A shortage of Adderall, which is used to treat attention deficit hyperactivity disorder, shows little sign of easing as manufacturers struggle to get enough active ingredient to make the drug and demand climbs.Just to demonstrate how serious this development is, the New York Times most emailed list now contains "F.D.A. Finds Short Supply of Attention Deficit Drugs".
Adderall, a stimulant, is a controlled substance, meaning it is addictive and has the potential to be abused. The Drug Enforcement Administration tightly regulates how much of the drug's active pharmaceutical ingredient (API) can be distributed to manufacturers each year.
The system is designed to prevent the creation of stockpiles that could be diverted for inappropriate use. Adderall and other stimulants are popular with students who may not have ADHD but are seeking to improve their test scores.
The DEA authorizes a certain amount of the API in Adderall - mixed amphetamine salts - to be released to drugmakers each year based on what the agency considers to be the country's legitimate medical need.
Increasingly that estimate is coming into conflict with what companies themselves say they need to meet demand for the drug, which is reaching all-time highs. In 2010, more than 18 million prescriptions were written for Adderall, up 13.4 percent from 2009, according to IMS Health, which tracks prescription data.
The number of adult, middle-class (probably mainly white) people, who have no discernible mental illness, yet who wrangle prescriptions for drugs like Adderall or Ritalin is an open secret, according to weighty anecdotal evidence collected by this blogger. Although he has a small social circle, he knows several people of both middle age and middle class who have complained to their respective doctors about their inability to focus their minds, and have been rewarded with prescriptions to what were formerly known as mother's little helpers. It appears that many physicians have little hesitancy in prescribing them; they are, after all, legal, and perhaps more importantly, it's a lot easier than arguing with demanding patients.
In a similar development a few years ago, after major league baseball banned stimulant use except for medical exceptions, the number of baseball players unfortunately diagnosed with ADHD skyrocketed. Presumably many of them suddenly found that they couldn't focus on fielding the ball without chemical assistance.
Nature conducted a survey a few years ago and found that
One in five Nature readers -- mostly scientists -- say they up their mental performance with drugs such as Ritalin, Provigil, and Inderal. [...]
While only a fifth of the poll's 1,400 respondents admitted to drug use to improve concentration, nearly two-thirds said they knew of a colleague who did. And if there were "a normal risk of mild side effects," nearly 70% of the scientists said they'd boost their brain power by taking a "cognitive-enhancing drug."
Ironic that a country who abuses cognitive drugs the most is on a steep decline.
ReplyDelete@Dennis - "what were formerly known as mother's little helpers."
ReplyDeleteI think the original 'mother's little helper' was the once world famous but now forgotten tranquillizer Miltown - quite similar in its effects to the later Librium and Valium, therefore *not* a stimulant.
It works well enough for that portion of the few percent of the population in which the benefits are not outrun by the side-effects. What the schools of course find attractive about Adderall is a side-effect.
ReplyDeleteJames Wilson
"Ironic that a country who abuses cognitive drugs the most is on a steep decline."
ReplyDeleteRitalin improves concentration, not common sense or moral courage.
Lawyers, speculators, pornographers, divirsity sensitivity consultants etc. can now worker longer and harder tearing the country down, thanks to chemical enhancement.
Nothing nicotine can't do...
ReplyDelete"pornographers (...) can now worker longer and harder"
ReplyDeleteYes I guess they need a lot of concentration. Ritalin, the new Viagra.
I do not know, do they make piss the chess champions for anti doping?
Anyway we have devices for improving our muscles or our senses, there is nothing strange or immoral in searching to improve our mind too. Yoga and meditation do this, and they are ancient.
Probably is the pill idea who repels most. A pill, and what's the effort of deserving a pill? Where is the hard work to morally balance the advantages? How vintage, this disdain.
Instead, it is a truly intriguing idea, unfortunately there are side effects, the biggest of them we need to trust the FDA or the big pharma.
Yeah I've gotten the feeling I'm competing against people who are willing to enhance, even if it's just 5 Hour Energy.
ReplyDeletePeople in general seem more intense and obsessive now, overreactive, hyperemotional. I thought maybe it was from years of antidepressant use building up in their systems. But it's more likely this new modern speed. Despite their assertions to the contrary, people just aren't cool anymore.
I saw this yesterday, too, Dennis. I immediately thought of all those beautiful little boys who wouldn't have their appetite artificially depressed, their sleep troubled, and their energy and drive chemically suppressed. Such a tragedy for the feminists and teachers.
ReplyDeleteThe symptoms for MDHD are real, and not everyone can create a coping mechanism for them, hence the market for these drugs.
ReplyDeleteI just saw the Exorcist again and the doctor first put the girl on Ritalin. I didn't remember that.
ReplyDeleteWell, the one living god is going to need a crisis before about summer if he is to win in November, but somehow, I do not think a shortage of Adderall will be enough.
ReplyDeleteLook at the great expansion of the "energy" drink market in recent years (mostly containing caffeine) and the popularity of coffee shops. Everybody wants to get wired up, it seems. People used to have a drink after work to wind down; now they want to get wound up.
ReplyDeleteDo we actually have more attention deficit disordered people now than 30-40 years ago, or is it simply being diagnosed more? Is the diagnosis being flung around more casually these days? Is all that Adderall really needed? I find it puzzling that more and more kids are receiving it. The adults, of course, mostly just want the buzz; that's not hard to figure out. They would probably prefer cocaine if they could get it.
The prescribing of drugs like Adderall is something that is arrived at in the privacy of a Doctors office. The hands-on judgment of a Medical Professional is involved directly in each case. Individual cases can be turned into broad statistics but that tells one not-so-much. In particular, stats do get at the only real question and that is, "Do these drugs help people more than they hurt them?" In the up-close judgment of their Docs, they frequently do.
ReplyDeleteThe story here is an old one. - Government goons try to enforce their notions of what the future of Medicine should be and inflict shortages thereby. They have done this repeatedly with Medical devices they had no idea the potential of.
BTW, the stimulant class of psyche drugs is by far the safest out there. Millions and millions of doses a year and hardly any problems.
ReplyDeleteSSRIs, which about every other adult seems to be on, have horrible side effects in comparison and there is little stigma attached to them, probably because "depression" is more weepy sounding than attentional issues.
stats about usage do Not get at the question of how individuals are benefiting or not from a drug.
ReplyDeleteDam keyboard.
For some out of control youngsters it's either ritalin or corporal punishment. The later is now illegal (even getting angry at kids is discouraged) so what else are teachers supposed to do?
ReplyDeleteIn addition, people with poor impulse control are rapidly outbreeding those with good impulse control so ADHD is actually on the rise.
I'd agree that feminised teaching content doesn't help but this is more of an issue at the high school level.
Personally I'd love to take adderall if it improved my mental focus but it doesn't usually work as well for inattentive introverts as it does for impulsive extroverts.
"In addition, NAMs are rapidly outbreeding those with good impulse control so ADHD is actually on the rise."
ReplyDeleteThere, fixed that for you.
com cont
ReplyDeleteImpulse control is not the same as control of attention. Folks with poor impulse control typically go off on strangers for no good reason and end up robbing 7-11s for pocket cash without being bothered by future time considerations.{jail, etc) They just might be merely stoopid.
The classic ADHD kid is (was) the one with a tested IQ that was about 4 STDV above his class rank. Every report card he ever got and had to carry home and got whipped for described his near terminal hopeless air-headedness and extreme way-wardness. Routinely, he was offered "one more"- chance to overcome the settled opinion among the local experts that he is by now "ready for the dumpster-just be quick about it." Program.
Then, bang, right out of the fucking blue he learns some things about himself and finds a smart Doctor to help him - then, then a few years after that the guy has had more career success than 99.99999% of the wankers who drool - out their semi-thoughts on the interwebs.
The worst thing about being chronically poisoned with a drug like Adderall is that every morning I must chose between driving my 911 RSA, my Lotus, or my Pinzgauer to my "job".
They are all good in the mountains. But with too many girls involved they can all turn weird and dangerous.
Back in the 1960's when I was young it seemed that everyone smoked and drank - a lot. Perhaps all this drug use today is just a continuation of that.
ReplyDeleteQuote of the Year:
ReplyDeleteBen N Indiana said...
What we DON'T see is black flight escaping White racism. There is no underground railroad terminating in Zimbabwe.
January 2, 2012 9:32 PM
I have to agree with Rum wholeheartedly.
ReplyDeleteI've experimented with combining nicotine gum, caffeine pills, and (real) Sudafed, and also with taking Adderall. Making yourself wired on cigarettes and coffee is not the same experience at all. When I tried Adderall, I expected some sort of rush, got none, and assumed it hadn't affected me. Then hours later, I realized I had been working on something nonstop and was HAPPY to be doing it and not feeling like s--t.
If I had a source of the stuff, I'd take it, too. The fact that it is over-/mis-prescribed for minors is irrelevant to the question of its usefulness for adults.
Say "No!" to drugs that Pfizer and Eli Lilly aren't making a profit off...
ReplyDeleteAdderall is a miracle drug for me, but (of course) there are a lot of people without a pressing need for it who use it. While the shortage is a pain, I don't begrudge people their desires to boost mental performance and general wellbeing via 5-20mg of Adderall in the mornings and maybe another dose in the afternoon. We would be better off if this didn't have such a stigma, as fewer people would be directed into more destructive psychiatric drugs (which ironically are lower–scheduled).
ReplyDeleteI think Chris has identified the appeal this whole class of drugs has to the productive professional - being able to slip into that state where you can concentrate on the task at hand without having intruding thoughts distrupt your progress ("hey, I work for feckless morons...damn, where was I?"). Coffee is the only enhancement I personally use, but I can see the appeal of something without the kidney-cranking stimulant downside.
ReplyDeleteI heard meth helps you focus too. Probably about as good for you as adderall. Looks like another money making scheme to treat a made up condition to me. Its a crime we make our kids take these powerful mind altering drugs with no idea of the long term effects. Here's an idea, if you want to concentrate on something, find a quiet room without blinking electronic devices all around you.
ReplyDeleteI've been diagnosed with ADHD over and over. My solution? I run. A lot. 3 marathons this year! Calms and focuses my mind. Yoga too. And I feel great! It does, however, take more effort than a trip to the pharmacy. I also tried a natural remedy called addieup which helpped a lot.
ReplyDeletea tested IQ that was about 4 STDV above his class rank
ReplyDelete---Childhood persecution---
more career success than 99.99999%
every morning I must chose between driving my 911 RSA, my Lotus, or my Pinzgauer
Welcome to Mangan’s, Mr. Blofeld. Here you’ll find your Adderall shaken, not stirred.
I guess I have some attention deficit symptoms. They started when broadband connections phased out dial-up modems. Like many symptoms of "modern" diseases, though, I think it's better to attack it at the root than to take medication for it. The more you enjoy what you are doing, the less you need artificial means to keep you from responding to every stupid stimulus.
ReplyDeleteWilliam F. Buckley was addicted to Ritalin.
ReplyDeleteThe mathematician Paul Erdős published more papers than any other mathematician in history and used amphetamines.
ReplyDeletehttp://en.wikipedia.org/wiki/Paul_Erdos
"His colleague Alfréd Rényi said, "a mathematician is a machine for turning coffee into theorems", and Erdős drank copious quantities....After 1971 he also took amphetamines, despite the concern of his friends, one of whom (Ron Graham) bet him $500 that he could not stop taking the drug for a month.[12] Erdős won the bet, but complained that during his abstinence mathematics had been set back by a month: "Before, when I looked at a piece of blank paper my mind was filled with ideas. Now all I see is a blank piece of paper." After he won the bet, he promptly resumed his amphetamine use."
"Impulse control is not the same as control of attention."
ReplyDeleteTrue, but what is usually referred to as ADHD by psychologists is primarily an impulse control problem not an attention problem. This is one of the odd ironies of the ADHD label.
I guess researchers see impulsivity as a greater social problem than inattention, so they are more interested in labeling and medicating it.
Pop psychology books on ADHD focus on ADHD in self-referred middle-class people. These people have a milder form of impulsivity than is seen in lower-class proles, and their most common problem is taking on too many tasks at once and not being able to finish them or do them in an efficient, methodical fashion.
Currently, only about 20 percent of those diagnosed with ADHD actually have inattention as their primary symptom, although this may be changing.
Admittedly low IQ makes a person more likely to be inattentive or impulsive, so among those with low IQs it would be much harder to diagnose ADHD.
Personally, I've meet a lot more impulsive people (of various IQ levels, almost always extroverts) than inattentive people, so to me it makes sense that less people are diagnosed with the inattentive type of ADHD.
As the saying goes, the problem with drugs is that they work.
ReplyDeleteWell .... time to go to the streets for some meth.
ReplyDeleteThese drugs are not good for you, regardless of if they help you concentrate, they destroy organs, age the circulatory system.
This represents a very real crisis, and also an occasion to think about the non-medication approaches to managing ADHD: http://goo.gl/2YPW4
ReplyDeleteIf you ask me Adderall is a miracle drug for academics. I remember taking tests in college while on adderall and the sharpness of my mind and memory was unbelievable. Recall of information from months old lectures and notes sprang to mind with complete ease.
ReplyDeleteI think if I would have taken my SATs with adderall I would have upped my score by 200 points or more. Unfortunately long term adderall use is terrible for the heart and mind.
I always wanted to be an academic but could not put in the hours necessary to write long pointless papers. My brain would break down too quickly. Then I discovered adderall. Now I feel unstoppable.
ReplyDeleteIt also cured many of my Asperger's symptoms. I used to have two good friends and now I have like 8. Still no girl, but I'm so damn screwed up that there's probably little hope for that.
William F. Buckley was addicted to Ritalin.
ReplyDeleteRichard Nixon too.
To WFB and Nixon we could add JFK and... Hitler. (Amphetamines, not Ritalin.)
ReplyDeleteLol, I just made up Nixon to show that I could also make statements without any evidence.
ReplyDeleteThere are several signs that stimulants are a good match for helping an individuals situation.
ReplyDelete1. Large improvements at low doses.
2. Indifference/lack of euphoria in response to the drug but delight primarily in the improved performance.
3. Very stable dose requirements over time.
4. Minimal effect on sleep patterns.
This happy picture is not uncommon when the original assessment was reasonably well done and I think it is mis-quided for any third party to become overly judgmental regarding what works well for others.
The whole Nazi war machine ran on amphetamines and anabolic steroids. Those things were invented in Germany in the 1930s. The allies often expressed amazement that the Germans could fight seemingly for days at a time and were so muscled up. And aggressive.
ReplyDeleteNASA doctors handed out meth by the bucket load during the Apollo program. IOWs, the US won the race to the moon partly by giving a lot of meth to a lot of talented engineers..
The Beatles were all epic speed eaters until they discovered other things.
Not sayin its is wrong or right but there it is.
Inderal makes me tired, I made my doctor stop prescribing it for high blood pressure and migraine. It definitely was no help to mental work, in fact it slowed me down. Moreover, when I complained of that, they considered that was a normal reaction to Inderal.
ReplyDeleteKary Mullis won the Nobel Prize in Chemistry and used LSD and other psychedelics and psychedelic amphetamines. He claims LSD helped him develop the work for which he received his Nobel.
ReplyDeletehttp://en.wikipedia.org/wiki/Kary_Mullis#Use_of_LSD
"Mullis details his experiences synthesizing and testing various psychedelic amphetamines and a difficult trip on DET in his autobiography. In a Q&A interview published in the September, 1994, issue of California Monthly, Mullis said, "Back in the 1960s and early '70s I took plenty of LSD. A lot of people were doing that in Berkeley back then. And I found it to be a mind-opening experience. It was certainly much more important than any courses I ever took."[28] During a symposium held for centenarian Albert Hofmann, "Hofmann revealed that he was told by Nobel-prize-winning chemist Kary Mullis that LSD had helped him develop the polymerase chain reaction that helps amplify specific DNA sequences."[29] Replying to his own postulate during an interview for BBC's Psychedelic Science documentary, "What if I had not taken LSD ever; would I have still invented PCR?" He replied, "I don't know. I doubt it. I seriously doubt it."[30]"
He also has had some strange ideas and beliefs:
"Since winning the Nobel Prize, Mullis has been criticized in The New York Times for promoting ideas in areas in which he has no expertise.[5] He has promoted AIDS denialism,[6][7][8][9][10][11] climate change denial[6] and his belief in astrology.[5][6]"
"In the book, Mullis chronicles his romantic relationships, use of LSD, synthesis and self-testing of novel psychoactive substances, belief in astrology and an encounter with an extraterrestrial in the form of a fluorescent raccoon."
He says he spoke with the glowing raccoon.
The whole Nazi war machine ran on amphetamines and anabolic steroids. Those things were invented in Germany in the 1930s. The allies often expressed amazement that the Germans could fight seemingly for days at a time and were so muscled up. And aggressive.
ReplyDeleteSteroids weren't discovered by the Nazis alone, there was lots of hormone research across Europe in the 30s. Swiss and German chemists shared the Nobel for synthesizing testosterone.