is the most effective medication by far (there is one other that is basically meth, but nobody gets it), but it is significantly more prone to addiction and abuse. It's also harder on the body and brain. Many countries won't normally prescribe adderall for ADHD and they are getting along just fine. As an extreme example, and one I don't agree with, in Japan possessing adderall is illegal but they still prescribe ritalin.
Adderall should have been seen as a last resort medication. Like a doctor prescribing ketamine to help with your depression. Instead you can get an adderall script if you tell your doctor ritalin isn't working on your second visit.
I was diagnosed with ADHD at the age of two and I was born in 1988... Never once has any stimulant medication that I have been prescribed "shoots my energy level through the roof, makes even the hardest task a breeze, can be the difference between barely getting along and having a rockstar career"
You know what it does for me? Makes me about 500% more functional than I am without my medication... Which is to say 90% as functional as someone without ADHD. I can take a shower. I don't immediately get frustrated with day-to-day tasks.
Please, stop taking my life saving medication to give yourself a fucking edge.
>Please, stop taking my life saving medication to give yourself a fucking edge.
On what basis? Does him taking your "life saving medication" somehow make it less effective for you? Or are you concerned that if normal people take for performance enhancing reasons that'll cause the government to crack down and impact you negatively? If that's the case, shouldn't your ire be directed at the government for instituting said crackdown, rather than adults making decisions for themselves?
You can blame the government policies and DEA's stringent rules, and I agree, but if they are going to limit it, maybe it'd be nice if the people who DO need it to function and not just so they can ace their finals in college, actually get it first.
Both are true. Neither will happen. So... yay society.
There’ve been significant shortages that made prescriptions hard to fill. That raises special challenges for the people who need it for daily functioning. The mechanisms required to patiently track down inventory to get their prescription filled are the ones people with ADHD are having trouble with.
Imagine if asthma medicine became so trendy that you had to hike up a mountain to get it. Great. If I could do that, I wouldn’t need the medicine in the first place.
It's absolutely frustrating every single month. Sometimes I have to make sure to have a week or more of extra medication just to have enough medication to manage my executive functioning well enough to be able to stay on top of the pharmacy so I can get my medication that manages my executive functioning.
I liken it more to a shortage of insulin and everything the diabetic can eat screws with their blood sugar horribly because that's how society kind of works for someone with ADHD and executive functioning. Everything is frustrating, everything is waiting, everyone seems so fucking slow (and it's not their fault you have to give people grace), everything basically "drains the tank".
I have to work with my doctor and the pharmacy in order to adjust my prescription so I could be prescribed the right kind of medication that works for me that also jives nicely with what the pharmacy inventory gets and I also have to make sure none of this looks like drug-seeking behavior so I have to talk with full disclosure with my doctor and be very forthright with frustrations. It's been a nightmare since the shortage happened. And if I didn't have other people in my life that care, I wouldn't be able to handle any of it on my own especially during the months when getting my prescription was more than just the next day after my prescription runs out usually.
So, uh, one time I mentioned to my doc that sometimes my meds were wearing thin by lunchtime. He wrote for another 15 pills that month so that I could break some in half for an additional half dose at noon. (I’m on a low dose of my stuff. Adding another half wasn’t a Dopesick jump or anything.)
Turns out, because ADHD I often forgot to take the afternoon dose and ended up with a couple weeks of buffer. That was a nice outcome on its own.
For people who have ADHD it tends to have the opposite effect. I'm not officially dx'd, but in the past...
I'm pretty sure I have ADHD (the test I took which was a standardized test has me on the low end of ADHD)... I've tried some stimulants and it is almost like your brain is so wired, the the drugs over-saturate it and exceeds a threshold and causes a sort of "crash"...
My regular doc has me on Clonidine because "BMI" (they don't want me to Belushi/Farley myself). Clonidine only helps with slowing my brain down, but doesn't help with the focus the way stimulants should (in theory). I'm still as unfocused but just slower, mentally. Which can be good, mind; and it helped my STRESS level during an insane level at work, but not really with focus or motivation issues.
In terms of stimulants I've had in my life:
Caffeine - usual addict (I drink two 240 mg energy drinks, maybe three a day. Wen I was an alcoholic and drinking heavy I would drink 4 cans a day - thankfully I'm no longer drinking and reduced my caffeine)
Ephedrine - as a teen, when it was legal (pre-2000s sudafed ban - when you could buy it in gas stations under the name mini-thins (which I think now are just... shitty caffeine pills last I heard)). I would get all tingly (like weak MDMA physical effects, but no real mental effects) I would crash hard shortly after, just fall asleep, when the drug was still in my system (e.g. most people wouldn't have crashed/fallen asleep)
Methylphenidate (Ritalin)- A coworker whose son had ADHD gave me some back in the early 00s. I tried both a lower and regular dose, both knocked me out. I was hoping for this magical "boost" - and maybe it wasn't the right med, and maybe it wasn't the right dose. IDK, I don't think I'd want that, because my understanding is Adderall is more effective (it's meth, where ritalin is more similar to the cocaine molecular structure - anyone please correct that if wrong it's been ages since I read up on this stuff).
MDMA in the past. This one doesn't knock me out, but it's also extra-serotonin goodness, and the rush is very nice (I bet if I took a lower/micro-dose of MDMA it would be more like Ritalin and Ephedrine) - and this was back in the 90s when MDMA was good - sold by Sammy the Bull Gravano on a mass scale, and you knew it was pretty pure (except the one time someone obviously sold me DXM which is 100% NOT MDMA LOL)
I currently take Venlafaxine, which also helps my focus very very slightly. It reduces my anxiety, which is why I take it, and in the same way Clonidine helps slow me down, so does Venlafaxine. It doesn't help me focus, it just slows me down.
So energy levels it is different for at least some people with ADHD (in fact it's funny - my friend shared a link the other day about this effect saying "if you get tired after stimulants like this, you have adhd" (maybe it didn't say tired, but the gist was the same). Looking up info - it says 2-6% of people may get tired instead (I assumed this was everyone with ADHD, but maybe it's a subset of them, then).
I only WISH I had the chance to be rx'd and TRY the damn stuff. It may not work, but at least give me a chance. I'm overweight yes, but my ticker is good. And I understand with alcoholism my "potential" for abuse is there (but I have no desire for opioids even though I've had them for medication).
The whole thing is rotten, how we manage it, how our society is built, and the demands placed on us (it's gotten worse the past 20 years, every job wants you to be 10 jobs at once). The only way TO be in this society is ADHD multitasking wizard, who can only activate for the bossman under extreme duress, and have no volition on their own, and struggle because of it.
It's got a lot of very varied side effects. You'll find different people with very different answers, but then again for many it's still a better result than not taking it.
Roughly, based on my and other friends with ADHD medication compared to friends that I can't confirm or deny might have sampled from our prescriptions.
Ritalin with ADHD: You get tired a.f. to the point of doubting if you got correct medication, because it was supposed to be stimulant but then you realise, that despite the feeling, you can actually just do stuff. You feel calm. You might experience the previously unfathomable "I hate doing this, but it needs to be done, so I might as well", without needing the stars to align, you just do it. After few hours this stops and you actually need to go lay down. Then you spent several months with your doctor getting the dose right, because needing to lie down after 4 hours is annoying
Ritalin without ADHD: Feels like super-coffee: more energy, more optimism. But not more focus. Actually, maybe less focus? Might help you zoom around your house doing chores, but not really tackling any sort of deep thinking work.
This matches experience of some acquaintance that went to a party, and might have sampled certain crystals, got quiet and tired while and while others were happy and energetic.
For both - dosage is tricky, and it is easy to get you to spiral into anxiety. Also, it is not good for your heart.
That's interesting, thanks for answering. I hadn't heard people describe the tiredness effect, I had assumed it would be the same as for non-ADHD people.
I guess they take it for the same reason you do. The effects aren't really different in people with ADHD vs people without [0]
> I cannot tell you how much literature there is trying to convince you that Adderall will not help healthy people, nor how consistently college students disprove every word of it every finals season. That makes “only give Adderall to people with ADHD” a moral judgment, not a medical one. Adderall doesn’t “cure” the “disease” of ADHD, at least not in the same way penicillin cures syphilis. Adderall will give everyone better concentration, and we’ve judged that it’s okay for people with terrible concentration to use it to overcome their handicap
if you’re normal, stimulants make you feel like a god (at first). adrenaline and dopamine pumping through you, you feel on point and like you can take on the world.
> Sounds like they took a good concept and cut way too many corners.
If by "cut too many corners" you mean the tech bros exploited loopholes in the system and created an unsustainable gigantic moral hazard for a quick buck — yep, they did it again.
The phrase “unsustainable gigantic moral hazard” applies to the current pharmaceutical and health industry. You know, the one that killed millions with opioids.
As far as I am concerned, burn it all down and put the most unhinged cokehead VCs in charge, who cares at this point. Hell, add some crypto AI NFTs in the mix while we’re at it.
“But the federal government sets annual production caps on controlled substances—including the amphetamines that make up the active ingredients in prescription stimulants like Adderall. And since the start of the Adderall shortage, the government has declined to raise the quotas, keeping the cap in place even as the demand for the drug has gone through the roof.”
Is it just me or is this completely insane? A drug that dramatically improves productivity has a cap on production? I’m not saying it’s not without risks but adults should have the right to make that decision for themselves. I feel like it’s “in” to advocate for freedom of choice when it comes to weed and psychedelics, and I understand that they have lower risk of addiction than adderall. But if you’re going to use the freedom of choice argument for those drugs then you need to apply it to others as well. I’m not saying this telehealth company is blameless (they’re not) but I agree with the article that the government needs to accept responsibility and raise caps. I don’t understand why they wouldn’t. There’s probably a correlation between the cap and GDP.
I thought basically all medicines and precursors to medicines came from China or India or somewhere outside of US government purview. How would a US maximum on production actually affect supply?
It's a controlled substance in the US (and outright illegal in some countries). The DEA sets a cap on how much can be distributed to pharmacies each month, which means the shortage is deliberately caused by DEA policy and can be ended at any time.
there can be serious downsides to amphetamines, even at normal therapeutic doses and in the case of no addiction. they have emotional effects and effects on cognition. people can become paranoid, start to have strange and erratic patterns of thinking, make bad or impulsive decisions, see patterns where there are none, etc. and these are particularly bad because it's hard for the individual to perceive themselves, making "personal choice" more difficult to argue for. in the mid-20th century amphetamines were widely available and the problems showed up very quickly. it would not be good to repeat this.
to be a little glib: if everyone at your company starts taking amphetamines, maybe you get massively increased productivity for certain workers, but you're trading it for some terrible managerial decisions, and also a deluge of extremely long emails.
Dose dependent response. If there’s an amphetamine tray alongside the coffee maker then people are going to talk if Doug keeps bogarting all the high mg pills, either to him or his manager. If it’s the C suite then you just take your risks staying there same as the places that have a full wetbar with rotating stock in the meeting room. Companies are run by all kinds of people and you’re kidding yourself if you think they’re all teetotallers.
Adderall to me is a wonder drug, so I had to stop taking it. It defeats morning drowsiness, lack of motivation, hunger. If the powers that be were smart they’d just government issue the stuff to everyone for the massive productivity boost.
I tried it, I found everything you said true _at the beginning_ but after a few hours as it wore off I paid the price for the initial boost and the net effect was near zero, or possibly even negative.
I've also been around a ton of people who are taking it constantly and well...they act weird, a bit more frenzied and not necessarily more productive on deep thinking tasks. Not sure if this was the case for me. It's an enjoyable experience, like a recreational drug. I see why people take it, and further I see why people believe it helps them be more productive, but I am highly skeptical of these claimed benefits.
>well...they act weird, a bit more frenzied and not necessarily more productive on deep thinking tasks.
This matches up with some research on that exact subject.
"Our findings suggest that “smart drugs” increase motivation, but a reduction in quality of effort, crucial to solve complex problems, annuls this effect."
Euphoria and crash is a sign of taking too much at once. This is why you’re supposed to titrate up from a dose that seemingly does nothing until you reach a level and number of doses that work best for your needs without impacting your mood or sleep too much. All the time release numbers are bullshit btw, there’s massive variability between people.
Adderall is great at making me produce, but horrible at true “focus.” It makes everything other than pure output feel like a waste of time. In the long run, I found this to be a pretty detrimental way to operate. Good for getting something across the finish line but since I’ve stopped taking it I’ve been able to go a lot deeper into stuff and plug away at long term projects rather than just checking off as many “tasks” as possible.
Drug war continues to be an enormous amount of waste and human suffering for no clear public benefit
The only "scandal" here is that an adult can't go buy adderall at a grocery store if they need or want it. There is no reason for cops to be involved in this sort of personal decision, and doctors are better suited to an advisory role in it than their current position as de facto legal enforcers
Yes and the point you’re trying to make is? That as a society we allow some things that might be risky and not others? Isn’t that obvious? We try to find a balance. Or are you suggesting that since we allow people to drive cars we should also give people easy access to all drugs?
Since you missed it, the vast majority of people can regulate their behaviour just fine and we deal with people who don’t without banning activities except for special medical exceptions.
The vast majority of people grew up in a society with regulations.
You telling me you’d be happy to let people drive a car without a drivers license? How about a plane? Should we just trust people to not drive if they’re not capable?
Those are private properties or privileged activities. Eating poison, in your private home being regulated means your home is not truly yours and you have no liberty.
I’m not sure about the others in this discussion but I’m certainly not saying you shouldn’t be able to eat poison at home.
I’m saying as a society we should want to try avoid selling poison freely if we know a non negligible number of people would, in fact, eat it at home and die as a result.
And again, I’m not arguing for criminalizing the people who do get poison and eat it. I’m not arguing for criminalizing anyone actually. I’m arguing for sensible checks in place. Which is what we’re already doing with things like drivers licenses and medical prescriptions.
So long as those people are adults who are functional (can care for themselves), it isn't society's business to protect them from self-harm. Your sensible checks are violations of liberty. A person's right and authority over themselves being infringed is a loss of liberty. Society gets involved when their actions affect non-consenting members of society.
Nonsense. Humans do fine at regulating themselves the vast overwhelming majority of the time, and edge cases worth intervening on generally involve more than one human
Again, “humans do fine” it’s in the context of societies with already regulations in place. Do you have an example of a society with no regulations where humans do indeed “do fine”?
For many substances we consider "obviously" illegal now, yes. Most famously, Coca-Cola used to use cocaine instead of the caffeine it currently has. Even for the "prescription-only" enforcement level, this used to be the purview of the FDA and the people subject to enforcement were the ones operating pharmacies, not their customers, or people who got stuff through side channels. Maybe cops still used the excuse of drug intoxication to deal with people more harshly, but they couldn't stop and search someone merely on the suspicion that they had contraband
Drug enforcement should work like industry regulation and consumer protections, not operate on individuals as criminal penalties
"Obvious" is a concept that only makes sense when there is significant shared context. When it is applied to the idea that is directly in dispute, it is about as compelling an argument as "because I said so"
Perhaps that seems obvious to you. I don't view it as obvious that anyone's individual health decisions should ever be made and enforced by the state. It is obvious to me that trying to "regulate" these choices through a prohibition framework is not only ineffective, but does massive harm. However, since we're arguing about that very question, I don't feel it sufficient to merely say "it's obvious" and leave it at that.
The Volstead act didn't save us from the evils of alcohol, but it did put a lot of people in jail, strengthen organized crime, and create a reactionary push for more draconian police powers. The difference now is that the Controlled Substances Act and its international equivalents are backed by more technologically powerful governments, and cover more substances. Even in the early 20th century, prohibition policies created powerful criminal cartels and draconian police states. The controlled substances act has created both in spades, and the downstream consequences are so vast that they have arguably defined the society we live in, with its mass-incarceration, constant surveillance, and at least in the US, an incredibly punishing, byzantine, and costly healthcare system
I’m not going to comment on the second part because I don’t live in the US and I have no idea what the situation is in your corner of the world on that front.
As for the first part, you said you don’t agree about the state having a say in your health but the original problem was related to selling all sorts of drugs openly.
Do we both agree that at some point some limitation has to be put in place otherwise some people would just abuse such a system? Or do you think we should just let people do whatever and then the role of a society is to help those who end up abusing those drugs?
Because it’s happening already, people are already abusing all sorts of drugs even with some restrictions in place.
And mind you, I’m not arguing for criminalization. I’m just arguing for adding at least some regulation like requiring a prescription. I see that as a good middle ground.
But maybe it’s just me being raised here that makes me see things differently than you, that’s always a possibility.
I don't think there's any productive place to put restrictions on what drugs adults are allowed to buy of their own volition. It's not the government's job to make sure I'm making the best decisions for my health, and by and large it doesn't in any other context. I really do think people should talk to their doctor and get their expert advice on what drugs to use, when to use them, and what to look out for. I think a lot of the time a doctor should say "No, you really ought to avoid that drug. Here's why". Creating a situation where this has legal weight and can wind you up in jail, no matter how you frame it (Like what's the penalty for getting a drug without a prescription?) is doing harm.
Even without the jailtime, if we assume some people need certain drugs, and they just can't afford to talk to a doctor, or can't get an appointment for 6 months, and at best can hope to go through a process of needing to circumlocute to avoid seeming "drug-seeking" while trying to ask advice about a particular drug and get legal permission to buy it, that restriction is harming those people. I don't think a doctor telling you not to try a drug should mean you can't make that decision for yourself. I don't think more people taking adderall should trigger an investigation into doctors that decides that too many of them gave their patients that clearly wanted adderall the permission they needed to buy it. This pits doctors against their patients inherently
We absolutely should use the government to regulate sellers of drugs. We should crack down significantly on false advertising, doctors being paid to push drugs, and poor quality control practices within manufacturing operations. This is something we do inadequately under the current regime. We absolutely can't do it for black market operations. People who want drugs that are illegal currently don't have an option they can really trust to the level of things government health agencies vet. Creating demand for black market drugs by locking people out of regulated ones causes any effort the government makes regulating the sales/manufacturing side of drugs to be useless for those people
If we aren't regulated then anti-drug laws shouldn't exist. A government made up of it's people cannot regulate it's people by virtue of having a superior self control or wisdom. How can there be liberty without this?
Absolutely. People should be able to buy and use products they want, and have some reasonable assurances they're getting what the packaging says they're getting, and they can access adequate information to make an informed decision about it. The drug war impedes all these things for no benefit
if they need it, they can go to a doctor, who'll prescribe it to them. there's a reason to limit drugs that have an enormous dependency potential that a lot of humans cannot deal with, obviously.
currently this is the way, and even through this way adderall and other drugs like opiates are getting in the hand of vulnerable people way too often - so getting rid of the restrictions isn't the way to go. if there wouldn't be and limits, these people would not suddenly think "ohhh so this is my responsibility now? okay, i just quit then." but "oh so this is available for like a dollar in walmart? i'll get it, i'm a bit down today and can't focus". and guess what, there will never be a day where they'll be able to focus without it anymore.
If doctors are to play a role in this process shouldn’t it be in treating or helping that small group who has a problem?
You’re making the same argument that alcohol and tobacco prohibitionists do. I can also make the same argument to ban this website or tiktok or all social media or all of the internet.
Sure, and tons of people think they can't sleep without melatonin, wake up without caffeine, handle pollen without zirtec, handle stress without nicotine, relax without alcohol, etc
Doctors can give good advice about all these things. They don't legally get to make the decision for you. Doctors are also stretched thin, and making them responsible for making the vast overwhelming majority of personal decisions about what drugs someone can use is a huge part of that. Also, sending cops after people clearly isn't making addicts stop wanting drugs, as you point out, nor is it helping those addicts. It is, however, creating a vastly powerful police state with a constant justification for surveillance, more and more every time someone sees a drug problem and somehow nonsensically thinks despite trying this for 50 years the answer is still more enforcement
Nicotine is one of the most addictive drugs anyone takes. It's incredibly habit-forming, often the standard against which psychopharmacological analysis compares addictiveness of other drugs. Withdrawal symptoms hit quickly, and include extreme cravings, brain fog, and irritability. Still, you only see the kind of desperation and violence around it you see with other drugs in places where it's not readily available, like prisons and warzones. Sure, people struggle with addiction. I have. I no longer use nicotine, despite finding it a very useful drug, and the process of quitting was greatly aided by being able to ask my doctor and various people around me for support and advice. I still will tell people close to me if I'm thinking of buying a vape, and often they'll help talk me out of it. Stigma and fear of legal reprisal prevents many addicts from seeking help from these avenues when the drug is illegal
The carceral approach to drugs does zero good and lots of harm to regular citizens, both in individual and systemic ways. It is entirely for the profit of police, prisons, and pharmaceutical companies
given the explosion in popularity of vaping and nicotine pouches (like Zyn) since this article was written, I think we now know this is false. Tons of people have become addicted to pure nicotine without ever touching tobacco.
Fair. I think how the nicotine is delivered is essential as well. Although I tried vaping for 3 months and it didn't take at all which I found interesting.
There are lots of very addictive drugs I could never get addicted to. For example, I find most kinds of painkillers range from kind of annoying to godawful for me. Opiates especially make me nauseous. Like can't even keep down food on morphine and codeine isn't much better. When prescribed them I've had to get off them quickly, well before I run out or sometimes even before the doctor thinks I should. And it's not just stuff I hate either. I have good memories of drinking and enjoy alcohol socially occasionally, but I'm never really inclined to drink to excess or even half the days of the week, as some people consider fairly normal. On the other hand, I've had really bad caffeine habits at various times and had a real struggle quiting nicotine. I think people vary a lot in how they respond to different stuff. I'm sure some people have tried lots of addictive stuff and never had it take, and some people try weed once and then smoke it every day, despite it being less habit-forming on average than nicotine. When I say nicotine's among the most addictive drugs, that's referring to a really broad aggregate, over which the individual variance is quite high and the combinatoric space of factors is staggering
> Drug war continues to be an enormous amount of waste and human suffering for no clear public benefit
I know this has been the line for years, but now that we've taken our foot off the gas we have grocery stores, maternity wards, and highways that smell like pot and we have a astronomical number of fentanyl poisonings.
Most drugs affected by fentanyl are illegal drugs, the government overprescribing has been around before the "legalize it". I believe its up to the consumer to discern whether a drug is for them. A drug user that's not desperate to get it by any means necessary will be less likely to encounter poor illegal drug production quality assurance. I don't believe legalizing it will reduce drug use, but it will mostly enable a Marley of safer drug production as far as immediate harmful effects. I'm not convinced legalizing drugs is long term beneficial to human mental health, but it would have the coeffect of people thinking Kore purely about what it is to be free and responsible
Wow you'd throw them in prison? Seems a bit much. I'd probably recommend one of a thousand other mechanisms of enforcement. At any rate, glad you conceded the other points. We found common ground and agree that the drug war was doing some good. I don't think I'll be eating any food that you've cooked though. I can't imagine what would happen if I sent you to the store for a ripe pineapple.
So your line is "Marijuana aesthetically displeases me and we're no longer jailing people for it, therefore drug war is good"?
Or is it "Fentanyl deaths exploding has happened despite it still not being legal to purchase, therefore somehow we need more drug war despite it having not prevented this outcome in any way"?
Somehow no matter what actually happens, it supports doing drug war harder. This doesn't sound like a very principled argument to me
Some drugs are probably not a great idea for most people. No drug is for everyone. Also, the state arresting people for what drugs they take adds a ton of problems without solving any, not the least of which being a fairly draconian police state that harms people who aren't even doing drugs, and we have decades of evidence that this is the case
> So your line is "Marijuana aesthetically displeases me and we're no longer jailing people for it, therefore drug war is good"?
Nowhere did I mention aesthetics.
> Or is it "Fentanyl deaths exploding has happened despite it still not being legal to purchase, therefore somehow we need more drug war despite it having not prevented this outcome in any way"?
Enforcement procedures have changed at all levels, regardless of classification.
> Somehow no matter what actually happens, it supports doing drug war harder. This doesn't sound like a very principled argument to me
Yes, I'm positing that drug enforcement has benefits and my statements are consistent.
> Some drugs are probably not a great idea for most people. No drug is for everyone.
Agreed.
> Also, the state arresting people for what drugs they take adds a ton of problems without solving any, not the least of which being a fairly draconian police state that harms people who aren't even doing drugs, and we have decades of evidence that this is the case
You mentioned, without further commentary, that you could smell marijuana various places, in the context of harms of the very limited relaxations in drug enforcement that have happened in some states in the US. Not only is it unclear to me that this is a direct consequence of that (Where I live, you could smell weed a lot of these places well before the state legalized recreational use), but the harm this causes is left unstated, which is why I call it an aesthetic objection
> Enforcement procedures have changed at all levels, regardless of classification.
Vague and also nonsense. Throughout the era of drug prohibition we've had a constant stream of these "crises" where a drug becomes popular for some reason, people die because they're using it unsafely, and the news squawks about it for months. Every version of drug policy has failed to prevent this problem, and yet people keep trying to pretend if we just throw more cops at the problem it will magically start working. It won't
> Yes, I'm positing that drug enforcement has benefits and my statements are consistent.
They're not. In one case, you name the fact that you notice a drug that's increasingly being legalized in various places as evidence that relaxing enforcement is a problem. In the other, you name a drug that's still actively quite illegal, that the DEA busts labs for making, doctors for overprescribing, and individuals for possessing, and say that the fact that it's the subject of the current well-known drug crisis is evidence that enforcement is too lax. What level of enforcement do you think will solve the problem? It really seems like whatever outcome we see from what policies, as long as someone, somewhere still uses a drug you think they shouldn't, your conclusion will be that this is evidence of inadequate cop involvement
> This is a false choice, filled with cliches.
This is the reality we currently occupy. Police stop and search people, break into their homes, confiscate their belongings, on the assumption that they might have drugs, or have made money selling drugs. They shoot people on the assumption that they can't be reasoned with because they might be on drugs. We ruin millions of people's lives by throwing them in jail for merely posessing drugs, which if anything exacerbates those individuals' propensity to buy black market drugs. This is all a direct downstream consequence of drug policy
Actually, I used the meaning of the word to arrive at the conclusion I did, whereas your objection seems to be to the fact that you didn't use that specific word
> You're changing your argument here.
Nope, same argument the whole time: Drug prohibition doesn't work, and it also causes harm. Perhaps it's confusing when I take time to respond to what you're saying specifically?
> You've forgotten what you're trying to prove and you've misunderstood in what sense I'm saying that my statements are consistent.
What a lovely little gotcha this would be if it referred to anything that actually happened.
> You're restating the same false choice.
Nope, I'm describing reality under the status quo of drug enforcement. I'm not talking in hypotheticals, I'm talking about what happened and continues to happen
> It's been real. I'm gonna leave it here. Consider that a win.
I know it's a trite idiom but nothing about this is "real." You, like many on this website, seem to think debate consists of acting smug and trying to find little "gotchas" while making no case whatsoever for your own beliefs. I understand that trying to define, let alone justify, exactly what it is what you believe is pretty hard. Perhaps that's why you'd like state actors to be empowered to make more decisions for people. Maybe people would have better discussions if they didn't think about it in terms of "winning"
Absolutely. It's actually hard to disentangle drug enforcement regimes in their current form from pressure exerted by the US, but even if they arrived at doing government overreach independently I would consider it government overreach. Also disparities in what substances are considered dangerous is evidence against this all being grounded in reality, not for it
> The government alleges that Done prescribed 40 million pills and generated $100 million in revenue since the start of the pandemic. Ironically, much of this alleged overprescribing took place as the U.S. experienced a severe Adderall shortage—for which government officials still refuse to accept any responsibility.
"Ironically"? Leaving out the improper usage of the word, is the author that incurious? Are they just determined to find an anti-government angle?
Did you miss the paragraphs immediately following the one you quoted?
>As Reason has documented very extensively, the Food and Drug Administration first declared an Adderall shortage in October 2022. Parents stuck at home with their children struggling to pay attention to school over Zoom, along with relaxed rules on telehealth prescriptions, caused ADHD diagnoses to skyrocket.
>But the federal government sets annual production caps on controlled substances—including the amphetamines that make up the active ingredients in prescription stimulants like Adderall. And since the start of the Adderall shortage, the government has declined to raise the quotas, keeping the cap in place even as the demand for the drug has gone through the roof.
I read the whole piece. It's interesting that you view this as supporting the point about irony.
I guess if you're completely convinced that the caps lack merit, these paragraphs offer some weak support to the usual Reason anti-government bent.
Personally I am not convinced one way or the other.
Either way, the fact is that taking action against over-prescribing (especially if it's in the millions of pills) IS a response to the shortage. And I say this as someone who has been personally affected by it.
Over-prescribed means people are receiving prescriptions who should not be, not that supply is artificially low.
The caps were in place before the pandemic, so they are not a "fix".
Did prescriptions skyrocket during the quarantine because we found a bunch of undiagnosed people, or because the relaxing of the rules made it very easy for companies to make a lot of money prescribing these medications to people who were struggling working from home?
>Over-prescribed means people are receiving prescriptions who should not be, not that supply is artificially low.
Refusing to increase the cap even though there's increased demand is arguably a conscious decision on the part of the government, and that makes them as responsible for the shortage as the telehealth companies, if not more so. A doctor could plausibly justify over-prescribing with a variety of reasons (eg. the dsm-v being super vague, wfh environment being more distracting, more awareness of adhd) but I can't think of how the government can justify keeping the cap the same, even if it thinks the drug is being over-prescribed.
> that makes them as responsible for the shortage as the telehealth companies, if not more so
Completely ridiculous. You might just as well say that the government is responsible for a lack of wage growth because they haven't decreased taxes to zero.
Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise...
The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed?
>Completely ridiculous. You might just as well say that the government is responsible for a lack of wage growth because they haven't decreased taxes to zero.
1. taxes aren't factored into wage growth figures
2. there's an obvious fiscal impact to lowering taxes. There's no fiscal impact to increasing the quota.
3. the government could plausibly be blamed for refusing to remove limits, even if there's plausible reasons for keeping the quota. eg. zoning restrictions to "preserve the character of the neighborhood"
>Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise...
Except that keeping the quota the same is a terrible way to curb over-use/over-prescription. It impacts "real" adhd users and "fake" adhd users alike. If anything it impacts people with actual adhd users more because once they're less able to navigate the bureaucracy and/or call up a dozen other pharmacies to get their supply. It's like trying to fix the obesity problem by keeping food production the same.
>The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed?
I'm not sure how you got the impression that I claimed Done's practices were legal. I was only claiming that there's plausible justifications for "over-prescribing" in general but no such justifications for keeping the quota the same. Even if the drugs were illegitimately prescribed, the solution can't be "let's keep the cap the same and let the "real" and "fake" adhd users fight it out"
I know you're sharp enough to pick up on imperfect analogies; picking mine apart doesn't really change the overall point. And the impact doesn't have to be fiscal, and I know you know this too. The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive.
Increasing caps just because demand increases is the wrong action to take. Taking legal action against entities responsible for massive over-prescription of controlled substances is a step in the right direction.
>Increasing caps just because demand increases is the wrong action to take. Taking legal action against entities responsible for massive over-prescription of controlled substances is a step in the right direction.
No, increasing caps is the right action to take because it makes no sense to subject legitimate users to grief (ie. jumping through hoops to obtain their supply and/or to go without it) in a misguided attempt to reduce abuse. By all means go after the people who are prescribing it incorrectly, but punishing legitimate and illegitimate users alike makes no sense, and that's what keeping the quotas the same does.
> The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive
And how do you account for the tons of raw material that manufacturers had on hand months into the shortage?
> The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive
Just to be clear you're claiming it's better to have a shortage (which affects both legitimate and illegitimate users) than to increase the quota and allow more illegitimate users to get their hands on the drugs?
>And how do you account for the tons of raw material that manufacturers had on hand months into the shortage?
Also, manufacturers are not required to disclose the reasons why medication supply is exhausted.
Your arguments indicate that you are searching for evidence that fits your conclusion.
at the end of the day, people who don't need this drug are more likely to abuse it and die from abusing it. So yes, despite your sarcastic question, it is the lesser of two evils to limit supply.
>LOL. Did you find that article from the comment I posted 30m ago?
No? It was in my browsing history months before.
>Manufacturers collectively had about 35 tons of raw material at the end of 2022, not just Ascent.
The point is that raw materials quotas isn't the only way that government regulations can gum up the works.
>Your arguments indicate that you are searching for evidence that fits your conclusion.
As opposed to what you're doing?
>at the end of the day, people who don't need this drug are more likely to abuse it and die from abusing it. So yes, despite your sarcastic question, it is the lesser of two evils to limit supply.
You'd need to consume a ridiculous amount to die from it, and pharmacies is probably the worst way of getting your hands on stimulants for high dosages. It's overpriced, you have to jump through a bunch of hoops to get a perscription, and your usage is strictly monitored by the DEA, so if you do decide to abuse it by taking an absurd amount, you'd have to wait for weeks for your next hit. Moreover, is this theory supported by evidence? Have we seen more adderall (or similar stimulant) deaths in the past few years? There's no shortage of sob stories on every media outlet[1] about some legitimate ADHD sufferer who's affected by the adderall shortage. Where are the sob stories about people who were wrongly prescribed adderall and overdosed as a result?
The Adderall shortage is 100% the governments fault. Not only do they refuse to raise the cap, theyve shut down multiple producers for absolute bullshit such as "had an extra copy of the regulatory paperwork". No evidence that any of these policies have helped public health, plenty that its hurt it.
> The Adderall shortage is 100% the governments fault.
A balanced, reasoned view if ever there was one.
New Adderall prescriptions _doubled_ in 2021 from the previous year. No one in favor of eliminating/increasing the caps seems eager to account for this.
At the end of 2022, months into the shortage, manufacturers collectively had 77,000 lbs of the active raw ingredient on hand (allotment of which is the thing subject to quotas), but naturally no share of the fault goes to them!
> theyve shut down multiple producers for absolute bullshit such as "had an extra copy of the regulatory paperwork"
I'm guessing this is in reference to Ascent keeping two copies of DEA Form 222, in which case I find your framing to be pretty dishonest.
"The government learned that Ascent kept two sets of DEA Form 222 — a standard regulatory form that tracks every batch of raw material that enters a factory and every finished pill that is shipped out. Ascent’s employees maintained one set of what the company called “working” 222s and one set of “official” ones that it filed to the government."
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[ 3.0 ms ] story [ 177 ms ] threadI said this in another thread, but I predict overdiagnosis of ADHD (as a mechanism to get access to Adderall) will come to lights as one of the biggest scandals of our time.
Last I checked, ~5% of the population suffers from ADHD.
The short-term benefits seem really high. And ADHD sits at one end of a normal distribution — lots of people suffer from elements of it, particularly when doing solitary work which requires lots of concentration.
[0]Mine requires regular video call checkins. As per law, we need to physically visit once a year or so. The original diagnostic visit was as thorough as I’d have expected from a traditional office visit. The main difference is that this doc was easy enough to book an appointment with that I could schedule one while dealing with ADHD. I might not have followed through if I had to wait 6 months and take an afternoon off to visit in person first.
But if you managed to accomodate yourself to just be able to actually rest to a usable state ... more power to you, and I would like to hear more!
I do have a feeling that if I exercised daily, and slept well for 8 hours every night ... I might not need that boost from those meds. But the meds do keep me more organized so that I am actually managing at least the sleep thing? Unless I take them too late? Trade-offs everywhere :D
I've had both adderall and ritalin scripts (both long and short term variations). I'm convinced that adderall is prescribe incorrectly. It is the most effective medication by far (there is one other that is basically meth, but nobody gets it), but it is significantly more prone to addiction and abuse. It's also harder on the body and brain. Many countries won't normally prescribe adderall for ADHD and they are getting along just fine. As an extreme example, and one I don't agree with, in Japan possessing adderall is illegal but they still prescribe ritalin.
Adderall should have been seen as a last resort medication. Like a doctor prescribing ketamine to help with your depression. Instead you can get an adderall script if you tell your doctor ritalin isn't working on your second visit.
You know what it does for me? Makes me about 500% more functional than I am without my medication... Which is to say 90% as functional as someone without ADHD. I can take a shower. I don't immediately get frustrated with day-to-day tasks.
Please, stop taking my life saving medication to give yourself a fucking edge.
On what basis? Does him taking your "life saving medication" somehow make it less effective for you? Or are you concerned that if normal people take for performance enhancing reasons that'll cause the government to crack down and impact you negatively? If that's the case, shouldn't your ire be directed at the government for instituting said crackdown, rather than adults making decisions for themselves?
Both are true. Neither will happen. So... yay society.
Imagine if asthma medicine became so trendy that you had to hike up a mountain to get it. Great. If I could do that, I wouldn’t need the medicine in the first place.
I liken it more to a shortage of insulin and everything the diabetic can eat screws with their blood sugar horribly because that's how society kind of works for someone with ADHD and executive functioning. Everything is frustrating, everything is waiting, everyone seems so fucking slow (and it's not their fault you have to give people grace), everything basically "drains the tank".
I have to work with my doctor and the pharmacy in order to adjust my prescription so I could be prescribed the right kind of medication that works for me that also jives nicely with what the pharmacy inventory gets and I also have to make sure none of this looks like drug-seeking behavior so I have to talk with full disclosure with my doctor and be very forthright with frustrations. It's been a nightmare since the shortage happened. And if I didn't have other people in my life that care, I wouldn't be able to handle any of it on my own especially during the months when getting my prescription was more than just the next day after my prescription runs out usually.
So, uh, one time I mentioned to my doc that sometimes my meds were wearing thin by lunchtime. He wrote for another 15 pills that month so that I could break some in half for an additional half dose at noon. (I’m on a low dose of my stuff. Adding another half wasn’t a Dopesick jump or anything.)
Turns out, because ADHD I often forgot to take the afternoon dose and ended up with a couple weeks of buffer. That was a nice outcome on its own.
I'm pretty sure I have ADHD (the test I took which was a standardized test has me on the low end of ADHD)... I've tried some stimulants and it is almost like your brain is so wired, the the drugs over-saturate it and exceeds a threshold and causes a sort of "crash"...
My regular doc has me on Clonidine because "BMI" (they don't want me to Belushi/Farley myself). Clonidine only helps with slowing my brain down, but doesn't help with the focus the way stimulants should (in theory). I'm still as unfocused but just slower, mentally. Which can be good, mind; and it helped my STRESS level during an insane level at work, but not really with focus or motivation issues.
In terms of stimulants I've had in my life: Caffeine - usual addict (I drink two 240 mg energy drinks, maybe three a day. Wen I was an alcoholic and drinking heavy I would drink 4 cans a day - thankfully I'm no longer drinking and reduced my caffeine)
Ephedrine - as a teen, when it was legal (pre-2000s sudafed ban - when you could buy it in gas stations under the name mini-thins (which I think now are just... shitty caffeine pills last I heard)). I would get all tingly (like weak MDMA physical effects, but no real mental effects) I would crash hard shortly after, just fall asleep, when the drug was still in my system (e.g. most people wouldn't have crashed/fallen asleep)
Methylphenidate (Ritalin)- A coworker whose son had ADHD gave me some back in the early 00s. I tried both a lower and regular dose, both knocked me out. I was hoping for this magical "boost" - and maybe it wasn't the right med, and maybe it wasn't the right dose. IDK, I don't think I'd want that, because my understanding is Adderall is more effective (it's meth, where ritalin is more similar to the cocaine molecular structure - anyone please correct that if wrong it's been ages since I read up on this stuff).
MDMA in the past. This one doesn't knock me out, but it's also extra-serotonin goodness, and the rush is very nice (I bet if I took a lower/micro-dose of MDMA it would be more like Ritalin and Ephedrine) - and this was back in the 90s when MDMA was good - sold by Sammy the Bull Gravano on a mass scale, and you knew it was pretty pure (except the one time someone obviously sold me DXM which is 100% NOT MDMA LOL)
I currently take Venlafaxine, which also helps my focus very very slightly. It reduces my anxiety, which is why I take it, and in the same way Clonidine helps slow me down, so does Venlafaxine. It doesn't help me focus, it just slows me down.
So energy levels it is different for at least some people with ADHD (in fact it's funny - my friend shared a link the other day about this effect saying "if you get tired after stimulants like this, you have adhd" (maybe it didn't say tired, but the gist was the same). Looking up info - it says 2-6% of people may get tired instead (I assumed this was everyone with ADHD, but maybe it's a subset of them, then).
I only WISH I had the chance to be rx'd and TRY the damn stuff. It may not work, but at least give me a chance. I'm overweight yes, but my ticker is good. And I understand with alcoholism my "potential" for abuse is there (but I have no desire for opioids even though I've had them for medication).
The whole thing is rotten, how we manage it, how our society is built, and the demands placed on us (it's gotten worse the past 20 years, every job wants you to be 10 jobs at once). The only way TO be in this society is ADHD multitasking wizard, who can only activate for the bossman under extreme duress, and have no volition on their own, and struggle because of it.
Ritalin with ADHD: You get tired a.f. to the point of doubting if you got correct medication, because it was supposed to be stimulant but then you realise, that despite the feeling, you can actually just do stuff. You feel calm. You might experience the previously unfathomable "I hate doing this, but it needs to be done, so I might as well", without needing the stars to align, you just do it. After few hours this stops and you actually need to go lay down. Then you spent several months with your doctor getting the dose right, because needing to lie down after 4 hours is annoying
Ritalin without ADHD: Feels like super-coffee: more energy, more optimism. But not more focus. Actually, maybe less focus? Might help you zoom around your house doing chores, but not really tackling any sort of deep thinking work.
This matches experience of some acquaintance that went to a party, and might have sampled certain crystals, got quiet and tired while and while others were happy and energetic.
For both - dosage is tricky, and it is easy to get you to spiral into anxiety. Also, it is not good for your heart.
> I cannot tell you how much literature there is trying to convince you that Adderall will not help healthy people, nor how consistently college students disprove every word of it every finals season. That makes “only give Adderall to people with ADHD” a moral judgment, not a medical one. Adderall doesn’t “cure” the “disease” of ADHD, at least not in the same way penicillin cures syphilis. Adderall will give everyone better concentration, and we’ve judged that it’s okay for people with terrible concentration to use it to overcome their handicap
[0] https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...
If by "cut too many corners" you mean the tech bros exploited loopholes in the system and created an unsustainable gigantic moral hazard for a quick buck — yep, they did it again.
As far as I am concerned, burn it all down and put the most unhinged cokehead VCs in charge, who cares at this point. Hell, add some crypto AI NFTs in the mix while we’re at it.
Literally cannot get worse than it is now.
“But the federal government sets annual production caps on controlled substances—including the amphetamines that make up the active ingredients in prescription stimulants like Adderall. And since the start of the Adderall shortage, the government has declined to raise the quotas, keeping the cap in place even as the demand for the drug has gone through the roof.”
Is it just me or is this completely insane? A drug that dramatically improves productivity has a cap on production? I’m not saying it’s not without risks but adults should have the right to make that decision for themselves. I feel like it’s “in” to advocate for freedom of choice when it comes to weed and psychedelics, and I understand that they have lower risk of addiction than adderall. But if you’re going to use the freedom of choice argument for those drugs then you need to apply it to others as well. I’m not saying this telehealth company is blameless (they’re not) but I agree with the article that the government needs to accept responsibility and raise caps. I don’t understand why they wouldn’t. There’s probably a correlation between the cap and GDP.
Its not working out.. Never did in fact.
to be a little glib: if everyone at your company starts taking amphetamines, maybe you get massively increased productivity for certain workers, but you're trading it for some terrible managerial decisions, and also a deluge of extremely long emails.
I've also been around a ton of people who are taking it constantly and well...they act weird, a bit more frenzied and not necessarily more productive on deep thinking tasks. Not sure if this was the case for me. It's an enjoyable experience, like a recreational drug. I see why people take it, and further I see why people believe it helps them be more productive, but I am highly skeptical of these claimed benefits.
This matches up with some research on that exact subject.
"Our findings suggest that “smart drugs” increase motivation, but a reduction in quality of effort, crucial to solve complex problems, annuls this effect."
https://www.science.org/doi/10.1126/sciadv.add4165
It's just amphetamines, right?
Discussion: https://news.ycombinator.com/item?id=40677059
The only "scandal" here is that an adult can't go buy adderall at a grocery store if they need or want it. There is no reason for cops to be involved in this sort of personal decision, and doctors are better suited to an advisory role in it than their current position as de facto legal enforcers
You telling me you’d be happy to let people drive a car without a drivers license? How about a plane? Should we just trust people to not drive if they’re not capable?
I certainly don’t want to live in that world.
I’m saying as a society we should want to try avoid selling poison freely if we know a non negligible number of people would, in fact, eat it at home and die as a result.
And again, I’m not arguing for criminalizing the people who do get poison and eat it. I’m not arguing for criminalizing anyone actually. I’m arguing for sensible checks in place. Which is what we’re already doing with things like drivers licenses and medical prescriptions.
We didn't have these "epidemics" of drug deaths to a greater degree than we have now. Why is that?
Drug enforcement should work like industry regulation and consumer protections, not operate on individuals as criminal penalties
The shared context here is population health.
The Volstead act didn't save us from the evils of alcohol, but it did put a lot of people in jail, strengthen organized crime, and create a reactionary push for more draconian police powers. The difference now is that the Controlled Substances Act and its international equivalents are backed by more technologically powerful governments, and cover more substances. Even in the early 20th century, prohibition policies created powerful criminal cartels and draconian police states. The controlled substances act has created both in spades, and the downstream consequences are so vast that they have arguably defined the society we live in, with its mass-incarceration, constant surveillance, and at least in the US, an incredibly punishing, byzantine, and costly healthcare system
As for the first part, you said you don’t agree about the state having a say in your health but the original problem was related to selling all sorts of drugs openly.
Do we both agree that at some point some limitation has to be put in place otherwise some people would just abuse such a system? Or do you think we should just let people do whatever and then the role of a society is to help those who end up abusing those drugs?
Because it’s happening already, people are already abusing all sorts of drugs even with some restrictions in place.
And mind you, I’m not arguing for criminalization. I’m just arguing for adding at least some regulation like requiring a prescription. I see that as a good middle ground.
But maybe it’s just me being raised here that makes me see things differently than you, that’s always a possibility.
Even without the jailtime, if we assume some people need certain drugs, and they just can't afford to talk to a doctor, or can't get an appointment for 6 months, and at best can hope to go through a process of needing to circumlocute to avoid seeming "drug-seeking" while trying to ask advice about a particular drug and get legal permission to buy it, that restriction is harming those people. I don't think a doctor telling you not to try a drug should mean you can't make that decision for yourself. I don't think more people taking adderall should trigger an investigation into doctors that decides that too many of them gave their patients that clearly wanted adderall the permission they needed to buy it. This pits doctors against their patients inherently
We absolutely should use the government to regulate sellers of drugs. We should crack down significantly on false advertising, doctors being paid to push drugs, and poor quality control practices within manufacturing operations. This is something we do inadequately under the current regime. We absolutely can't do it for black market operations. People who want drugs that are illegal currently don't have an option they can really trust to the level of things government health agencies vet. Creating demand for black market drugs by locking people out of regulated ones causes any effort the government makes regulating the sales/manufacturing side of drugs to be useless for those people
currently this is the way, and even through this way adderall and other drugs like opiates are getting in the hand of vulnerable people way too often - so getting rid of the restrictions isn't the way to go. if there wouldn't be and limits, these people would not suddenly think "ohhh so this is my responsibility now? okay, i just quit then." but "oh so this is available for like a dollar in walmart? i'll get it, i'm a bit down today and can't focus". and guess what, there will never be a day where they'll be able to focus without it anymore.
You’re making the same argument that alcohol and tobacco prohibitionists do. I can also make the same argument to ban this website or tiktok or all social media or all of the internet.
Doctors can give good advice about all these things. They don't legally get to make the decision for you. Doctors are also stretched thin, and making them responsible for making the vast overwhelming majority of personal decisions about what drugs someone can use is a huge part of that. Also, sending cops after people clearly isn't making addicts stop wanting drugs, as you point out, nor is it helping those addicts. It is, however, creating a vastly powerful police state with a constant justification for surveillance, more and more every time someone sees a drug problem and somehow nonsensically thinks despite trying this for 50 years the answer is still more enforcement
Nicotine is one of the most addictive drugs anyone takes. It's incredibly habit-forming, often the standard against which psychopharmacological analysis compares addictiveness of other drugs. Withdrawal symptoms hit quickly, and include extreme cravings, brain fog, and irritability. Still, you only see the kind of desperation and violence around it you see with other drugs in places where it's not readily available, like prisons and warzones. Sure, people struggle with addiction. I have. I no longer use nicotine, despite finding it a very useful drug, and the process of quitting was greatly aided by being able to ask my doctor and various people around me for support and advice. I still will tell people close to me if I'm thinking of buying a vape, and often they'll help talk me out of it. Stigma and fear of legal reprisal prevents many addicts from seeking help from these avenues when the drug is illegal
The carceral approach to drugs does zero good and lots of harm to regular citizens, both in individual and systemic ways. It is entirely for the profit of police, prisons, and pharmaceutical companies
https://gwern.net/nicotine
I know this has been the line for years, but now that we've taken our foot off the gas we have grocery stores, maternity wards, and highways that smell like pot and we have a astronomical number of fentanyl poisonings.
Or is it "Fentanyl deaths exploding has happened despite it still not being legal to purchase, therefore somehow we need more drug war despite it having not prevented this outcome in any way"?
Somehow no matter what actually happens, it supports doing drug war harder. This doesn't sound like a very principled argument to me
Some drugs are probably not a great idea for most people. No drug is for everyone. Also, the state arresting people for what drugs they take adds a ton of problems without solving any, not the least of which being a fairly draconian police state that harms people who aren't even doing drugs, and we have decades of evidence that this is the case
Nowhere did I mention aesthetics.
> Or is it "Fentanyl deaths exploding has happened despite it still not being legal to purchase, therefore somehow we need more drug war despite it having not prevented this outcome in any way"?
Enforcement procedures have changed at all levels, regardless of classification.
> Somehow no matter what actually happens, it supports doing drug war harder. This doesn't sound like a very principled argument to me
Yes, I'm positing that drug enforcement has benefits and my statements are consistent.
> Some drugs are probably not a great idea for most people. No drug is for everyone.
Agreed.
> Also, the state arresting people for what drugs they take adds a ton of problems without solving any, not the least of which being a fairly draconian police state that harms people who aren't even doing drugs, and we have decades of evidence that this is the case
This is a false choice, filled with cliches.
You mentioned, without further commentary, that you could smell marijuana various places, in the context of harms of the very limited relaxations in drug enforcement that have happened in some states in the US. Not only is it unclear to me that this is a direct consequence of that (Where I live, you could smell weed a lot of these places well before the state legalized recreational use), but the harm this causes is left unstated, which is why I call it an aesthetic objection
> Enforcement procedures have changed at all levels, regardless of classification.
Vague and also nonsense. Throughout the era of drug prohibition we've had a constant stream of these "crises" where a drug becomes popular for some reason, people die because they're using it unsafely, and the news squawks about it for months. Every version of drug policy has failed to prevent this problem, and yet people keep trying to pretend if we just throw more cops at the problem it will magically start working. It won't
> Yes, I'm positing that drug enforcement has benefits and my statements are consistent.
They're not. In one case, you name the fact that you notice a drug that's increasingly being legalized in various places as evidence that relaxing enforcement is a problem. In the other, you name a drug that's still actively quite illegal, that the DEA busts labs for making, doctors for overprescribing, and individuals for possessing, and say that the fact that it's the subject of the current well-known drug crisis is evidence that enforcement is too lax. What level of enforcement do you think will solve the problem? It really seems like whatever outcome we see from what policies, as long as someone, somewhere still uses a drug you think they shouldn't, your conclusion will be that this is evidence of inadequate cop involvement
> This is a false choice, filled with cliches.
This is the reality we currently occupy. Police stop and search people, break into their homes, confiscate their belongings, on the assumption that they might have drugs, or have made money selling drugs. They shoot people on the assumption that they can't be reasoned with because they might be on drugs. We ruin millions of people's lives by throwing them in jail for merely posessing drugs, which if anything exacerbates those individuals' propensity to buy black market drugs. This is all a direct downstream consequence of drug policy
Ah, so you made it up. Words have meaning.
> ...the problem it will magically start working. It won't
You're changing your argument here.
> ...evidence of inadequate cop involvement
You've forgotten what you're trying to prove and you've misunderstood in what sense I'm saying that my statements are consistent.
> ...This is all a direct downstream consequence of drug policy
You're restating the same false choice.
It's been real. I'm gonna leave it here. Consider that a win.
Actually, I used the meaning of the word to arrive at the conclusion I did, whereas your objection seems to be to the fact that you didn't use that specific word
> You're changing your argument here.
Nope, same argument the whole time: Drug prohibition doesn't work, and it also causes harm. Perhaps it's confusing when I take time to respond to what you're saying specifically?
> You've forgotten what you're trying to prove and you've misunderstood in what sense I'm saying that my statements are consistent.
What a lovely little gotcha this would be if it referred to anything that actually happened.
> You're restating the same false choice.
Nope, I'm describing reality under the status quo of drug enforcement. I'm not talking in hypotheticals, I'm talking about what happened and continues to happen
> It's been real. I'm gonna leave it here. Consider that a win.
I know it's a trite idiom but nothing about this is "real." You, like many on this website, seem to think debate consists of acting smug and trying to find little "gotchas" while making no case whatsoever for your own beliefs. I understand that trying to define, let alone justify, exactly what it is what you believe is pretty hard. Perhaps that's why you'd like state actors to be empowered to make more decisions for people. Maybe people would have better discussions if they didn't think about it in terms of "winning"
"Ironically"? Leaving out the improper usage of the word, is the author that incurious? Are they just determined to find an anti-government angle?
>As Reason has documented very extensively, the Food and Drug Administration first declared an Adderall shortage in October 2022. Parents stuck at home with their children struggling to pay attention to school over Zoom, along with relaxed rules on telehealth prescriptions, caused ADHD diagnoses to skyrocket.
>But the federal government sets annual production caps on controlled substances—including the amphetamines that make up the active ingredients in prescription stimulants like Adderall. And since the start of the Adderall shortage, the government has declined to raise the quotas, keeping the cap in place even as the demand for the drug has gone through the roof.
I guess if you're completely convinced that the caps lack merit, these paragraphs offer some weak support to the usual Reason anti-government bent.
Personally I am not convinced one way or the other.
Either way, the fact is that taking action against over-prescribing (especially if it's in the millions of pills) IS a response to the shortage. And I say this as someone who has been personally affected by it.
What's the "merit" for these caps? If the problem is that it's being over-prescribed, capping production is probably the worser way of fixing that.
The caps were in place before the pandemic, so they are not a "fix".
Did prescriptions skyrocket during the quarantine because we found a bunch of undiagnosed people, or because the relaxing of the rules made it very easy for companies to make a lot of money prescribing these medications to people who were struggling working from home?
Probably a mix of the two.
Refusing to increase the cap even though there's increased demand is arguably a conscious decision on the part of the government, and that makes them as responsible for the shortage as the telehealth companies, if not more so. A doctor could plausibly justify over-prescribing with a variety of reasons (eg. the dsm-v being super vague, wfh environment being more distracting, more awareness of adhd) but I can't think of how the government can justify keeping the cap the same, even if it thinks the drug is being over-prescribed.
Completely ridiculous. You might just as well say that the government is responsible for a lack of wage growth because they haven't decreased taxes to zero.
Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise...
The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed?
1. taxes aren't factored into wage growth figures
2. there's an obvious fiscal impact to lowering taxes. There's no fiscal impact to increasing the quota.
3. the government could plausibly be blamed for refusing to remove limits, even if there's plausible reasons for keeping the quota. eg. zoning restrictions to "preserve the character of the neighborhood"
>Demand for addictive stimulants will always go up the more available they become. It became more available during the pandemic, and surprise, surprise...
Except that keeping the quota the same is a terrible way to curb over-use/over-prescription. It impacts "real" adhd users and "fake" adhd users alike. If anything it impacts people with actual adhd users more because once they're less able to navigate the bureaucracy and/or call up a dozen other pharmacies to get their supply. It's like trying to fix the obesity problem by keeping food production the same.
>The indictment alleges exactly why Done's practices were illegal. Did you read the DOJ announcement or just the Reason screed?
I'm not sure how you got the impression that I claimed Done's practices were legal. I was only claiming that there's plausible justifications for "over-prescribing" in general but no such justifications for keeping the quota the same. Even if the drugs were illegitimately prescribed, the solution can't be "let's keep the cap the same and let the "real" and "fake" adhd users fight it out"
Increasing caps just because demand increases is the wrong action to take. Taking legal action against entities responsible for massive over-prescription of controlled substances is a step in the right direction.
No, increasing caps is the right action to take because it makes no sense to subject legitimate users to grief (ie. jumping through hoops to obtain their supply and/or to go without it) in a misguided attempt to reduce abuse. By all means go after the people who are prescribing it incorrectly, but punishing legitimate and illegitimate users alike makes no sense, and that's what keeping the quotas the same does.
> The public good intended by the quotas doesn't go away because more people suddenly want a pill that makes them instantly feel better and more productive
And how do you account for the tons of raw material that manufacturers had on hand months into the shortage?
Just to be clear you're claiming it's better to have a shortage (which affects both legitimate and illegitimate users) than to increase the quota and allow more illegitimate users to get their hands on the drugs?
>And how do you account for the tons of raw material that manufacturers had on hand months into the shortage?
https://nymag.com/intelligencer/article/adderall-shortage-ad...
Ascent represents just 12% of manufacturing volume - as stated in the article.
Manufacturers collectively had about 35 tons of raw material at the end of 2022, not just Ascent.
https://www.bloomberg.com/news/newsletters/2023-02-28/are-ad...
Also, manufacturers are not required to disclose the reasons why medication supply is exhausted.
Your arguments indicate that you are searching for evidence that fits your conclusion.
at the end of the day, people who don't need this drug are more likely to abuse it and die from abusing it. So yes, despite your sarcastic question, it is the lesser of two evils to limit supply.
No? It was in my browsing history months before.
>Manufacturers collectively had about 35 tons of raw material at the end of 2022, not just Ascent.
The point is that raw materials quotas isn't the only way that government regulations can gum up the works.
>Your arguments indicate that you are searching for evidence that fits your conclusion.
As opposed to what you're doing?
>at the end of the day, people who don't need this drug are more likely to abuse it and die from abusing it. So yes, despite your sarcastic question, it is the lesser of two evils to limit supply.
You'd need to consume a ridiculous amount to die from it, and pharmacies is probably the worst way of getting your hands on stimulants for high dosages. It's overpriced, you have to jump through a bunch of hoops to get a perscription, and your usage is strictly monitored by the DEA, so if you do decide to abuse it by taking an absurd amount, you'd have to wait for weeks for your next hit. Moreover, is this theory supported by evidence? Have we seen more adderall (or similar stimulant) deaths in the past few years? There's no shortage of sob stories on every media outlet[1] about some legitimate ADHD sufferer who's affected by the adderall shortage. Where are the sob stories about people who were wrongly prescribed adderall and overdosed as a result?
[1] eg. https://www.npr.org/sections/health-shots/2023/02/18/1157832...
A balanced, reasoned view if ever there was one.
New Adderall prescriptions _doubled_ in 2021 from the previous year. No one in favor of eliminating/increasing the caps seems eager to account for this.
At the end of 2022, months into the shortage, manufacturers collectively had 77,000 lbs of the active raw ingredient on hand (allotment of which is the thing subject to quotas), but naturally no share of the fault goes to them!
> theyve shut down multiple producers for absolute bullshit such as "had an extra copy of the regulatory paperwork"
I'm guessing this is in reference to Ascent keeping two copies of DEA Form 222, in which case I find your framing to be pretty dishonest.
https://nymag.com/intelligencer/article/adderall-shortage-ad...
"The government learned that Ascent kept two sets of DEA Form 222 — a standard regulatory form that tracks every batch of raw material that enters a factory and every finished pill that is shipped out. Ascent’s employees maintained one set of what the company called “working” 222s and one set of “official” ones that it filed to the government."
Sounds like keeping two sets of books to me.