Just Say No To Concentration

Advice Goddess Blog ^ | December 28, 2011 | Amy Alkon

[Tolerance Sucks Rocks]

Yesterday, my entire afternoon got eaten by my panic over shortages of Adderall, the drug that changed my writing life from daily torture that I slogged through because I'm a hard worker to sometimes-hard work I love.

Instead of writing, I wasted my time on the phone to a bunch of local pharmacies, and emailing my very good-natured doctor multiple times ("Can you prescribe in Mexico?"), and searching for Canadian pharmacies -- maybe one in Windsor where maybe I could get Gregg to pick me up 10 or 20 or maybe even 30 pills...in all the spare time he has.

Here in Los Angeles, a number of my vast HMO's pharmacies do not have a single pill of Adderall. Not a single pill. Nor do most pharmacies. Including that of the Costco near me and various other drugstores. And that is the case in many pharmacies across the country. Per Dani Carlson at WOOD Grand Rapids:

Koelzer said they've had a problem keeping Adderall on their shelves at Kay Pharmacy.

"We've had customers coming in crying when they find out the drug's unavailable or they've gone to many different pharmacies and finally came to us because they've heard that we have it, and we don't in many of the cases, and they have tears running down their face," said Koelzer.

That was me, boohooing like a baby on and off on Tuesday afternoon, because just as my writing life has changed so substantially in such positive ways, those gains are likely going to be taken away from me if those shortages don't end.

Two possibilities: The government is holding back some the ingredients from pharmaceutical companies -- they have been doing this for a while in hopes of cutting down on drug abuse. More on government-controlled drug ingredient quotas here. Yeah, sure, somebody might end up snorting meth, and some college students will probably snort Adderall during finals. And that's justification for keeping drugs from those of us who truly need them?

The drug I was taking for many years for ADHD, Ritalin, never worked that well on me, but I only discovered that after I started seeing this doctor that I came to feel I could trust on science. I finally confessed to him that it had become almost physically painful for me in struggling to concentrate throughout my writing day, and that I was contemplating taking Ritalin with Mucinex to boost my focus. Bad idea, he said, and prescribed me Adderall to see how it worked.

Like Ritalin, Adderall is a dopamine reuptake inhibitor, but it also pushes a little dopamine out into the brain, and apparently, I really need that D. The first day I took my first Adderall was the best writing day I've had in 20 years. I used to have a tornado of s*** whirling around my head at all times, and it stopped and put itself neatly away in cabinets when I took this drug. After years of struggling to pay attention, suddenly, all I had to do to focus was decide to focus, and I found creative decision-making and managing a lot of information, if not easy, tasks I could manage if I worked at them.

Sadly, I've been meaning to write this post about how Adderall changed my life, but I was going to title it "Adderall: A Love Story." Now the story is that there's no word on when this Adderall shortage will end.

The other problem is, even if I can find Adderall somewhere (Fresno?), if I have to buy the drug off-plan, at a regular pharmacy, I will lose the very low price I pay with my insurance -- which has always been one of the points of having insurance. In fact, if I have to go on Vyvanse, considered sort of a sub for Adderall, it costs FOUR TIMES what Adderall does in pharmacies. That's $400 a month, while I just take the cheapo generic amphetamine salts combo that costs me a ten-spot or two. As in, $10 or maybe $20.

The big question is, is it government meddling that's causing the shortage or is it Shire pharmaceuticals, trying to manipulate doctors into prescribing its expensive, patented-till-2023 drug Vyvanse?

I used my detective skills to track down the phone number and email address of a DEA spokespiece who's acted all bewildered about the shortage in news stories that have quoted him. Left him a message and I'll call him back tomorrow. Since the government has no problem meddling in vast swaths of our lives, I'm wondering why they aren't doing something over there at the DEA and FDA other than acting bewildered while countless ADHD and ADD patients across the country are wondering if they'll have to risk arrest in some 'hood to fill their legally obtained prescription. (Go on Twitter and elsewhere and search "Adderall" -- you'll see.)

Here's more on the story from fellow ADD-er Moe Tkacik, at TheFix.com:

Shire has publicly blamed DEA quota restrictions for its anemic generic shipments; the DEA has issued an apparent denial, albeit one short on specifics. A chemist at one of the five authorized "active ingredient" manufacturers in the business of supplying pharmaceutical companies with amphetamine says he and his colleagues "have all been scratching our heads trying to figure out what's actually going on."

The prevailing "water cooler" theory, according to the chemist, is that Shire is trying to "embarrass [the generic drugmakers] by making them look unreliable"--which could theoretically threaten some of their accounts, which could also in turn hurt their case in future applications to the DEA for a share of the annual amphetamine production quota. The DEA's decisions to award quota of controlled substances is a somewhat mysterious process, but the aggregate number of about 26 million kilograms for 2011, up from 1.3 million in 1996, the year Adderall was introduced. And even that 26 million wasn't high enough to accommodate the applications; the chemist says the agency recently granted the generic drugmaker CorePharma, which makes generic Adderall and dexedrine, just half the amphetamine allotment for which it had applied. So it stands to reason that if the agency lowers the quota in response to lower unit sales this year, the great amphetamine famine could be here to stay. And since Shire's own quota for Vyvanse's lisdexamphetamine is 9 million kilograms--hugely generous for such a new drug--it is more than prepared to accommodate a surge in new customers.

To keep this in some perspective, my problem is just getting my hands on a drug that helps me be high-functioning while doing my work. Think about the people suffering terrible pain who can't get the drugs they need because the DEA is worried somebody might get high.

F*** the drug warriors, the drug war industrial complex, and the scumbag sellout candidates who support it and all sorts of other destructive measures, from SOPA to the TSA.

And sure, maybe this was some Shire-caused dealie, but if you look on the FDA's own site about drug shortages, they are very clear that government is the cause of some of them. See "API" -- "This shortage is due to Active Pharmaceutical Ingredient (API) constraints."

F***ers.

[Naturescures]

The shortage was basically a “perfect storm” , DEA quotas on prduction, demand outpacing supply, and (prehaps) a move on the chess board to funnel consumers into the next, revenue producing drug of choice (Vyvan..)

[oblomov]

I have some symptoms of ADD-PI, but I prefer to take legal, unregulated cognition enhancers such as piracetam, aniracetam, Noopept, sulbutiamine, idebenone, and magnesium l-threonate. They have a profound effect on mental flexibility, memory, focus, and verbal ability. These supplements should be cycled. Their effect appears to be cumulative when used properly over extended periods.

[webstersII]

“I prefer to take legal, unregulated cognition enhancers such as piracetam. . . .”

I have never heard of these. Are they prescribed by doctors?

[oblomov]

>>I have never heard of these. Are they prescribed by doctors?

They do not need to be prescribed, since they are not approved for any indication by the FDA. They are approved in the EU and/or Japan for cognitive disorders (Alzheimer’s, ADD, etc), and are prescribed by doctors there.

Many doctors in the US prescribe them to patients, but these doctors tend to be osteopaths or other “alternative medicine” practitioners who dislike the side-effects profiles of FDA-approved treatments.

Most mainstream doctors (and the FDA) focus on treating dysfunction rather than preventing it.

There is a community of “life extensionists” in the US that makes extensive use of these supplements. There are a handful of doctors that practice with these principles in mind, and they prescribe these nootropic agents, as they are called, for proactively maintaining cognitive health.

I can say that nootropics have helped me a great deal in my work (improved cognitive function, increased creativity) and personal life (better listening skills and greater empathy). There has been no effect on the actual content of my thinking (I’m just as conservative as when I started using them, ha ha), but the thinking process has simply felt easier and less taxing.

There is almost no potential for abuse, simply because the effects are subtle and they take time (weeks) to become evident. Used properly, there isn’t a “rush” or a similar feeling of being on a drug. In fact, I have found that the racetams reduce the pleasurable feelings that I get from drinking moderate amounts of alcohol. For example, over the holidays, I had 3 glasses of wine at dinner. I knew I had drank enough that it was unsafe for me to drive, but my thinking remained sharp.