

Anatomy of the Great Adderall Drought - pier0
http://motherboard.vice.com/2012/2/16/anatomy-of-the-great-adderall-drought

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alexhaefner
I find this absolutely startling: "It’s well known that many college students
use Adderall to give themselves an extra edge for getting work done whether
they’re prescribed or not ... Furthermore, a 2009 study on non-medical use
(defined as use of a prescription drug without a doctor’s order) of Adderall
among full-time college students showed that subjects aged 18 to 22 were twice
as likely as their counterparts, who were not full-time college students, to
have used Adderall."

Along with: "Stephanie Lee found her freshman year of college unusually
difficult. She had trouble adjusting to the levels of stress she encountered."
And: "Without Adderall, you might feel bored by your math homework or unable
to focus on the multiple steps needed to reach a solution, but on Adderall you
might literally feel like you’re in love with math."

So many people are taking this drug to deal with the fact that they cannot
handle the type of work, or the stress. I find it fascinating that people have
come to assume that the problem is with them because they find the work
uninteresting, or they find school stressful, and not because that is how the
systems (colleges) and the work (math, science) are designed. Instead of
telling people how they are not designed properly for the work, perhaps we
should take some time to reflect on how the work is repetitive and not
creative, and not fulfilling, and that is perhaps the issue.

Note: I do think math and science and intellectual work can be creative when
at a high level. But at a learning level you're treated more like a machine
designed to learn and repeat.

I was recently chatting with another student about how classes here are just
becoming increasingly demanding. In looking at computer science classes as an
example, the complexity of even the basic computer science classes has grown
with time, and nothing has been removed. Every one of our professors expects
us to spend 10-15 hours per week just on their class. And it's obviously not
possible. Instead of trying to find ways to optimize time, people are trying
to optimize their minds to be something that is not creative, but rather very
much like a machine. College is not designed around passionate work, it is
designed to be a grind on you and force you to do a lot of work you hate.
Every four months you take all the previous work you did and throw it out and
start over. How is any part of that designed to be gratifying? I don't
necessarily share entirely positive views of college. It's an institution
designed to meld and mold people to fit into our economic model.

I have spent some time thinking about this trend and have come to the
conclusion that it could be a real damage to creativity and individuality when
you can medicate your mind into a machine.

~~~
DanBC
I'm also surprised that they're taking adderall for an off-label use, when
there's not much research supporting that use, and that they're not taking
anti-anxiety medication (diazepam, lorazepam, etc (but addictive potential is
worrying)) or taking a known placebo such as homeopathic tablets. Why aren't
dealers pushing homeopathic pills as "street adderall"?

~~~
danneu
Because Adderall is cheap, easy to get, amphetamine works, and it's worlds
different from things that are not amphetamine (homeopathic pills?!).

~~~
DanBC
> _easy to get_

In response to something titled _"the drought"_ ?

> _amphetamine works, and it's worlds different from things that are not
> amphetamine (homeopathic pills?!)._

I would love to see placebo controlled trials for this particular use case
(students needing a bit of help to concentrate).

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AJ007
I'm against drug prohibition. I'm also against telling people they have a
medical disorder and need to take a recreational drug for it.

And damn right Adderall is a recreational drug, it makes stuff that is boring
fun. I've also watched people working while using it, they are easily
distracted and then focus 100% of their attention on the distraction. Makes
for a good illusion of productivity.

~~~
phillmv
I think a lot of people, for either environment or genetic reasons, just have
crappy brain chemistry for succeeding in our modern, deep-focus oriented
world.

Back in the day, you work on the farm, you chat with people, you do your
regular business. You didn't have to sit still in a large box for 70% of the
day, and so it wasn't such a big deal if you were a little "light headed".

I have a wee cousin who has ADHD and she's a problem child from hell. We know
this 'cos her father was also a problem child from hell. She literally has an
immense problem sitting still.

Once she takes her meds though… it's hard to describe the feeling I had when I
realized she had spent the last half an hour quietly colouring a book.

So yeah. Some people pop it to do all nighters; for a lot of other people it's
necessary in order for them to achieve the neuronormativity expected of them
in say, an office job or 12 years of mandatory schooling.

~~~
jonhendry
"in order for them to achieve the neuronormativity expected of them in say, an
office job or 12 years of mandatory schooling."

And there are a lot of fields a person might want to enter, entirely on their
own initiative (not teacher-imposed), that inherently require you to spend a
lot of time doing 'boring' or repetitive things. And if you don't, you'll
fail. Or give up painting/piano/whatever early out of frustration.

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noonespecial
One of the greatest coups corporatism can pull in modern times is to get a
patent on something and then get the government to mandate its use and
restrict all substitutes. Its 100%, grade A, screw society, corporate win.

~~~
kristopolous
I'm curious as to the pricing structure in less corporatist countries,
especially in places with public health care where (unlike the US), the
government has the legal right to bargain prices and doesn't just satisfy any
arbitrary price set by a manufacturer.

~~~
anigbrowl
It's flatter, but patients are given their medicine and told to take it rather
than being invited to select from a menu. Pharmaceutical companies don't
advertise direct to the public and doctors make all the decisions about which
version of a drug patients should be taking, based on the clinical outcome (eg
whether the side effects of a generic are well-tolerated or problematic). In
the US you have to be a lot more knowledgeable about what you're taking and
the information is much more available, so in that sense the patient has more
control, and arguably more freedom; on the other hand most of us are not
doctors and spending time becoming expert on the finer points of your meds is
perhaps like becoming an expert on the difference between Coke and Pepsi - you
may strongly prefer one over the other, but is it really making any difference
to your nutritional outcome?

In other countries the win for the drug companies is predictability; the
government will negotiate far more aggressively but will then contract to
purchase a certain amount for the next x years, providing the drug companies
with a predictable revenue stream. Where public healthcare is the norm, the
government also absorbs a lot of the insurance/liability costs; if a drug is
approved for sale but later turns out to have problematic side-effects, the
government will compensate or support the affected patients, on the theory
that since it approved the medicine for sale it accepted the potential risks
as well. Obviously, there are exceptions, such as if a manufacturer had data
on clinical risks that it concealed to get approval, but those cases are a
minority.

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refurb
Another great example of a gov't regulation that isn't in sync with the
marketplace.

If you are a company that produces product A and product B, and the gov't says
you can only produce a limited amount of A+B, why wouldn't you automatically
shift all of your production to the product with the highest profit margin.
This is economics 101!

~~~
pyre
Assuming that Shire has a patent on Vyvanse, then this is more like limit
production of A+B and create product C that is more expensive and has an
artificial monopoly (patent). This will then drive everyone that needs
products A or B to your new product C. Profit!

~~~
refurb
I didn't get a sense from reading the article that Shire is limiting
production of their branded amphetamine salts. However, you do have a point in
that having more patients on a branded therapy makes a move to Vyvanse more
likely.

~~~
pyre
I was going off of this:

    
    
      Luckily, Shire had magically possessed enough amphetamines from
      their DEA quota to produce plenty of their new ADHD medication,
      Vyvanse. In fact, Shire doubled its third quarter profits from 2010
      to 2011, with most of that increase resulting from Vyvanse sales.
      During this time, coinciding nicely with the Adderall shortage,
      Shire hiked the price of Vyvanse.

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Game_Ender
The government centrally controls the production of narcotics, and people are
wondering why there are shortages? It is obvious the purpose of their central
control is not working, people who need the drug can't get it, and people who
want to "abuse" it are still able to acquire the drug. I doubt we will see the
sane solution of just stopping control on the production of these drugs.

~~~
jrockway
Technically, "narcotic" means "opiate" (or more generally, a sleep-inducing
drug), which Adderall is not. I think you meant "schedule II controlled
substance", or something.

~~~
ahupp
The legal and medical definitions of narcotic are not the same, unfortunately.

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phren0logy
This article ignores an important point about Vyvanse. It's a pro-drug: it's
metabolized into one of the components of Adderall, but at a constant rate.
That means you can't crush and snort it (well, you can, but the constant rate
of conversion does not change).

As such, it has less abuse potential than Adderall XR (though not zero abuse
potential). In states like Florida where there has been more scrutiny on
prescription of controlled substances, these details can be important.

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mindcreek
I live in Turkey and I am using concerta for about 5 years now, if you have
ADHD the drug calms you and makes focusing and completing tasks easy, it also
unfortunately makes you immune to coffee no matter how much coffee you drink,
you can still drink more :).

When somone without ADHD uses the drug it causes tachycardia, high blood
pressure, restlessness and sometimes paranoia, not all of them though, it
migth be a recreational drug to someone but I need it to function in my daily
life and I'm not using it to have fun in any way, I had periods ( at most 6
months) which, I had not taken any concerta of methylphenidate derivative and
results were not good for my productivity.

It is also a type II controlled substance here in Turkey You are prescribed
one pill for one day and you cannot have more even if you want to, but we dont
have any quotas on the precursors and drug use in Turkey is very low
considering Europe and US.

~~~
kristopolous
How much money is a 30 day supply?

~~~
mindcreek
85$

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NegativeOne
Yet again the government tramples it's citizens freedom and desires and tells
THEM how to live. Doesn't matter if this drug helps countless people across
the country function in their day-to-day.

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vvpan
Have any of you been diagnosed with ADHD? How dose it get diagnosed? I am
really wondering how much is known about this ailment.

~~~
tweak2live
Attention deficit is a conduct disorder, which means that its diagnosis relies
entirely on assessment of patient's behavioural patterns. Since it's next to
impossible to keep a patient under 24/7 observation, secondary sources have to
be used. In most cases, the diagnostic process reduces to an "intake session"
interview with a patient and a few multiple-choice diagnostic questionnaires.

So an AD* diagnosis is trivial to hack. Moreover, it's impossible to design a
diagnostic process that's not easily hackable because, ultimately, everything
will boil down to a subjective assessment of patient's behaviour, i.e. a
"doctor's call". Furthermore, the more you restrict prescriptions and tighten
the diagnostic criteria, the more you increase the risk of denying medication
to "legitimate" sufferers. Since the guiding philosophy of the medical
community prioritizes "helping people" over "prescription security", the
problem of how to keep people from getting "illegitimate" prescriptions is
ultimately intractable.

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funkah
What a scam. People don't even understand how these drugs work in the first
place, and now the government, insurance, and pharm industries combine to
screw people out of the things they're convinced they need for their brains to
work. Gross.

