Sunday, March 6, 2011

The Supply Chain, Adderall, and Flying by the seat of your Pants

There are so many drug products on back-order or limited supply right now that working in a pharmacy can feel like a scavenger hunt, especially when we're asked to keep inventories down and don't have a lot of 'cushion' to work with. I hate having to bounce people around on different generic manufacturers of the same drug because the one they got before is unavailable. If all forms of the drug are totally unavailable we have to track down the prescriber for an alternate --- but if the person doesn't want an alternate ("Midrin generic is the ONLY thing that works for my headaches -- would anyone else have it?") --- well, I'll make a couple of calls but after the second or third "no" I've got to give the prescription back and send them out to continue the search on their own. I swear I'm spending so much time trying to find a solution to these problems -- calling other stores, scouring the wholesaler's listings for SOMETHING --- it almost requires a full-time person right now. And it's not just prescription drugs; a lot of OTC's are affected too (PanOxyl soap?? -- really??).

We can't get the 5mg tablets ---- but hey, I can instruct the customer to split the 10mg tablets, right? Problem solved. Uhhhh..... not so fast. Customer calls the next day and swears that those half-tablets made her deathly ill. Every fiber of my being wants to protest --- "but, there's NO reason in the WORLD why that should happen !! It's the same thing !!! It's the............." ------------- oh, never mind. As Charlie Brown would say, AAUUUUGHHH.
I've got enough problems without this.

One that has hit us hard is the generic Adderall shortage --- unfortunately this medication is HUGE in one area where I work. The XR capsules have been unavailable for awhile and now the regular generic tablets are starting to go too. We can get brand name Adderall XR but of course people are charged the brand name copay (which they love) if we can get it to go through at all. Or, the insurance lets us fill the brand name but doesn't reimburse us for it.

Just as an aside here, the stuff is way overprescribed. There, I said it. I know there are kids who have seen their school and reading performance greatly improve because of it, and that is good, but I cannot believe that all the kids and adults we have on this drug truly have attention deficit disorder. Apparently it's quite popular amongst the college set if you need to pull an all-nighter. People become so casual about it. Parents call in because their kid has run out, knowing full well the prescription is not technically refillable, and the doctor needs to write and sign a new one each time. I am of the opinion that Adderall is not an emergency. I even had one parent say "yeah, I know it's a controlled substance and blah-blah-blah." (YES, she actually SAID "blah-blah-blah"). Sorry to inconvenience you with these pesky DEA rules, ma'am.

But I digress. I know we shouldn't whine too much, because here in the USA we are lucky to have access to pharmaceuticals, and if we can't get one there are usually plenty of suitable alternates. If you come down with pneumonia, or kidney stones, or a migraine, or gout --- well, in many other parts of the world you're just SOL.

But damn, I hope that generic Adderall is back soon... so I can concentrate (!?) on the more relevant parts of my job again.

56 comments:

pharmacy chick said...

I really appreciate what you have said, because we too fight with supply issues. Man, it seems like we are in a 3rd world country sometimes..I have just resigned to not stressing about it. we either HAVE it or we DONT, and no amount of worrying is going to change it. When we finally ran out of oxy 5 a couple of weeks ago I just called up a few of our legit longtimers and said "heads up,,,this is what is going on..have a plan B in your sights.." and as far as adderall goes...I just say we are out of stock at this time. You cant change it, you cannot fix it and its not your fault.

Frantic Pharmacist said...

OK, in no way was I implying that Adderall is not a godsend for some people, especially kids. I'm well aware of the biochemistry, believe me. However, in this particular pharmacy site, fully TWENTY PER CENT of our days' prescriptions can be for ADD drugs, and that is way, WAY out of whack. Of course, that is the fault of the prescribing habits of the doctors as much as anything. I'm not passing judgment on anyone, but when I can't get any generic Adderall XR (or any other drug) and people must pay the brand name copay and get mad at me -- and accuse me of trying to put something over on them -- then I'm a little frustrated too. And many of my adult patients, particularly, think of this as just another prescription ('blah, blah, blah') and don't want to be bothered with our silly DEA rules and regulations. That was the point of this post, and perhaps I didn't word it as well as I should have.

Teri H said...

I am a Frantic middle aged person, who has only Googled anything a couple of times in my life. I have ADD & depression & panic attacks. Adderall made a major difference in my life. I would just stay in bed all day without it. I purchase my perscriptions at Costco, the pharmacy girls have always been nice to me, but yesterday I went to two Costco stores & called one,about filling my RX for Adderall, they were very rude, as if I was a drug addict. I am very depressed at the thought of being without my medication. I was told it could be a month or not at all before they get any. So What is the cause of this sudden shortage? by the way I have no insurance. Anxious in MI.

Frantic Pharmacist said...

Teri H-
We often have a hard time getting an explanation for drug shortages. Usually it is an issue with the 'raw materials' that the manufacturer uses to make the medication, but again it's confusing because sometimes one strength of the drug will be available, but not the other.
Many of the medications are made outside the U.S. as well. Your pharmacy ought to be able to make some suggestions as to what you can do in the meantime -- use a different strength (take 2, or halve it, or whatever approaches your usual dose). If you are using the Adderall XR (which is very expensive, even in generic) you might want to consider switching to the twice-a-day Adderall tablets anyway -- much cheaper. Once you have that information you can take it to your doctor's office (or phone them) and your doctor should write you a prescription to cover it-- then you may need to shop around to find a pharmacy that has enough stock. In short, take matters into your own hands. Hopefully the shortage will resolve soon - Just this last Friday, for example, we did receive a small supply of generic Adderall 20mg, which has been out for some time. They will probably 'ration' it till they catch up. Seriously, in spite of the frustration expressed in my posting, I am glad you have found a medication that works for you.

Brady Westwater said...

I take adderall for a dopamine shortage that causes me to sleep up to 18 hours a day. And I have to take it since every other drug I have ever taken - provigil, eldepryl, despramaine, and 20 others have all totally stopped working over the past 15 years. But as of this month - I can't find ANY generic of any kind anywhere in all of Los Angeles

Shannon said...

My husband takes Adderall and has taken it for quite some time now. ADD runs on his side of the family, and some of my children take medication as well. We didn't obtain this medication by whining to our doctor. They were diagnosed by an educational psychologist with 30+ years experience in the field, after having a considerably difficult time keeping up in school. Quite frankly, I am sick of being treated like some meth addict on a street corner every time we have an issue with our medications. I have had school nurses make insinuations to my children, cannot get pills that we were shorted by the pharmacy, etc. It is getting to the point where I am going to amazing lengths, just to make sure my hubby has his meds, so he can be productive at work.

I hate to be cynical, but I have a hard time believing that our new "health care system" isn't somehow tied to the now routine drug shortages. As for the kids...if the schools would put recess and physical education back into their daily curriculum and focus less on standardized testing as is the case due to NCLB, then maybe Johnny wouldn't be wiggling in his seat all day.

Mike said...

" cannot get pills that we were shorted by the pharmacy,"

Of COURSE you were shorted by the pharmacy! That ALWAYS happens on schedule II controlled substances. Pharmacists LOVE to short people on those.

Anonymous said...

Thanks for working so hard for your customers. Our family takes a lot of medications for an assortment of reasons, some quite serious. Our pharmacist has been wonderful helping me keep it all straight and on top of refills (where allowed by law). We've been shorted on ADD meds, but because they keep such tight records they found the error and replaced the pills. It was all very friendly and professional. One of my children would be lost without Adderal. Alternate meds either make him very sick or don't work. I know our pharmacist will do all she can to help him.

Another child has a serious condition that requires several medicines. Because of changing doses the prescriptions run out at all different times. One of his meds is common, but he has to have liquid or it doesn't show up in his blood levels like it should. Our pharmacist bends over backwards without complaint to make sure he has what he needs and never makes me feel bad when I can't remember which meds we've just refilled and which are due, even though some of them are controlled substances. She always seems startled when I tell her how much her help means. She obviously doesn't get thanked as much as she should.

Sometimes the DEA rules do seem to be excessive. Probably because I underestimate the depths to which drug addicts will stoop. I don't see how drug abuse can be fun, but apparently it's popular. That's not the pharmacists fault, it's the drug abusers who are causing the trouble.

Anonymous said...

Dear Frantic,

I have been affected by the Adderall shortage, with all of the five pharmacies I tried being all out.

At one of the pharmacies, I was told that they had the brand name version in stock, but couldn't dispense it to me unless my doctor wrote me a different prescription. Does this seem right to you?

Shouldn't they have allowed me to fill the prescription with the brand name version with a higher copay?

The prescription was for "Adderall", and the "brand name only" box was left empty.

Frantic Pharmacist said...

It doesn't sound right to me -- people can always request the brand name on a prescription, assuming they're willing to pay for it (either cash price, or the higher copay.) So they should have been able to fill it for you, unless there was something else that differed from the original prescription and they didn't explain that to you clearly...

Anonymous said...

I've been getting burned by this supply shortage as well, even in NYC, calling sometimes 40 pharmacies (not an exaggeration -- most of them say "we're on backorder" with no timetable) before I can get a prescription filled. For whatever reason, they refuse to let me just reserve my dosage per month in advance, and of course my doctor can't write it with too many days in advance to make sure I can get it in time. It's a terrible Catch-22 for people. Why can't they get you listed on a program that reserves it at the pharmacy? Wouldn't that just make them more money? I swear, I'd pay $20 bucks a month extra to a pharmacy that could let me fill on a regular 30-day schedule to have it continuously. I'm not trying to get around controlled substances laws, I still have to have a prescription for pickup. I am sympathetic to the idea that it is sometimes overprescribed, but that argument also obscures how many people (like myself) need the drug to function daily. It is a serious smack in the head when you have to work a 12 hour day suddenly without something you absolutely need to be effective.

Red said...

ADDERALL ROADRUNNER..My daughter and I are both prescribed Adderall and having a very hard time trying to find our meds. We live in Lafayette,LA and we,too, are feeling the "shortage crunch"!! We get our scripts filled at a 'mom and pop' pharmacy and still are experiencing the problem when people say that one might have better luck using the smaller pharmacies/private pharmacies, rather than the chain pharmacies in getting our scripts filled. Not so!! I, too, want to know what is the problem?? We have taken every kind of 30mg. generic there is and we both agree that these do not work as well as the non-generic adderall. I literally get ill taking this orange round tablet of Adderall and the 20mg. also. I have read a few comments which stated that some are feeling depressed when having to take the generics of this rare tablet. I thought I was losing my mind at first when I mentioned this to several pharmacists while giving me a look of disbelief and thinking it but, not saying it,"Yeah, right,are you crazy?!" Well, thanks for confirming that I am NOT crazy!!!There is definitely,absolutely,positively a difference in the generic and the name brand. The name brand works for me as it should and I need it!! I have depression as it is and taking Prozac for it, so I certainly don't need depression on top of depression!! So, when is all this going to be resolved and when is the drug administration going to rectify this issue??? It is extremely frustrating not knowing what is going to be in my medicine bottle every time I have to get my Adderall filled!!! Adderall Surprise!!!

Anonymous said...

You are crazy. The generic is the same bc it's the same. It just is. The pink generic 30mg is prettier tho. I sell Medicare Part D/Prescription insurance policies and I have no idea what is going on in the world of drug manufacturing. At least Pharmacists don't either. I am prescribed Adderall and lately I feel dirty driving over 30 miles and calling nearly 20 different pharmacies every month to get my fix. I have to wonder if the manufacturers of these newer, much more expensive ADD meds have lobbied to better compete in this growing market. Surely, physicians and drug companies only have my best interest in mind?! hehe... I had several doctors try to put me on $200+ prescriptions of dextro-this or dextro-that. NO, I will break the plain old amphetamine salt tabs in half and administer them to myself evenly throughout the day to save the hundreds per month. I shop doctors and pharmacies and XR brands. It consumes a ridiculous amount of my time. BUT if you are serious about your healthcare, you will have to become more involved. I truly believe in the benefits of Adderall and alot of the meds that are discriminated against simply bc they are cheap and they work. Healthcare is a nightmare. That's all. So don't chew out your pharmacist... or your insurance agent. Thanks, Frantic, for the post!

Dominic Molise said...

Does anyone know why generic Adderall IR has suddenly increased in price by (no exaggeration) 250%?!! Last month I paid $40 for 90 20mg tabs (daily dose is 20mg 3x/day, for severe atypical depression); this month it was $105 at one pharmacy and nearly $150 at another!!! What the hell is going here? Barring a trade embargo on ma huang root (the general source of ephedra, the basic substance from which amphetamine is synthesized) I fail to see how the price could jump so high with no warning or explanation.

This is becoming unbearable. I am a 22-year old student with serious, documented psychiatric difficulties, yet no insurance to cover any medical expenses because both of my parents are in financial ruin since my dad had a nervous breakdown. My mother is disabled because of her own mental health issues and we are barely surviving by moving back in with my grandmother. My father lost his business 5 years ago and is still struggling to make a living by going back to work at the same job he originally started in over 25 years ago. I don't know what I am going to do until my financial aid comes in. Every bit of the bare-minimum wages I manage to wrench out of the closed fists of my current corporate overlords goes directly to medical expenses and I already owe more than I can even possibly pay as it is. If anyone has any info on what is going on with these outrageous price hikes or if there are any good insurance plans for people with pre-existing conditions that I could utilize, I would be extremely grateful. By the way, I live in Biloxi, Mississippi.

Anonymous said...

Here in Phoenix everyone is out of it, a couple of days ago there was an announcement at the large chain pharmacy I work for that all strengths of the generic and brand, XR and non XR will be unavailable until February of 2012 nationwide. I noticed it kept not coming in, but I got lucky and was able to get in about 1000 of the 20mg IR tablets before they ran out, but they are going fast because everyone else in town is out. I ordered a lot of the brand XR as well, it doesn't make sense that a company can't make enough of such a popular drug. Customers are coming from way across town to get it. (70 miles away because Phoenix is huge).

Anonymous said...

I'm glad it's not just me. This started around the time I moved from one side of Houston to another, so I thought it was just this side of town. But I called my old pharmacy and they are out too. Adderall I can manage without for a week or two. But if seroquel were to run out? That would ruin me. It is the ONLY thing that allows me to sleep regularly. And without sleep, I cannot do my job. And without my job...you get the idea. I've been on psychiatric meds for almost ten years. It's a constant part of my life. I have to go to the psychiatrist at least every two months to maintain my prescriptions, and then, if something changes, I have to return in 30 days. I NEVER just get handed prescriptions for drugs. I have to go through every two months with her how the medication is working. I just left a message for her because she mailed me my latest adderall refill prescription and obviously I'm not going to be able to fill it. She tried to convince me to go on something called vivance (sp?) during my phone appointment Monday. Maybe this was why. I don't know why she wouldn't just tell me there was a shortage of adderall. Whatever. Like I said, I can get by without it. I just hope they never run out of seroquel when I need it. That would be an entirely different story.

flexxdd said...

The funny thing is that we, sufferers of ADD,(or ADHD in my case) certainly do not choose to need Adderall. Obviously, one can make the argument that no one NEEDS anything as long as they continue to breathe, and have a heartbeat, et cetera, but you know what I mean. Personally, I have tried MANY alternatives to Adderall but all have fallen short in regards to the desired results. I too, cannot express how upset I am when every single month I have to fight with pharmacies, over getting my prescription filled because of the 50,000 regulations, or the shortages, or the pharmacist's discretion, etc. It is absolutely ridiculous when I have to set aside a full day every month in order to "hunt" down my prescription. In Florida, they won't even tell me if they have enough to fill my prescription over the phone, instead I have to drive around the county every month, and see the same annoyed faces, at the same pharmacies, to hear the same news, month in and month out. Imagine if it were any other medication, people would riot in the streets if they couldn't function to the ability in which they had become accustomed to, over long periods of time (about 8 years for me). I am 6 months away from my B.S. in Computer Engineering at the very top of my class, and nothing has ever been able to center my studies like Adderall has. Period. I don't make the rules, I just accept that these are the rules, according to my individual genetic makeup. Give me something else that works as well and I'll gladly switch. Just stop treating me as if I'm a barefooted, "pillbilly" trying to get my "fix" and try to be considerate of my plight.

Anonymous said...

I feel like crying as I'm reading this because we're all suffering needlessly. This month I had to switch doctors in order to get my IR adderall script. Previous dr made the decision that he'd no longer write scripts for the IR. The XR did not work for me - I was on a rollercoaster ride. Finally got the script 10/6. Drove to six pharmacies but they were out. Settled on a partial script - I'd lost the focus for driving/functioning -- and was relieved to have found that. I agree, I hate feeling that they think I'm drug addict when I just want to be able to get out of bed and function. Definitely seems like a drug company scam. Wondered if any compounding pharmacies made it? In Fla the pharmacy can't even call other pharmacies to see if they have it. Driving around in ditz mode is really hard.

Anonymous said...

To the latest Anonymous: If a drug is commercially made, it cannot, by law, be compounded. So even though the Adderall is tough to come by, it can't be compounded. At least in Missouri, pharmacies can call to see if anywhere else may have the drug. As for telling people over the phone how much we have, we will tell a Dr's office if they call and ask. If a customer calls and asks if we have "X" amount, we may or may not answer that. Sometimes you don't want people to know how many C-IIs you have locked up somewhere!

nograce1006 said...

Oh my, I had no idea this shortage was going on until two days ago when I took my script of 20mg Adderall to my regular pharmacy and was simply told they didn't have that, no explaination, no "We should be getting that in on such-and-such day". I thought it was strange but I went to another pharmacy later, no worries and was told they didn't have it either, "what?" was all I could muster. At first I thought there must be some dark cloud just hovering or a conspiracy against me, till the pharmacists offered some comment about the situation. That night I spent 3+ hours calling every major pharmacy chain available from the metro Detroit area all the way to our home town, Fort Gratiot. With various answers and even some hopeful leads I spent most of today, 40 some miles from home calling and seeking this medication, and like most of you commented, I felt like and was treated as though I were a complete drug addict!

Like another commented I suffer from dibilitating depression and ADHD, and with two very small children and my job as a high-school teacher there is no way I can function properly without this medication. I do agree, working with many children in a high-school setting as I do, this drug is way over used and has become a standard crutch for many students. I can tell right away the kids that truly need it and the ones who are either abusing it or possibly someone else in their life is actaully the abuser as they don't even use the drug themself. When I started teaching some 12 years ago, anytime there was drug dogs or busts for illegal items in the lockers on the students, it was always those traditional substances, marajuana, cocaine, alcohol, sometimes some of the newer drugs like exstacy, now, there is almost always some sort of prescription drug especially aderall and ritilin. So really there are all sorts of ways to view this issue but my main concern is the prescriptive benefits that I receive from this medication and where I'm going to find it next. I had to have my Doc re-write my script for 10mg of 120 tablets to equate the dosage I usually receive. I ended up finding a pharm that could fill most of the script, 102 of them, so I took it, for a very inflated price than what I ususlly pay for it I must say. This whole thing is just scandalous!

Oh, and just as a side note, the manufacturers of the generic form of adderall have a new drug, I smell a rat, considering Aderall is currently unavailable, yet here's the new drug, probably triple the cost, that the manufacturer, Sine I believe it is, has the sole rites to and does not have to share with the manufacturer of the non-generic form of adderall. Mayber there should be some research into that, sounds like a conflict of interest if you ask me!

Anonymous said...

adderal 150.for a 3o day supply? what is going on? this is not America.

Tank Murdock said...

Something is funny. I'm here in L.A., same thing. And it's very tough to get any kind of solid answer from the pharmacists. The generic (BARR) is made in Israel, so maybe there's some problem there that causing the shortage - war, etc. It's an incredible hassle and adventure every month, with a couple of pharmacists looking at me like a drug fiend, when in fact the drug is for a legit condition (and has helped turn my life around).

Two different pharmacy assistants (at different locations) made the same crack about the drug being hoarded by rich folks to give to their kids to help them with school, the SAT etc. Yeesh.

Yes, I can sympathize with the Pharmacist getting the stink eye over the brand name price/copay. It isn't their fault. One of the real problems is that the drug is scheduled and that's due to too many abusers out there, and they abuse lots more than Adderall. Hopefully the bottle-neck will be broken at some point and the big Adderall hunt I've had to go on each month will disappear. But it has been bad for quite some time now.

Anonymous said...

I've been on the same hunt as everyone else and I'm sypathetic for the pharmacies it really isn't their fault and as for some of the looks I've recived I can't blame them I've seen a lot of people out there with drug abuse problems but I will say this I personally need it I can't function without I can't focus and make stupid mistakes and am a wreck after a few days of not having it I have actually fallen and got hurt because I simply can't focus on walking but I do want to say thank you to the pharmacies here in va they have been most helpfull in my hunt and for the addics that don't need this they need to stop cause its causing even more problems for us that need it for everyday life it isn't fun not being able to function just cause someone wants sometype of fix and for the ones on this page that feel bad for needing your medication for a medical reason don't the people that are abusing this should not you and be patient with the pharmacies they don't enjoy this anymore then we do and as for the people that manufacture this medication shame on you if we have something that works then don't make up this shortage to push something that don't work on us or something we can't afford. I have sat here reading for an hour or more and as for the person that said if it were anything else we would protest your probably right but we are all so confused at the moment the people that need this medication couldn't orginize something like that but like I said thank you to the pharmacies here in va for assiting me in my search every month and for every one else good luck and keep your heads up this can't last forever

Anonymous said...

There was a time in my life where I thought I was hopeless and nothing could help me. Adderall changed my life, personal relationships, confidence, depression, ability to function like most "normal" people, and now I can't get it? I'm feeling as though I'm going to begin failing at life again. Whoever is in control of this just doesn't understand that there are some people that need medications to get through the day. What alternatives are there? Currently I'm taking 20mg of IR. What is the big difference between IR and XR? Sincerely, Afraid of what my life will once again become.

Anonymous said...
This comment has been removed by a blog administrator.
adria said...

I live in New Jersey along the river across from pa....all the pharmacies here have generic ir. and are still receiving new shipments regularly...

....

Weary said...
This comment has been removed by a blog administrator.
Shannon Kish said...

I have narcolepsy and adderall is imperative for me to stay awake. Sadly, this shortage is becoming more and more difficult

Dominic Molise said...

To Weary -

The definition of abuse is using something improperly, i.e. taking a pill whenever you feel like it, instead of the manner it which it was indicated by the prescriber. I take my meds exactly as prescribed - 20mg x 3/day, spaced 4 hours apart. Like I mentioned before, I've taken this medicine, which is prescribed to me by a psychiatrist (not some poorly-trained primary care doc) for a very serious and debilitating psychiatric disorder, for 10 years. Anyone who has taken adderall for any significant length of time will tell you that it eventually does not work as well as when they first started taking it. It's basic pharmacology - saturating dopamine receptors in excessive dopamine causes the autoreceptors to eventually downregulate the amount of allowable stimulation in order to protect the receptors from damage caused by oxidative stress - otherwise known as "tolerance". This is a universal reaction that anyone would eventually experience after continuous exposure to a catecholaminergic releasing agent, even when taken within the therapeutic range.

It is just the way the drug works. Painkillers and other like-substances are used both legitimately by people who need them, and abused illegally by those who are looking to get high; but that doesn't change the fact that BOTH the user and the abuser will feel high when they take the drug. One of the main side effects of amphetamines is euphoria - which makes you FEEL like a "god among imbeciles" even when you are not, and even if you don't realize that this is the feeling that you are experiencing. Anyone who says different is in denial. And that is exactly why I commented in the first place - to warn that anonymous poster of the dangers of relying on the adderall too heavily, because if you don't, then you really do risk the chance of becoming an addict without even realizing it. In order to use this drug responsibly, you absolutely MUST be cognizant of the effect that it has on you, and be honest enough to call it for what it just simply is - drug-induced euphoria.

I posted that warning for not just that anonymous poster, but for anyone that is considering using, or ab-using, adderall. People need to realize what they are really getting themselves into when they talk about long-term use of a psychostimulant. Adderall is not the miracle that it appears to be and I don't want ANYONE to ever fool themselves into believing that lie. I did - and I have paid a huge price for it. Not because I abused it, but because I relied on a drug to fix something that I should have tried to resolve without it. That's tough to do though, when you're 12 years old and every doctor you come across tells you the same thing - adderall will fix you.

Lacie said...

I work in the medical field. At the office I get to deal with MANY patients who need adderall to get the job done, xanax to make them chill out, ambien to make them sleepy, zoloft to make them happy, Lortab to make their smashed finger stop hurting (NOT EVEN KIDDING), & so on...I've read every single post on this page & started wondering to myself... Do drug addicts know they're addicted??? I've taken Adderall since I was 13 y/o for ADD. I'm now 23 years old and honestly ashamed to bring it up because I feel like people are looking down on me for needing it to get through the day... But does that mean I'm addicted??? Am I addicted to Adderall?? Sure I can go without it, but do I want to? NO! Because I know how I would literally spend all day being lost and forgetting my head if it wasn't attached to my shoulders!!! That's not how I want to spend my days. I could if I didn't want to work because then I would just sleep all day. But I WANT to work... I WANT to be able to do my job that I love. I couldn't do my job if I didn't have my meds. So, addicted or not, I've asked myself the question & I gave myself an answer... So what's yours?

harleybabe66 said...

I agree with Weary, you do need a 12 step program!!! We the people that do need it to function every day is paying the price for the ones who don't need it. I have also been on this drug for years, I am not addicted to it and can not pay attention or have the patience to pay attention without this medication. So, I can say I am nothing like you described of yourself and sounds to me you may have some other problems to go along with ADD or AD/HD and maybe you should be re-evaluated!!! There are a lot of people that need this medication and we function in society as normal human beings not addicts. If you feel the medication is a waste of time why do you keep buying it? You just cause more of the shortage.

Anonymous said...

Shire caused all the problems. They created shortages
http://www.fiercepharma.com/story/shire-blames-adderall-shortage-dea/2011-05-06

Anonymous said...

My 20 year old son was struggling with school. He was recently diagnosed with depression and ADD. The depression from my wife and ADD from my side. Since he began taking Adderall his grades improved from low D's to B's and A's. He is more helpful around the house, proactive studying, 180 degree turn around since he began medicating. Unfortunately, living in the pill-mill capital of the world, every time he goes to get his refill he is looked at suspiciously. My wife being a nurse and knowing the propensity for selling it and addiction, administers it to him every day allowing her to control. So we know his use is a legitimate one. It's been 32 days since his last refill, he is totally out and can't find a pharmacy in Tampa. Last couple of weeks of school and we're afraid how long is this shortage going to last and the how it may impact his grades the second half of the semester.

Anonymous said...

Why are not pharmacies being more pro active about taking care of the problem? Pester the company who makes the medication, contact the people who can make all this big headache. You knew you were running out and yet let it go to this point. People need to speak up. That a so called industrialized nation is running out of a medication, needed by thousands is unforgivable.

Frantic Pharmacist said...

Its November, and the shortages continue. In my area we've been able to patch together supplies from different manufacturers and use different strengths, etc. but there are some generic brands that my manager refuses to order because they are too expensive (I don't necessarily agree with that, because it leaves people high and dry.) I understand that there may be an issue with yearly 'quotas' being reached by manufacturers -- don't know if that is true but perhaps in the New Year things will get better.

Anonymous said...

If anybody hasn't at least tried ritalin, focalin, or concerta, now might be the time to look into it. Sure, it is no where near the same as adderall, but it will allow you to at least function in the meantime. Another idea is wellbutrin xl (bupropion xl). Many people associate this drug with smoking cessation, but it is actually a novel antidepressant that acts very similar to amphetamine, albeit much slower, i.e. it takes a couple of weeks to see the full benefit. Bupropion is a NDRI class antidepressant that affects only norepinephrine and dopamine, which are the two chemicals that are also targeted by adderall. It is also significantly less expensive - I paid about $30 for a month supply of 150mg xl tabs vs. over a hundred for generic adderall ir. It is not anywhere near as strong as adderall, but it does give me a boost and helps to keep me from sleeping all day.

Anonymous said...

I take adderall 15mg 3x a day and have for about 5 years now. One thing that helps me is that I try not to take it on the weekends when I don't have to work. I feel that it gives my body a bit of a break. It also helps if my doctor or me are unable to make it to my next appointment and have to reschedule. This way I have a few days until I run out and do not have to go without it at work where I need to stay focused.

Anonymous said...

To those people posting who suggest that we try an alternative drug to Adderall, I want to suggest that this might be an option for people who use it for ADD / ADHD symptoms, where there are a number of alternatives available. However, for myself and the many people out there who use Adderall or its generic equivalent for treatment-resistent depression, there really aren't any alternatives for us, except the blackness and despair of debilitating depression.

I have tried virtually every anti-depressant medication available over the past 30 years with virtually no relief from my depression. Finally, a mix of Lithium to act as a mood-stabilizer and Adderall to lift my mood, help me focus and concentrate, and generally make me feel like a "normal" human being has saved my life.

For myself and others like me, this isn't just an annoying inconvenience. I feel that it's criminal for the drug manufacturers to withhold production of a medication that is so critical to so many people's lives. We don't care about the politics of amphetamine abuse or their efforts to push newer, more expensive "alternatives" on the market. I don't have an alternative, except the despair and pain I have to suffer now without access to this medication that has so dramatically changed, perhaps even saved, my life.

Dominic Molise said...

To Anonymous

I hear you man. I've had recurrent refractory depression since I was in my early teens, and Adderall seems to be the only drug that at least puts a dent in the general malaise. I'm not settling at that, though. I have been really pushing my psychiatrist to let me try out some of the more esoteric options that are currently being researched. In particular, I'm interested in adding either memantine or cabergoline to my current regimen because their are some studies out their that have found significant positive results and I figure, what the hell? I've tried everything else but tricyclics, MAOI's and ECT, but I'm not going to go down those roads until I'm certain that I don't have any other options. If anyone's had any experience with either of those drugs, I would be very interested to hear about it.

Bon said...

Hi,
I understand the frustration of the pharmacists who have no control over the shortage. I am a sixty year old woman who has been taking Adderall for as long as it's been available. I have ADHD and treatment resistant depression (antidepressant alone helps somewhat but still have chronic dysthmia..low level depression, with antidepressant medication). The combination of a low dose antidepressant and low/moderate dose adderall has changed my life. I never feel "buzzed" or "high" as some people who use the medication recreationally feel...and I didn't have that feeling when I first started taking it..I only felt relief for the first time in my life..I imagine it is what the average person;s "normal" feels like..I am focused, yet calm..not euphoric, but clear headed and balanced. I can still feel happy, sad, excited, angry but my moods are related to situations, and on a typical day I feel fine. I have never had to increase my dose, so for the person who claims it is addictive, perhaps this is true for people who do not have attention deficit disorder ..for many, it is the only medication that besides helping them focus,relieves depression (which may be the result of ADD/ADHD when it isn't being treated)). I have tried ritalin and dexedrine and they are not very effective in my case, causing unwanted side affects. I have participated in cognitive behavioral therapy, thinking that perhaps I could stop the medications...each time I've tried this my symptoms have returned. So yes, there are people like me, who were lucky enough to be prescribed the right combination of medicine to greatly improve quality of life. This shortage is indeed troubling.

Soon to be useless w/ no meds said...

Please don't drive around looking for it! Go home and use your phone! I called 7 pharmacies before I found it last month. The 7th one was one of two I drove to the previous day who were out. It's all in the timing in some places.

Soon to be useless said...

Shire (manufacturer) vs. DEA

"The DEA determines an annual quota for each class of controlled substance. Manufacturers submit applications to DEA for a portion of the quota."

Wall Street Journal:

http://online.wsj.com/article/SB10001424052748703992704576305482186274332.html?mod=WSJ_article_comments#articleTabs%3Darticle

Anonymous said...

FYI If you live in Arkansas and are having trouble finding Adderall or the generic you should contact any of the Cornerstone Pharmacy stores. We are working hard to maintain our supply of this medication and should be able to fill your prescription. See our website for a location near you www.cornerstonepharmacy.com

Dominic Molise said...

Can somebody who works at a pharmacy in coastal MS, LA, or AL post if they have Dexedrine in stock? My doctor wants to switch me from adderall to dexedrine because of my anxiety, but I can't find anybody that even carries it. Any help would be greatly appreciated.

dmzelda203 said...

To the person that said that someone else was crazy and that generic medications are the same as brand name:

My opinion differs from yours on that. I am a nursing student who studies pharmacology and medication administration continuously, and I also have a background in biological sciences.

Prescription drugs, even when they are the same "drug," can be manufactured differently. The processes for synthesizing drugs and certain procedures may not be exactly the same, so the active ingredient may be produced differently--and it may also be produced along with different byproducts. Also, most of what you physically see in a pill is filler material, and those materials could certainly vary from brand name to generic. So, although the active ingredient is of the same name and composition, it's rate of absorption could certainly affected, and it's overall effects could potentially vary (or be less effective).

This is known in the medically community, and it is my understanding that it is more common in certain medications than others for there to be a different between generic and brand name. For that reason, primary care providers will, under certain conditions, specify that the ordered medication is only brand name and that a generic is not used.

Please don't feel like I'm trying to rain on anyone's parade! I agree with you for the most part... typically, the generic does exactly what it should do, nothing more, nothing less, and for the price different it makes sense to go with a generic version. I just wanted to let it be known that there can be differences, and someone who believes that a generic does not work as well for them might not be "crazy."

Anonymous said...
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Anonymous said...

Adderall outage is affecting us in CA....Teva/Barr and brand NOT AVAILABLE! I called around to other pharmacies, and I am planning to ask my Dr. to write my script for Ritalin, (one pharmacy has plenty). I took Ritalin when first diagnosed, I remember it worked ok, Dexostat was by far the best IMO (Shire stopped making it due to lack of demand). That is when I switched to Adderall. I am wondering if Ritalin will be as effective...lil help?

Anonymous said...
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Dominic Molise said...

To Anonymous,

You know, I am really getting tired of people who don't even use this medication posting inflammatory comments like this when they don't even understand the science behind the biological mechanisms that cause these reactions. Once and for all - ADDICTION is when you continuously overuse a substance for a purpose other than that for which it was prescribed. DEPENDENCE is when you have used a medication for so long that your body adapts to the substance so that it cannot function properly without it. WITHDRAWAL is a NORMAL bodily reaction that EVERYONE will experience if they abruptly discontinue ANY psychoactive substance after using it for an extended period of time. Amphetamines do this to EVERYONE that uses them, regardless of if they are taken at levels above, within or even below the therapeutic range.

This is just how psychotropics of any kind work. Try telling someone who has taken lithium for 20 years that they are an addict just because they can't get off of it. Or for that matter, antidepressants, antipsychotics, anticholinergics, antihistamines, MAOI's, anxiolytics, Alzheimer's and Parkinson's medications - all of these also cause withdrawal, even though they are used LEGITIMATELY.

Another thing is that people aren't driving 30 miles to get a bottle of pills just for the sake of staying "focused." This drug is important for many people just to feel some sense of normalcy and control in their lives. That doesn't make them addicts, it makes them patients. And by the way, you saw yourself what it looks like to withdraw from adderall, well the same thing happens to us when our meds are suddenly unavailable. People don't have the luxury of being able to detox in the middle of trying to just live their daily lives. Suddenly running out of medicine in the middle of a hard work week or while you're trying to prepare for final exams can be absolutely devastating; not to mention being subjected to the immense neuropathic pain, insurmountable fatigue and possible suicidal ideation. Until you have personally experienced this, you really have no right to just throw unjustified accusations around, especially when you don't possess the expertise to make such judgments. Just because you work in a detox ward doesn't make you an expert on neurobiology.

Anonymous said...
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Anonymous said...

As a R.N. and Narcolepsy patient,
Adderall was an absolute Godsend!
But, now after 6 years on this med, I have to go thru a million phone calls to try and find a pharmacy that has any! And, without health insurance, the name brand is untouchable!! The generics are bad enough! I was getting Adderall 30 mg. for approx. $1.33 each. Now, the only thing around is the spansule, or extended release, for $5.00 per capsule!!!! And, that's IF the Pharmacist will give you ANY indo on the phone!!!! A lot around here will not, 'cause they think you're gonna jump in the car and come over and rob them!!! Seriously!! Makes searching for a certain med, or even checking on prices extremely difficult, and stressful!!! Imagine, its been 2 days without your med---your head is making all sorts of "odd" and "Weird" sensations in your brain, like its swimming in a pool, or something! I can never describe the actual "head" trip that occurs when a psychotropicis suddenly withdrawn, but it is strange, uncomfortable and I don't even want to think what happens next---that's about as far into withdraw that I've been so far, and I would prefer not to return!! I have the Rx's from my Doc, but they don't do much good if there's no medication to fill it with!!!!! I would think that the Manufacturer has a certain responsibility to all the patients that are now "hooked" on this miracle med!!! Why doesn't someone with the authority and "pull" to punish them do something??? My pharmacist told me he called the Manufacturer and was told there was a lack of the " basic ingredients" and they were having a very difficult time obtaining them. WHAT??? That excuse might be OK for, say... a bakery, that has run out of the batter for your favorite cupcake! BUT---we're talking long time use and "therapeutic blood levels"!!!!!
Not a sugar craving!!!! Too bad the rich always can afford what isn't available to us peons, cause you can bet on it that if some rich kid needed his adderall---Daddy would start up a new drug company just for the purpose of keeping his child on an even keel!!
Imagine the chaos at all the "Prep" schools if there suddenly were no CNS stimulants available??? Heck, imagine the chaos there WILL BE if a suitable substitute isn't available soon---just might have to start my own OCCUPY---just for Adderall!!! Oh sure, that will work!!

Anonymous said...

RN
I agree wholeheartedly. I've been taking "adderall" since 2000 and it was a godsend. I used to pay a 3.00 copayment for a brand name medication that worked. I feel like Robert DeNiro in awakenings without it. Now I pay 150.00 for 20mg that I cut in half so it lasts two months and costs less. I dread everytime I have to fill the script because for the last year and a half I've had to call 50-100 pharmacies and this last time I didn't get the same adderall that I've been getting. It feels like generic and it's from that crappy company TEVA. Shire, the FDA, the DEA and pharmacy's need to get their shit together and realize ADD and related neurobiological conditions are REAL and need to be addressed as such. If people don't get the medication they need they will self medicate and the consequences could be catastrophic to those individuals.

Anonymous said...

. It takes a large amount of intelligence and empathy in order for the non ADDer's to understand the how 'real' ADHD is. An ADDer need his or her medication as much as a person need their glasses to get around, drive, read. I wonder if anyone ever says, Prescription glasses or over prescribed! Parent's just want an excuse for their kids bad grades? FLEXXDD said it best, Sufferers of ADHD don't choose to NEED adderall! My two daughters including myself go to doctor everything three months for med check, call in the refill everymonth then have to drive over to the clinic to pick it up then spend hours on the phone trying to find a pharmacy that has adderall!! I can't even imagine having a job and trying to keep up with the adderall race! As for college kids abusing it, well maybe true. Kids were getting high on spray cans back in the day...is it safe to assume most people buying spray cans were buying them to get high?

Dominic Molise said...

This really has been a rough year, hasn't it?

Anonymous said...

Has anyone heard anything positive about the shortage of adderall? I really am not concerned about all the hypogrties who say that it is abusive. I know this it has changed my life for the past 2 years. I have felt better, focused, alert, helpful in my job and home life. Hope we get better news soon.

ironmen150 said...

My doctor informed me that the adderall generic shortage was caused by several of the generic adderal companies being bought out by corepharma. Now I believe there is one or two generic companys left including corepharma. They have one plant making the meds and are trying to catch up. Things are finally catchin back up. Last summer, adderall generic was 10 dollars. Now mind you with the cost of manufacturing, the machines, the matanience, there simple was so money to be made by the companys. SO corepharma pulled a fast one, bought out the other mfgs who were glad to get out of the market as it wasnt making money, thus leaving them as the top dog for generic adderal. They have one plant creating it, thus shortage, thus price hike, thus charging name brand prices. Very smart, but very criminal in my mind. Ethics and integrity dont go far these days do they?

As for positive? Yes the supply is begging to increase again, but the cost will never be as low as it was.

My conspiracy therory by the way involves nuvigil. Last year they promoted it to help adhd and add as well as the initial use (work shift sleep disorder). The price of nuvigil is 360 a month w/0 insurance. I wouldnt be supprised if nuvigil was behind the corepharma take over of the generic adderal, decrease the supply, and force people to try nuvigil. I tried it, horrible stuff for me, but others liked it. Its just like provagil.

Anyways theres my 2 cents.