Adderall, OxyContin Prescriptions to Require In-Person Visit Under DEA Plan
wsj.com
wsj.com
I suppose what I'm saying is that while I understand the need or desire to regulate powerful drugs, I fear further zealous overreach by the DEA et al that has already made it difficult for responsible users to access important medications.
It's so tough to stay on top of making the phone calls every 30 days to fill it, and now figuring out what meds are actually available and what would work for me that I've pretty much given up at this point.
You want to get real angry? Cannabis and psilocybin are both schedule I drugs while cocaine is schedule II. I know cocaine has medical uses and is unfairly maligned, but still.
Comparing one’s pain to another is meaningless, if the pain of both can be treated.
Pain isn’t necessary. It is enforced.
I dont. We have now almost 60 years of drug prohibition, and increasing levels of criminality of abuse of drugs with nothing really to show for it except billions, or trillions in wasted resources, the millions of destroyed lives with little or no evidence that any of the criminalization has done anything to curb abuse of drugs
If nothing else is clear, one thing for sure is.. the DEA is the most ineffective federal agency ever created bar none.
>>I fear further zealous overreach by the DEA et al that has already made it difficult for responsible users to access important medications.
It absolutely has, and likely has increased overdose's and death at the same time.
They've ignored pursuing policies that focus across the spectrum of illicit drug use and instead implement hamfisted solutions to problems only when they've grown so bad that legislators have to intervene. Often thier approach, purely from a law enforcement perspective, is interdiction and supression. To them drug abuse is a criminal problem which can only be solved by aggressive policing, confiscations, and arrests.
Now I hear that dealers in the US are cutting opioids sold to PWID with Xylazine which is highly destructive to tissue. There is no healthcare system to speak of available to the addicts so they don't end up in healthcare until their wounds have become gangrenous. It's no wonder an enforcement agency fails in this area because their mission is not to provide care and rehabilitation to criminals. Drug trafficking is supply and demand, maybe they should realize focusing on only half the problem isn't going to be a comprehensive solution.
This shouldn’t impact patients with an existing doctor and prescription. It only applies to initial visits.
This rolls back a COVID exception that allowed internet companies to remotely prescribe Schedule II drugs after a cursory call. Companies were using it to create Adderall subscriptions as a service. In fact, the rampant overprescribing might be why you’re seeing shortages right now.
For a while, having the receipts for previous scripts was enough. Then they started needing medical records, which is like, okay fine. This most recent move has my new physician demanding I get rediagnosed (in an area where the next available appointment with a psych taking new patients is in, like, July). Because "this is a family practice, my license is on the line".
The gradual ratcheting of pressure by the nanny-state DEA has doctors spooked.
Never mind that the more beurocratic hoops you put in front of someone with an executive function disorder, the closer to impossible you make it for them.
And the shortage is because of the dea. They placed arbitrary limits on what any one producer is allowed to make, so when one of them has supply chain issues, no one can cover for them.
Disband the DEA.
It says "Equal Justice Under Law" on the front of which building?
Isn't the prescription system an illegally discriminatory protection racket? How can the state grant rights on the basis of medical status as determined by a physician that the citizen must pay?
"You may only legally risk [juggling chainsaws in the privacy of your Lawrence v home] if you have a qualifying disability as determined by a physician you must pay?"
Physicians can self-prescribe controlled substances.
Patients can risk unintentional self-harm by choosing to participate in a Clinical Trial of a wholly-untested treatment; they do have such Equal Liberty as is necessary to pursue Happiness.
Do pharmacies have the right to deny service? Per the more recently fraudulently-packed Supreme Court ("Where's his birth certificate,[ tax return, arrest records, and level of foreign debt]"), You don't have to serve a gay cake to a gay wedding.
The UNDHR (UN Declaration of Human Rights) specifies "Equal Protection" of "Equal Rights" as fundamental rights.
Shouldn't a US Constitutional Amendment be necessary to unequally deny rights on the basis of medical status (under the guise of authorization of right to regulate substantial affectation of Interstate Commerce), if an amendment was necessary to (also unequally) prohibit alcohol?
How can we work together on our shared objectives: maximize compliance with the Constitution, provide for the national defense, minimize self-harm and physician liability, and secure the blessings of Liberty?
How and why is there a profit margin in pharmaceutical resale without a license? What is the comparative cost of the pharmaceutical generic?
We could give people a discount - equally - for speaking with a physician. There should be a financial incentive to work with a physician on what works and isn't working.
The specific regulations referenced here aren’t new. They were only granted a temporary exemption during COVID, and now that is expiring.
The DEA literally loosened their regulations during this period, and now that is expiring.
The fact is, 10 years ago, it was a lot easier to get these meds. More recently, I've had to deal with piss tests, scared physicians, and other formats of bullshit. Because why? It's some grave social ill that some people like adderall and don't need it? Cut us a break.
My therapist was like, "you obviously have ADHD but I can't diagnose you, you should talk to your primary." My primary was like, "you obviously have ADHD but I can't prescribe anything -- not because I'm not allowed but because I need to cover my ass. You need to see a psychologist or psychiatrist and get a letter. Then I can manage your medication." You know how many psychologists in my area do evaluations like this -- none.
What a racket. Entire thing is a farce, you can’t test for a mental disorder through observation to begin with and research proves how easily one can get an ADHD diagnosis by putting on a performance. It’s not as if these check and balances do shit.
It's almost like once a bunch of congress folk lost their payouts from the Sacklers (who recall essentially got away with mass manslaughter) they've decided it's time to be hard on drugs by punishing people with legitimate needs.
It’s not targeting the average doctor. It’s targeting the pill mills that were setup to prescribe Adderall as a subscription service. You paid a monthly fee to get Adderall prescriptions and the doctors would rush through a token “visit” to get through as many patients as possible in a day.
People who need adderall prescriptions don’t spontaneously get better.
Imagine the outcry if diabetes, or heart diseases, etc drugs started needing you to get a dr sign off every month: how long do you think before the same service would exist for those?
This is very simple: congress consists largely of untrained people looking for “hard on crime” sound bites, and as long as they’re just targeting generics that aren’t super profitable it doesn’t hurt their pay days.
I used to regard myself as an honorary drug addict/alcoholic because I’m morbidly obese. My whole family were addicts, inspiring me to never try alcohol or illicit drugs. In my declining years I actually sort of hope I will get some fun out of legal drugs like this, but it hasn’t worked out that way. My life expectancy is low and I am mildly considering trying some illegal drugs
If you’re in pain following surgery, the prescribed medication isn’t expected to feel “fun” or produce a recreational high.
Note that this does not mean that you are immune to addiction or recreational effects. In fact, this exact mindset is a common story underlying many addiction stories: A belief that the person’s response is in some way unique or less than average, leading to cavalier engagement with drugs.
Don’t go down this path.
Straterra for ADHD.
Tramadol, ibuprofen, Tylenol 3, and gabapentin for pain.
Nothing stronger than hydroxyzine and clonipin for breakthrough anxiety.
Everything else should be dealt with by mature coping mechanisms. Europe does it just fine - but not here in USA.
I guess providers get rated by customers and we’re capitalists so addicts are the byproduct.
Even people in this thread say they make sure to call every month for refills. That behavior is definitely noticed by physicians. Patients won’t do that for other drugs of far greater importance to their health. They’re very sticky for the fun stuff no matter the friction put in place.
If it works for you, great, but for many including myself it was a waste of time.
I'm not from the US or Europe btw, but if you want a sound complaint against the status quo in the US, I'd argue against the popularity of the Adderall mixture of L and D-amp over LDX (Vyvanse), which seems more effective (only D-amp) and less addictive.
Adderall, I have no such aggression amplification problems with, at the cost of needing a substantially higher dose. I'm much more patient and tolerant of frustration, have many fewer ANT's (Automatic Negative Thoughts), and I don't need to take regular breaks to cool off.
While Vyvanse undeniably worked for me in terms of increasing my capability to pay attention throughout the day, and as a consequence, get tons done, not only in terms of work, but living a normal life with hobbies; that price tag of inducing eggshell walking among those I love was just too damn high.
So I'm back on Adderall... Learning new coping strategies... trying to just get by. Point being, please abstain from painting in broad strokes and assuming just because you may have some pet theory down, that that translates without loss in practice. It doesn't. Not by a long shot.
In fact what you describe I also experienced with Vyvanse for years and it just toned down in the recent years by staying at a lower dose and then adding an SSRI (which pretty much removed all those 'triggers' I had of berating people, yet not the 'stim look' that people have on their eyes when on stimulants, that only fades out after the 8-12 hours when you become human again)
One time I tried Bupropion instead, I got immediately super short fuse, berating people and so on. Reminded me of a boss I hated so much that would grill me over small things on my PRs for hours, rather than moving on quickly. I didn't want to become anything close to that guy so I just stopped.
My point is, the studied outcomes are usually just one variable, that ignores a lot of the extra behavioral effects we as patients get in practice, but it's a good pointer in guiding where to aim treatment first for most. And it seems now LDX is being tried first, before Adderall over there in some practices, with the added convenience of making refills easier.
Good luck with your journey pal, I only wish it'd be easier for all of us.
You are not the sufferer of the malady in question. You have not mastered the art of walking around in someone else's bag o'flesh for 30+ on years, and you have zero place to be lecturing others or opining without having lived with someone whose ADHD isn't responsive to Straterra. Of having to put up with the crippling disorganization; with having to endure the frustration of both the sufferer themselves, and that of those around them.
When it gets to the point I have to drop 10+ years of medical records onto a practitioners desk, and STILL get handwringing and whining about "you need a rediagnosis" which requires ceasing treatment and unloading, and results in massive disruption of my, and my loved one's lives, and my ability to work and hold down a job, and my ability to pick up the pieces once everyone ends up going "Welp, yup, that one's a hell of a case of ADHD. Just like they said the first five times they were diagnosed”; which by the way, is fundamentally inflicting diagnostic harm on me; your regulatory regime has gotten out of hand.
You think I like this? You think Schedule II is fun to be on the receiving end of? You think I haven't accounted for all the lost time, opportunity, and spend on the drug? You think I like having to fight with insurers for continuity of mental existence? I wouldn't wish it on anyone.
And you have the gall to sit here and leave this stain of a bird dropping of a post, pitching
>They’re very sticky for the fun stuff no matter the friction put in place.
...as some sort of indicator that "Oh it's because they're a druggie."
No, it's because if I don't, the world will be subject to the deleterious consequences of an adult human, tuned to maintain operation with pharmacological assistance, suddenly operating in the abscence thereof in a highly degraded state.
Good Lord. Find some bloody perspective. There's about three types of people I can't stand, period; and sanctimonius people that think they can apply one size fits all treatments to others are one of them.
Your argument that it helps you just doesn’t move the needle for me. I see dead 20 year olds nearly every day from fentanyl or hypertensive brain hemorrhages from meth users. That’s just in Seattle - I’m sure it’s similar in every major US city. There’s no
So while you describe this benefit to you, I think of it analogously as gun ownership. There are people who use guns appropriately for self defense, hunting, etc - but thousands of people die from them every year due to inappropriate and illegal use. And yet there’s no constitutional protection for amphetamine and opioids - but here the US is today, in a drug crisis of its own making.
That’s my perspective. I see the end of one extreme every single day. This is a population level problem and you want me to contextualize it to a single individual. I guess my response to that is that I have contextualized it and reject it. I might be some sanctimonious wind bag to you (who you can’t stand) but you don’t have to see the dead all the time. And this trail of mayhem begins at our irresponsible pharmaceutical industry. The high functioning cheerleading users have 0 perspective and want me to lose sight of the forest. No thank you, I’ll stick to the one size fits all treatments. No opioids or amphetamines.