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Nope. The two most common non-amphetamine ADHD drugs, methylphenidate and atomoxetine, are both now old enough that they’re available in generic form, and methylphenidate is cheap enough that step therapy is not routinely required before insurers cover it. Even one of the pretty new and therapeutically effective long-release amphetamines, Vyvanse/Elvanse, is now available as a generic as of (I think) summer 2023. So are most of the other amphetamines. You’re right in general about how much of the pharma industry prefers to operate, but wrong about what’s true in the specific context of ADHD treatment, and also wrong (even if your remark was only tongue-in-cheek) about whether people with ADHD get high when they do take an amphetamine as prescribed. That last misconception is actually quite harmful, whether or not you were joking. It’s a perverse fact that most of the obstacles which state and federal legislators, state and federal regulators, major pharmacy chains, and pharmacists put in the way of smooth access to most ADHD medications - primarily as part of the war on drugs - are uniquely hard to handle and overcome for people with ADHD, due to the types of life struggles that ADHD causes in particular. The widespread stereotype of people with ADHD as drug seekers looking to get high, at least in much of the US, makes appropriate policy outcomes hard to achieve and hard to experience in practice. The benefit of medicines to people with ADHD is no less legitimate than the benefit of Ozempic or insulin to people with diabetes. And nobody with ADHD gets high from therapeutic doses of ADHD medicines. Anyone who does get high from such doses doesn’t actually have ADHD, and so either they got the prescription from a doctor guilty of diagnostic medical malpractice (or a doctor complicit in a false diagnosis/prescription) or they lied to the doctor in a fraudulent way when undergoing the diagnostic process. Those are worth punishing, but not at the expense of making it unreasonably difficult for the medicines to be accessed by the very same population for which they are quite legitimately approved and prescribed. |