@@ ADHD Med shortage - NYTimes article

[ESF]

Poppy , I'm sorry you are struggling. A couple things:

First, a short assessment isn't exactly a red flag (though the pill thing I'm not sure). While some providers to require the longer assessments before diagnoses or prescriptions, many don't use them. My psych did not. I asked her about them once, and she said they are useful for some providers and patients, but many practicioners just do a verbal assessment.  Her view is that the tests are fine for kids, but less useful for diagnostic purposes when dealing with intelligent adults who have developed coping mechanisms, and she preferred to diagnose by asking about those coping mechanisms.  

Second, there are lots of kinds of stimulant medication and ones that work well for some people may not work well for others. I found traditional Ritalin was HORRIBLE for me; extended release Ritalin to be  ok, and Adderal and Vyvanse to work very well.  Other people have different experiences. So you may need to find a new dr who is willing to work with you to find a good fit.

Finally, based on what you've said, I'd start with a therapist who specializes in ADHD and executive function issues, not a coach.  As a late diagnosed person, I found it really useful to talk through things and understand why I do what I do.  It doesn't necessarily solve the focus problems to understand that, but it could help with the shame and guilt.

[jwright]

Aug 17, 2023 11:15:14 GMT -5 lilac05 said:

karinothing , thanks for sharing that. I wasn’t really aware that this was a thing. I’ll look more into it.

I think sharing or selling ADHD meds is very common in colleges and even high school, especially in competitive atmospheres.  Not even just to stay up to party, but to pull all-nighters for studying.  As others have shared it absolutely has negative affects. 

[redheadbaker]

Aug 18, 2023 9:37:17 GMT -5 jwright said:

Aug 17, 2023 11:15:14 GMT -5 lilac05 said:

karinothing , thanks for sharing that. I wasn’t really aware that this was a thing. I’ll look more into it.

I think sharing or selling ADHD meds is very common in colleges and even high school, especially in competitive atmospheres.  Not even just to stay up to party, but to pull all-nighters for studying.  As others have shared it absolutely has negative affects. 

There are lots of complaints on ADHD reddit boards about parents stealing their kids ADHD meds to sell, too. 

[lilac05]

Aug 18, 2023 9:37:17 GMT -5 jwright said:

Aug 17, 2023 11:15:14 GMT -5 lilac05 said:

karinothing , thanks for sharing that. I wasn’t really aware that this was a thing. I’ll look more into it.

I think sharing or selling ADHD meds is very common in colleges and even high school, especially in competitive atmospheres.  Not even just to stay up to party, but to pull all-nighters for studying.  As others have shared it absolutely has negative affects. 

Yeah, I thought about all of this after I posted. Go figure that I’d impulsively post in an ADHD thread!

[wildrice]

Aug 18, 2023 13:33:59 GMT -5 lilac05 said:

Aug 18, 2023 9:37:17 GMT -5 jwright said:

I think sharing or selling ADHD meds is very common in colleges and even high school, especially in competitive atmospheres.  Not even just to stay up to party, but to pull all-nighters for studying.  As others have shared it absolutely has negative affects. 

Yeah, I thought about all of this after I posted. Go figure that I’d impulsively post in an ADHD thread!

I think I was probably a little too dismissive in my post, too, and I'll blame my ADHD for anytime I post something without thoroughly thinking it through, lol. That being said - I still wonder if the harm outweighs the good here. It sounds like it's pretty easy to get a prescription these days, so if anything that should be curbed - not medication production or distribution for those who are already diagnosed and benefitting from proper use. I also just googled "ADHD drug addiction" (which granted may not be the right terms!) and I hit on several articles stating that 15% of people with ADHD have drug or alcohol addiction issues. So leaving these folks untreated for ADHD opens them up to other addictions, ones that I would argue are more dangerous. Addiction to a stimulant is harmful, yes, but if someone turns to opioids to self medicate because their life feels out of control, is that a better outcome?

When looking at the population as a whole, are there more people suffering from ADHD medication abuse than people who are suffering from untreated or intermittently treated ADHD? And if that's the case, is the best way to address that really to limit production and leave needed medications unfilled? 

Anyway I don't know the answers to these questions, but I hope someone is asking them. There has to be a better way to balance the needs of everyone.

[wawa]

Aug 18, 2023 13:57:41 GMT -5 wildrice said:

Aug 18, 2023 13:33:59 GMT -5 lilac05 said:

Yeah, I thought about all of this after I posted. Go figure that I’d impulsively post in an ADHD thread!

I think I was probably a little too dismissive in my post, too, and I'll blame my ADHD for anytime I post something without thoroughly thinking it through, lol. That being said - I still wonder if the harm outweighs the good here. It sounds like it's pretty easy to get a prescription these days, so if anything that should be curbed - not medication production or distribution for those who are already diagnosed and benefitting from proper use. I also just googled "ADHD drug addiction" (which granted may not be the right terms!) and I hit on several articles stating that 15% of people with ADHD have drug or alcohol addiction issues. So leaving these folks untreated for ADHD opens them up to other addictions, ones that I would argue are more dangerous. Addiction to a stimulant is harmful, yes, but if someone turns to opioids to self medicate because their life feels out of control, is that a better outcome?

When looking at the population as a whole, are there more people suffering from ADHD medication abuse than people who are suffering from untreated or intermittently treated ADHD? And if that's the case, is the best way to address that really to limit production and leave needed medications unfilled? 

Anyway I don't know the answers to these questions, but I hope someone is asking them. There has to be a better way to balance the needs of everyone.

I will say - I'm kind of laughing here because while stimulant abuse is serious - it feels like a very ADHD thing to be like, "who would even abuse this stuff?  jeez."  
I never "got" stimulants in college - they didn't feel fun.  I knew people who snorted adderal or whatever for funsies.  It always mystified me.  Now that I've trialed some meds and their main effect is that I NOTICE THE PASSAGE OF TIME but also have zero appetite...no fucking wonder. 
They're not fun for me. They never were.  because I had adhd and didn't know it.

But I also haven't found a med that I can stand to take - I don't get hungry on what I've tried so far so I don't eat all day, and then they wear off and I feel like absolute raging poo because I'm staving and am in a terrible mood in the evening when I want to be able to relax and enjoy my time with my loved ones.  I'd rather be bad at my job, thanks.  And I tried just setting a "eat food" timer, but eating food when I'm not hungry at all is disgusting and I hate it. I should try something different (I only tried two things) but ugh to making a doc appointment and going through that cycle again, and hey, they're not available anyway so why bother, right?  

[SusanBAnthony]

Yesterday the phone refill line told us vyvanse was not available and a generic was coming "sometime in August". Sounded not good....

Today I went in person and they had it, and magically applied a coupon so that it was only 20$! I don't understand the vyvanse pricing at all. It seems to range from a few hundred bucks to ~80$ to 20$. Some of that is related to our deductible but some seems random or coupon related.

Either way I'm thrilled it was that easy. I thought our time had finally come to not be able to get it. Fingers crossed this wasn't the last easy refill.

ETA: if you are in twin cities MN, try an HCMC pharmacy. After CVS and Walgreens nearly drove me to a complete toddler style throw myself on the floor meltdown multiple times, I can now genuinely say I love my pharmacy, my tech, and my pharmacist. 10/10 would recommend.

[k3am]

Well this info makes me think twice about putting DD on adhd meds.. I’m not sure it’s worse to have her continue unmedicated or have her medicated, see improvement, and struggle to get meds. Ugh.

[basilosaurus]

Poopy, I used to manage a psych clinic, so I saw everything. If a patient was constantly reliant, we would sometimes prescribe a bigger size so they could cut down on copays and extend the prescription. We weren't allowed to give more than a 30 day script, but that didn't dictate dosage.

Sometimes we saw people like traveling actors who couldn't get their normal needs for the length of their tours. It's not an automatic red flag to me. Yes, it's controlled, yes it can be abused, but if someone comes in every 30 days for years, never asks for an early refill, yeah, we can work on a double prescription. For a new patient? Maybe not. But if it's a check in regularly with info, maybe.

I didn't like how that ml thread went into "maybe you're just an asshole" territory. That might be true. Also a lot of people might have felt like failures their whole lives when there were solutions. I don't think anyone should feel guilty for whatever it takes to improve their lives.

[raleighnc]

Aug 18, 2023 16:55:10 GMT -5 k3am said:

Well this info makes me think twice about putting DD on adhd meds.. I’m not sure it’s worse to have her continue unmedicated or have her medicated, see improvement, and struggle to get meds. Ugh.

💯 better choice to do meds. 1) you will find which one she needs, and 2) she will realize that how she interacts with the world is not her fault. That's the number one theme I read about from every adult with ADHD. Every day that you feel out of control of your life because of time blindness or whatever is demoralizing.

It sucks to scramble each month for the parent, but you actually are in a better position because you are probably going to try a new med or dose each time. Which means you don't necessarily have to wait the full 28 days to fill a new script. If your DD tolerates a dose but it's suboptimal, you can ask your doctor to try the next dose up after a couple of weeks. Use the suboptimal dose for weekends or as backup for shortages. And Jornay has not really been affected by the shortages, at least here.