[mandevil]

The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse.

Your psychiatrist is trying to deal with the DEA monitoring, and doesn't want to be the one who first puts you on it, but continuing an existing Rx is not treated the same by the DEA, as I understand it. So the online doc is putting her license more at risk to a DEA investigation, but your in-person doctor is less exposed.

N.B. this is how I understand the things that my wife has said to me. She is actually a pharmacist who has to deal with these things, and I might have garbled something.

[lysp]

> The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it.

The other thing on top of limiting its production, it's not just for the US, it's worldwide.

Australia has a shortage of various types of ADHD medication due to this DEA production limit too.

https://www.tga.gov.au/safety/shortages/information-about-ma...

Also, the Australian Government requested increased production to cover these shortages, and the DEA rejected that request.

So those limitations have a worldwide effect due to the US being one of only a few countries that produce these drugs.

[bawolff]

Is there something stopping other countries from spinning up a factory?

[graemep]

They have. It was originally made by a British company but is now out of patent and is made by multiple companies in multiple countries.

[unmole]

- Supply chains

- Skilled workforce

- Risk capital

- Regulatory overhead

[bawolff]

Other drugs are made outside the USA, what is so special about adderal (besides us regulations which other countries dont have to listen to)

[safety1st]

Probably that it's basically a weaker form of meth. I mean they're chemically similar, they have the same effects, adderall is potentially addictive, nobody wants to end up dealing with something similar to America's meth epidemic. That's not to say you can't manufacture and prescribe this drug safely, but a lot more people are going to have a lot more reservations about it than if you want to crank out a generic Tylenol or something.

[gosub100]

If that was true there would be a shortage of pain pills

[colechristensen]

Nothing is special about it. Lots of drug manufacturing is low-risk low-reward but setup costs are high so nobody thinks it's worth the investment.

[claudex]

Maybe it's just that the cost to set up the production elsewhere is too much for the expected market. The shortage of the drugs doesn't mean there will be enough buyer to cover the cost (and make enough profit).

[bratwurst3000]

the article is about methylphenydat (ritalin) and not adderall. Amphetamie is such an easy molekul, stepping up production should be super easy.

[chris_wot]

Trump wouldn't like it.

[chris_wot]

He has literally targeted Australia for our pharmaceuticals.

[tstrimple]

> the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse.

I know that I process Adderall differently having ADHD, but I still struggle to see how it's used recreationally. I took it somewhat consistently for over a year for ADHD treatment until I missed an appointment and couldn't get around to scheduling another before my prescription ran out. After that getting back on became more trouble than it was worth. Not once did I ever feel a high from Adderall. My best naps were on Adderall. Not once after dropping it did I ever feel withdrawals or the urge to take more. The only thing I felt while taking it was constant dry mouth and my brain no longer constantly jumped between topics outside of my control.

My brother abuses controlled substances. When I told him I was taking Adderall he warned me to be careful and talked about his issues with it and I just couldn't relate at all. I'm no stranger to addiction. I'm an alcoholic and am addicted to nicotine via fruity vapes. But Adderall? Nothing at all.

[adastra22]

My doc says the best diagnostic for whether you have ADHD is to prescribe Adderall and see what happens. Those with ADHD react very, VERY differently to the drug than the rest of the population.

[bratwurst3000]

i dont think thats true. I have ADHD and get amphetamine as medication. I gave it some friends and it had similiar effect as with me. they where hyper focused and aware. I think its what amphetamine does with every human. Regular humans have more focus and adhd people have suddenly focus but netherless same.

[adastra22]

Focus is the same. It's the euphoric high and increased hyperactivity in neurotypicals which is the divergent response.

[shlant]

the euphoric high also happens in those with ADHD but only when they first start taking it. I would assume if you took it recreationally and not consistently you would have the same effect

[drzaiusx11]

My problem is I forget to take my Adderall. I've also experienced shortages in my area for 3+ months. When I eventually start back on my meds after a long hiatus, it seems to work just like it did when I stopped.

I could use some more euphoria in my life, sadly Adderall does not provide it (for me.)

[notfromhere]

Eh. When you take it the first time the euphoria is more that you can focus and the mind becomes quieter. It’s not like a party drug

[bratwurst3000]

thats where i have to disagree. if I give anyone 5mg dexteoamphetamin they would be less hyperactive and more focused on one thing. If you do too much it doesnt matter if you are regular brain or not. 80mg of dextroamphetamin would make everyone look like a speed freak.

If it would make people hyperactive it wouldnt be used for learning and sitting there 16h hyperfocused.

IMHO

edit: to explain better. imagine a adhd brain having dopamin swings between -1 and +1. While there are those swings people cant execute their plans and cant focus on one goal. when you give them adderal or similar they get a powerboost to blasting +2 dopamin lvl and can keep that for hours.

so if you give a regular human beeing the same amount of adderall it will blast its brain on +2lvl dopamin also.

so adhd people and regular people behave the samw on adderall.

the thing with adhd it is not a lack of dopamin but an iregular flow of dopamin that is the problem. The solution is to hypercharge the brain with dopamin to get constant lvl.

[beaugunderson]

your doc is buying into a very pervasive myth, see e.g. https://journals.sagepub.com/doi/10.1177/070674370200601S07

[chipsrafferty]

I doubt that very much

[LoganDark]

> I still struggle to see how it's used recreationally.

- Adderall keeps you awake. Some people use that to be awake for very long periods of time. Long drives, marathons, etc.

- Adderall can make boring tasks seem engaging, so it can be used, for example, to help a student study. Combining that with no need to sleep that night, can become a bit of an unfair advantage.

- Adderall can cause a high, even though I've only ever experienced that with pure dextroamphetamine. For me it caused everything to feel warm and pleasurable somehow, the first couple weeks I was taking it.

Now I feel nothing except the wakefulness, although when I stop taking it for a while and then start taking it again, sometimes I will spontaneously do every chore that's been building up over the past months in a single day. That's just how it goes for me apparently.

[radu_floricica]

That's not recreationally. That's actually a good, useful drug effect (even if not specifically for ADHD).

I'm more than a little pissed that governments don't let us use drugs like this responsibly.

[Henchman21]

Governments treat their citizens like children to be watched over, not like adults capable of making decisions. Until that changes, expect to be pissed off.

[LoganDark]

> I'm more than a little pissed that governments don't let us use drugs like this responsibly.

I mean yes. Proper education and harm reduction is vastly superior to this "controlled substances" bullshit.

[adastra22]

> Adderall keeps you awake

For many (not all) ADHD'ers, amphetamine or caffeine makes them sleepy.

> Adderall can make boring tasks seem engaging

This is true

> so it can be used, for example, to help a student study ... can become a bit of an unfair advantage

Unfair? This isn't sports. Nobody is being cheated by a study-enhancing drug.

> Adderall can cause a high, even though I've only ever experienced that with pure dextroamphetamine. For me it caused everything to feel warm and pleasurable somehow, the first couple weeks I was taking it.

Interesting. FYI ADHD people feel none of that. If anything, the opposite: on stimulants ADHD people feel relaxed and normal, bringing them down from hyperactivity and allowing them to focus on their life.

[LoganDark]

> For many (not all) ADHD'ers, amphetamine or caffeine makes them sleepy.

You're right, I was mainly speaking about people without ADHD using stimulants.

> Unfair? This isn't sports. Nobody is being cheated by a study-enhancing drug.

No, but it can lead to bad health effects for the student, and bad habits like dependence.

> Interesting. FYI ADHD people feel none of that.

I guess my ADHD diagnosis must be mistaken then? And my executive dysfunction must come from somewhere else...

ADHD is not a single neurotype. As even the most basic example, multiple different expressions of autism can each have ADHD.

> on stimulants ADHD people feel relaxed and normal, bringing them down from hyperactivity and allowing them to focus on their life.

Stimulants still help me regulate my sleep cycle and focus, but I don't think I experience hyperactivity from not being on them. (anymore at least; when I was younger I almost couldn't sleep without melatonin. That resolved itself before I ever touched stimulants, though.)

--

I have heard of people with undiagnosed ADHD self-medicating with meth. Slightly different than people without ADHD using stimulants recreationally. I personally hope to never touch meth because I heard it can ruin one's relationship with other stimulants, and I don't want my medication to become any sort of recreational thing because I need to depend on it and not seek highs, but I feel like self-medication can be perfectly valid if someone knows what they are doing. Big if though.

[adastra22]

My blanket statement was perhaps too broad. There are less than 10% of ADHD people whom do not demonstrate the paradoxical response to stimulants. That said, the percentage of misdiagnosis is at least that high, which makes one wonder. Mild bipolar is often misdiagnosed as ADHD, for example, and often discovered exactly because stimulants don't work as expected.

I missed on first read that you said the stimulants only had that high for the first few weeks though. That sounds different from what I understand to be the neurotypical response.

> Stimulants still help me regulate my sleep cycle and focus, but I don't think I experience hyperactivity from not being on them.

You may have the distracted variation rather than hyperactive.

[LoganDark]

> You may have the distracted variation rather than hyperactive.

Well, I do have a dissociative disorder. Though I'm fairly sure I would be ADHD combined type, because I do have extremely hyperactive moments.

By the way, "the distracted variation" is called inattentive.

[shlant]

> Adderall can cause a high

> Interesting. FYI ADHD people feel none of that.

Please don't speak for a whole group of people when you don't know what you're talking about. Euphoria is very common when people with ADHD first start taking amphetamines, it just goes away after a week or so.

[hirvi74]

> Interesting. FYI ADHD people feel none of that. If anything, the opposite: on stimulants ADHD people feel relaxed and normal, bringing them down from hyperactivity and allowing them to focus on their life.

That is common myth. It's a matter of dosage over time. If one takes 120mg of Adderall in one go, then I can assure you they will not be calm nor relaxed. The relaxed feeling comes with a build of tolerance over time and with the lowest therapeutic dosage possible.

I won't deny that people with ADHD might perceive more benefits from stimulants than those without ADHD. I person with poor vision probably would perceive more benefit from eyeglass than I do with 20/20 vision. The glasses work the same for both of us, I just don't benefit from the effects. Also, stimulants do not work for about 10%-30% of people with ADHD, and if the reactions were truly that different, then there would be no controversy about testing for ADHD. It'd be as simple as just examining the effects of a pill.

In the beginning, I felt euphoric from stimulants and I am ADHD as they come. On the rare occasion, I still might get hit with a glimpse of it. Though that is typically after I take a break from medication for some time.

Back when I was in college, I cannot tell you how many people I knew with legitimate ADHD that used to rail Adderall and Adderall XR pills (yes, the XR are just as easy to abuse).

Check out this subreddit if you care. Search for the term "ADHD" and you will see how the medication affects a portion of the ADHD population:

https://www.reddit.com/r/StopSpeeding/

[adastra22]

There’s a lot of myth in this myth-correcting post. I’ve doubled dosed by accident and although I felt like my heart was going to explode (and was very anxious over that), I still felt absolutely nothing resembling a euphoric high.

If you have good vision you do not benefit from glasses. In fact it makes things worse, as those with good vision are able to use their eye muscles to adjust focus but the glasses make that harder.

[hirvi74]

> I’ve doubled dosed by accident and although I felt like my heart was going to explode (and was very anxious over that), I still felt absolutely nothing resembling a euphoric high.

Doubling one's dosage does not mean much without stating the prescribed dosage. 5mg => 10mg is much different than 60mg => 120mg.

Also, the euphoric high tends to become lessened the longer one is on stimulants, even if the dosage is increased, due to neuroadaptation, i.e., a decrease in dopamine receptor availability and changes to downstream signaling effects of dopamine transmission.

Increasing the dosage on the second day of medication vs second year of medication may likely have significantly different effects in regards to the presence of euphoria.

[LoganDark]

> If one takes 120mg of Adderall in one go, then I can assure you they will not be calm nor relaxed.

If one takes 120mg of Adderall in one go, and they don't have a tolerance, I'd be surprised if their heart doesn't explode.

[hirvi74]

Unless you are a Finnish super solider like Aino Koivunen

https://en.wikipedia.org/wiki/Aimo_Koivunen

[idiotsecant]

Yes. Some brains react to some stimulants differently. That's the whole reason ADHD can be treated with Adderall.

[astrange]

This isn't true, it affects everyone the same way. But you could say the optimal dosage is different for different people.

I think people just like saying this because they're afraid stimulants will get banned otherwise.

[idiotsecant]

That's wildly inaccurate. A brain is a complex system with emergent properties that result in us. The basic effect is an increase in Norepinephrine interactions but the effect that has on people with ADHD is obviously very different.

It's like saying that engines with fuel and engines with no fuel respond the same way to adding fuel: it increases the length of time they will run.

Stop adding fuel and the resulting system behaviour will be quite different.

[hirvi74]

> The basic effect is an increase in Norepinephrine interactions but the effect that has on people with ADHD is obviously very different.

I've heard it described as a difference in magnitude. If a person with ADHD has an arbitrary "focus" score of 5/10, and a normal person has a focus score of 8/10. If a stimulant brings them both up to a score of 9/10, then the effects may appear more noticeable in the ADHD person because a 4 point jump is typically far more apparent than a 1 point jump.

[Arcanum-XIII]

I’ve seen friends with stimulant and can say with full confidence they are not reacting to them the way I am. They’re « high », ideas everywhere and nowhere, acting like their overstimulated, full of energy… when I’m quieter, energy level normal, can think at one thing at a time without switching… and sleeping under the effect is not an issue. I a have great nap.

So no. Maybe if I try a récréative drug will I have my adhd multiplied, but here it’s not. I think it should have been fun while younger discovering that amphetamine could quiet me when everyone was dancing under the influence.

It’s not perfect. No medication are. If you abuse it, take it without need… yeah it can be abused. Don’t try heart medication either. Or lithium for kicks. Or…

[hirvi74]

> I’ve seen friends with stimulant and can say with full confidence they are not reacting to them the way I am.

That means very little. Do you think all people react the same way to all medications? If someone takes an SSRI and it doesn't work, then does that mean they do not have depression, anxiety, or whatever the medication is indicated for? Do opioids only work for people with chronic pain?

As someone with ADHD, it's extremely common for people with ADHD to think they are some sort of rare subspecies of humans where everything different in their life is due to ADHD. In all aspects of life, people with ADHD are far closer to normal than they might want to believe. It's why people even doubt the existence of ADHD at times. I've yet to see anyone seriously doubt the existence of Schizophrenia, for example.

[wafflemaker]

All drugs affect everyone differently. Something that's ok with you can literally kill someone else - simple example - smoking weed with someone that has some lung disease.

That's why just having them illegal makes them 100x more dangerous. Through less knowledge among users, no guidance on packaging and difficult to identify the substance if someone had to be taken to the hospital.

[lazide]

Literally not true. There are clear, reproducible, and obvious differences in brain chemistry between people.

[LoganDark]

> This isn't true, it affects everyone the same way.

Adderall causes me to be essentially unable to move or function. When I tried it, I was very hungry but I couldn't get myself out of bed to get food so I had to sleep it off! Pure dextroamphetamine works a treat for me though.

[bratwurst3000]

this is true. Regular people get hyperfocus and adhd people get focus. real adhd is a neurologic disorder. its an instability in the flow of dopamin. so adderall puts dopamin flow on 200% and suddenly there is a steady flow for adhd people.

there are maybe 10% of people getting not focused and awake of adderal.

But "adhd brain reacts different then regular brain" is not true. For both its 20x dopamin release in 8 hours.

[hnthrowaway847]

I wouldn’t be surprised if this study were funded by some pharmaceutical lobbying shell organization.

I was on various forms of prescribed amphetimines for years and developed paranoia. It took me a few years to somewhat recover. My family has PTSD about that period of my life. I can’t think or communicate well anymore. Fuck that industry.

[neuronexmachina]

> I wouldn’t be surprised if this study were funded by some pharmaceutical lobbying shell organization.

Funding info is at the bottom of the article, the project was primarily funded by the Swedish government.

[vbril]

Also in that section:

> LZ is supported by ìShizu Matsumuraîs Donation (2024-02228) and KI Research Grants (024-02570). LL was supported by the Swedish Heart-Lung Foundation (20230452), the Söderström König Foundation, and Fredrik och Ingrid Thurings Stiftelse. BD was supported by a grant from the American Foundation for Suicide Prevention (AFSP). SC, National Institute for Health and Care Research (NIHR) research professor (NIHR303122), is funded by the NIHR for this research project.

It may be none of them. It may be all of them. There could be corruption. There could be subtle manipulation. You have no idea how much money there is in the industry. They make things happen.

Some in the medical profession believe that these abused drugs are safe for their patients. Others know better but they still prescribe them. Some pharmacists will tell you that they’re good for your brain because they increase blood flow, because that’s what they’ve been sold by the reps and the studies they’re fed.

[intended]

The fear over a paper, which can be studied and evaluated, is much higher than it need be. It would be something else if it were a media release, advertisement, or an actual compound being lauded.

[astrange]

It doesn't matter who funds a study if it's properly designed. You see this kind of dismissal on /r/science all the time and it's always just evidence that they're not qualified to actually read the study.

[shlant]

> You see this kind of dismissal on /r/science all the time and it's always just evidence that they're not qualified to actually read the study. reply

In my experience it's more because the conclusions butt up against the persons personal beliefs or experiences (like OP's)

[will_e]

Respectfully disagree.

I knew someone that worked for the tobacco industry where they had labs that constantly were looking for reasons that tobacco was good for you. It meets your qualifications for properly designed studies, but it was purely about trying to convince convinced others that a known addictive substance that caused emphysema and lung cancer was beneficial to your health.

Something similar happened in the weed industry, though it it’s proponents were initially just people that wanted pot to be free for anyone to grow, and then it got taken over by capitalists that didn’t mind using massive amounts of energy to fund vertical gardening, or genetically modify yeast to create THC, or to genetically modify the plant itself to produce an untested derivative of it that would meet the qualifications for hemp products, and then peddle it to teenagers at massive doses without control, pairing it with sugar-free sweeteners and causing serious health problems like uncontrollable vomit coughing, basically inventing a new disease from scratch.

[astrange]

> I knew someone that worked for the tobacco industry where they had labs that constantly were looking for reasons that tobacco was good for you.

If you're implying publication bias, that's addressed by preregistration, though you either have to be careful about looking it up or else rely on meta-analysis.

Otherwise if they're publishing true results then there you go. Nicotine does have some benefits; it's basically the only effective nootropic and it's pretty effective for schizophrenia which is why almost all schizophrenic people are smokers. Of course the problem is it's super addictive and all the ways of taking it give you cancer.

[nicholta]

> convince convinced

You probably didn’t mean to add “convinced”.

https://truthinitiative.org/research-resources/tobacco-indus...

https://pmc.ncbi.nlm.nih.gov/articles/PMC2564674/#:~:text=In...

> massive amounts of energy to fund vertical gardening

You probably instead meant “massive amounts of energy in vertical gardening”.

https://www.nature.com/articles/s41893-021-00691-w

https://pmc.ncbi.nlm.nih.gov/articles/PMC8349047/#:~:text=Ho...

[nickff]

The only thing more popular (on those/these forums) than shallow dismissal is piling on (i.e. the recent Coldplay episode).

[bawolff]

Afaict the study was not looking at the risk of that type of side effects.

In any case, paranoia is a known potential (but rare) side effect, its not like pharma companies were keeping this a secret.

[shlant]

"I experienced negative side effects so the science must be bought and paid for"

[ljf]

I found this article about the steps the DEA are taking, really interesting https://www.catherinemccarthymd.com/med-shortage-news-1/the-...

[unethical_ban]

You're right, and the situation is a harm to those who need adderall. Besides, adderall is not nearly as dangerous as Opiods. Whoopty-doo if it's diet Coke. This is why, even though I don't like Adderall's side effects for my ADHD and don't use it often, I keep the prescription, because fuck the government trying to squeeze pharmacists and doctors.

[chipsrafferty]

So even though there's a shortage, you're keeping your prescription to "fuck the government" but actually only fucking someone who needs it and cannot get it?

[LoganDark]

Yep. No matter how long I've been taking my ADHD meds, I can just stop them at any time. I'll sleep for a while (I think my record is 25 hours of sleep), but that's it. No life-threatening withdrawals. No panic. No pain. Safer than any opioid (except perhaps naloxone?).

[mithametacs]

The withdrawals are fucking garbage from even mild abuse (3x prescribed). I passed out and cut my head. And was anhedonic. And lethargic.

And I started taking it as an adult. So I had 4 or 5 ADHD diagnoses under my belt.

[phendrenad2]

The DEA is a runaway paperclip maximizer[1]. Their directive is "prevent drug abuse", and they will continue to pursue that goal to the detriment of everything else. There is ZERO feedback loop here. You need to build that feedback loop of you want one. It's your government, shape it how you want it.

[1] - https://hackernoon.com/the-parable-of-the-paperclip-maximize...

[99_00]

All abuse is bad. Some abuses are worse than others.

What abuse are they seeing with adderall? What I hear in casual conversations is that people are abusing it to learn things. Is that what the DEA was seeing too?

[hirvi74]

> What abuse are they seeing with adderall?

Probably accounts that were similar to these:

https://www.reddit.com/r/StopSpeeding/

[graemep]

Yes, it is most commonly used a study drug.

It is a strong stimulant (more like cocaine than like coffee) and potentially addictive so potentially dangerous and requires medical supervision.

it is a formulation of amphetamine.

[notfromhere]

You aren’t really going to get addicted to therapeutic doses. Recreational doses are like 5-10x what a doctor would prescribe, with restrictive laws in the U.S. you can only get a months supply at a time.

Would be pretty dumb to use your months dosage for 3 days of partying

[graemep]

The question was "what abuse are they seeing with Adderral?". Abuse is mostly going to involve illegal supplies and illegal use.

> Would be pretty dumb to use your months dosage for 3 days of partying

It would be, but people can be pretty stupid. I know personally of a case where kids were sharing their doses.

[chipsrafferty]

Very few people are taking 350-700mg of Adderall... Recreational doses can be lower than the highest prescription dose.

[99_00]

It can't be as appealing and addictive as cocaine but most commonly be abused as a study drug and have recreational use be much less common.

It would never happen. So it must be much less appealing than cocaine.

[adastra22]

I didn't realize studying was a crime.

[graemep]

Using controlled substances to study is a crime. Working is not a crime either, but using cocaine to be able to work harder is a crime.

[lazide]

wall street looking around nervously. Oh who am I kidding, no one cares about that one.