Xanax and Adderall Access Is Being Blocked by Secret Drug Limits 242
Patients diagnosed with conditions like anxiety and sleep disorders have become caught in the crosshairs of America's opioid crisis, as secret policies mandated by a national opioid settlement have turned filling legitimate prescriptions into a major headache. Bloomberg reports: In July, limits went into effect that flag and sometimes block pharmacies' orders of controlled substances such as Adderall and Xanax when they exceed a certain threshold. The requirement stems from a 2021 settlement with the US's three largest drug distributors -- AmerisourceBergen Corp., Cardinal Health Inc. and McKesson Corp. But pharmacists said it curtails their ability to fill prescriptions for many different types of controlled substances -- not just opioids. Independent pharmacists said the rules force them come up with creative workarounds. Sometimes, they must send patients on frustrating journeys to find pharmacies that haven't yet exceeded their caps in order to buy prescribed medicines. It's unclear how the thresholds are impacting major chain pharmacies.
The Drug Enforcement Administration regulates the manufacturing, distribution and sale of controlled substances, which can be dangerous when used improperly. Drugmakers and wholesalers were always supposed to keep an eye out for suspicious purchases and have long had systems to catch, report and halt these orders. The prescription opioid crisis, enabled by irresponsible drug company marketing and prescribing, led to a slew of lawsuits and tighter regulations on many parts of the health system, including monitoring of suspicious orders. One major settlement required the three largest distributors to set thresholds on orders of controlled substances starting last July.
The "suspicious order" terminology is a bit of a misnomer, pharmacists said. The orders themselves aren't suspicious, it's just that the pharmacy has exceeded its limit for a specific drug over a certain time period. Any order that puts the pharmacy over its limit can be stopped. As a result, patients with legitimate prescriptions get caught up in the dragnet. Adding to the confusion, the limits themselves are secret. Drug wholesalers are barred by the settlement agreement from telling pharmacists what the thresholds are, how they're determined or when the pharmacy is getting close to hitting them. The exact limit for each pharmacy is kept secret in order to prevent pharmacists from gaming the system, according to Krista Tongring, leader of the DEA compliance practice at Guidepost Solutions and a former agency attorney. The purpose, she said, is to keep pharmacies from manipulating "their ordering patterns so as to get around the thresholds." According to a Cardinal Health document, limits are "calculated on a daily, monthly, and quarterly basis," reports Bloomberg. "But without more detailed information, it's impossible for pharmacists to predict when they are going to have to turn patients away."
"Pharmacies can request increases to their thresholds, but those take time to adjudicate, leaving patients scrambling to find their daily medicines elsewhere in the meantime."
The Drug Enforcement Administration regulates the manufacturing, distribution and sale of controlled substances, which can be dangerous when used improperly. Drugmakers and wholesalers were always supposed to keep an eye out for suspicious purchases and have long had systems to catch, report and halt these orders. The prescription opioid crisis, enabled by irresponsible drug company marketing and prescribing, led to a slew of lawsuits and tighter regulations on many parts of the health system, including monitoring of suspicious orders. One major settlement required the three largest distributors to set thresholds on orders of controlled substances starting last July.
The "suspicious order" terminology is a bit of a misnomer, pharmacists said. The orders themselves aren't suspicious, it's just that the pharmacy has exceeded its limit for a specific drug over a certain time period. Any order that puts the pharmacy over its limit can be stopped. As a result, patients with legitimate prescriptions get caught up in the dragnet. Adding to the confusion, the limits themselves are secret. Drug wholesalers are barred by the settlement agreement from telling pharmacists what the thresholds are, how they're determined or when the pharmacy is getting close to hitting them. The exact limit for each pharmacy is kept secret in order to prevent pharmacists from gaming the system, according to Krista Tongring, leader of the DEA compliance practice at Guidepost Solutions and a former agency attorney. The purpose, she said, is to keep pharmacies from manipulating "their ordering patterns so as to get around the thresholds." According to a Cardinal Health document, limits are "calculated on a daily, monthly, and quarterly basis," reports Bloomberg. "But without more detailed information, it's impossible for pharmacists to predict when they are going to have to turn patients away."
"Pharmacies can request increases to their thresholds, but those take time to adjudicate, leaving patients scrambling to find their daily medicines elsewhere in the meantime."
It's getting pretty bad (Score:5, Interesting)
For the last 4 years out of the 10 I've filled the *very same script* from the *same doctor*, I've been lied to about stock. Lied to about the stock of other stores when I ask for an alternative. It's outrageous, but I've found that if I drive my SUV rather than my beater to the pharmacy, I'm about 30% more likely to have a script filled.
For the last 3 months, I've had all of my scripts sent in digitally and I have not had any problems with filling. It seems it's encouraged to turn away by whatever means possible those who come to the window. Regardless of documented history. It's absolutely miserable.
I suppose the larger question is: what in the world is going on with the us (in the US) that made such madness happen-- both in supply and demand. It feels like I stepped between two parties fighting and now they're pointing fingers at me.
I would just like to fill this please. Like last month, and the 119 before.
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what in the world is going on with the us (in the US) that made such madness happen
They'll try any amount of victim blaming to "solve" "the drug problem" but won't spend a single red cent making a better world where the addicts don't feel the need to obliterate themselves, because that would cut into profits. And if you suffer as a result, zero fucks are given for you because that doesn't affect the bottom line.
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It's outrageous, but I've found that if I drive my SUV rather than my beater to the pharmacy, I'm about 30% more likely to have a script filled.
I'm confused. Does the pharmacy go and check the parking lot and ask you for your license plate? Or is this another one of those absurd American "I'm afraid I'm too unfit to get out of my car - drive through" experiences?
I think fundamentally the USA is using all the wrong metrics for all the wrong reasons when it comes to judging people. You're right though with the blame issue. The opioid crisis is not caused by people picking up their medication or pharmacies filling scripts. They were caused by big-phar
Re:It's getting pretty bad (Score:5, Informative)
The [youtube.com] Sacklers [youtube.com] happened [youtube.com].
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It's the same thing as the entire rest of our healthcare system. Healthcare in the US consists of three primary tenets. Number one? Suffer. Unless you have lots and lots of money. Then you can suffer a little less. Number two? Give the medical / health insurance / pharma industry money. LOTS AND LOTS of money. Then give them a little more. Then give them some more. What do you mean you expect some form of alleviation from the suffering for that money? I'm sorry. You should probably pay still more if you wan
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Both of my parents had coverage through Kaiser, and my older sister still does. Their experiences have all been positiv
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In the US? How would I do that when I'm forced to use "in network" doctors, all of whom seem to be laced up exactly the same way. Most of the hospital staff around here are doing everything they can to leave the field because once the bigger places snap up the smaller places it becomes an MBA lead efficiency scheme. Shove patients through as fast as possible, prescribe as many drugs as possible, get them out and get more in. Nobody that I know of from my generation that went into medicine can stand being part of the current machine. It's all about profit and suckering people.
I bowed out. Up to the passage of the ACA I had health insurance. After? It priced me out. I can't afford 17% of my salary (a cost that increases every year regardless of my use) just for the privilege of still getting to pay a massive amount of deductible if I ever have so much as a sniffle. The scam has picked up steam since then. Now we're just racing to see how many people we can make destitute, and how quickly. My country has decided health doesn't matter as much as profit. Not a surprise, just a sad statement of fact.
Quoting myself to add: This is literally EVERY aspect of life for most of us in the middle class now. And there's only so much energy in the day to waste on such things. I've spent six months trying to hire an electrician to fix a busted mast on the house for the main power line coming into the house. We're running out of tradesmen willing to work smaller jobs. They're all hired out to the bigger contractors. And you can't hire a contractor to take care of small stuff. If I wanted to build a new house I cou
Two things (Score:4, Informative)
Second, a ton of working class people started taking pain killers to keep working when they should've been on disability. You get hurt at your job, but you gotta work or you don't eat, so you get hooked on drugs. We decided that "drugs are bad, m'kay" but we didn't want to put those folks on disability and give them addition treatment, so we just cut them off.
Being already addicted they switched to illegal stuff and started dying of overdoes, and politicians smelling blood in the water used that for another round of "tough on crime" bullshit. With a little bit of "border security" nonsense thrown in for good measure (never mind that most of the drugs coming over the border are smuggled by Americans)
So the usual suspects: Corporate Greed & incompetent politicians who would rather fearmonger and punch down than solve problems.
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I suppose the larger question is: what in the world is going on with the us (in the US) that made such madness happen
It is not just the US. I used to get an over-the-counter nasal decongestant in Canada but the last time I tried that they had removed the bottles from the shelves and you had to ask for it specifically. That was then followed by an extensive inquisition about why you wanted it. This surprised me so I asked what this was about since a nasal decongestant is hardly a drug I would have thought could be abused by anyone. It turns out it isn't but it is apparently a very useful ingredient for making illegal drug
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No I didn't. The settlement was on purpose knowing that the victims will get none of it.
Purdue is bankrupt. None of the victims are going to see any of that money. The Sacklers have basically funnelled all the money and assets into their personal fortunes which due to various bits of legal shenanigans ensures it is locked away and untouchable.
The courts are busy actually tryin
Scarcity assures retail price adjustments (Score:2)
I'm hit too...I hate it here. (Score:2)
They claim we can't be trusted to pick and choose what we need to function, but apparently impartial well trained 3rd parties can't be trusted either.
Yeah, I don't need to sleep. BTW if you don't know, that's a great way to trigger mania in some people. Just stay up all the time. I can attest. The one time I was hospitalized I just couldn't sleep more than a few (3-4 max) hours a day, often less than that. But they can't offer benzodiazipines because a-holes will take them and drink to feel great (aka
Re: I'm hit too...I hate it here. (Score:2)
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Quaaludes
Wait, that's why it's consistently "on backorder"? (Score:2)
Good job finding something else government can't do right.
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Governments can do this just fine - my medicine is always available on time and free (at the point of use). There may be problems with your healthcare system, but they aren't caused by the fact that a government is involved, just by how you've chosen to set the system up.
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Do you really think we had any say in the matter?
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The French certainly seem to have solved the problem of getting the current government to listen to them, so that's not an insoluble problem.
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A lack of Ritalin nearly killed my grandmother. That was before this, because I’d be dangerously fucking livid if I had to drive halfway across the state to find the my-grandma-keeps-breathing pills, and I would have been the one tasked with picking up her prescription back then.
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The doctors told us to let her go in her sleep.
My mom made a huge fuss and she got her drugs. She woke up, and lived another decade.
Controlled Substances (Score:2)
Any Controlled Substance in terms of Pharmacology has implications for addiction or other adverse side effects and why they're controlled.
in the US, we have a massive problem with legal pharmaceutical abuse, destroying lives and families. The blame needs to be squarely put on the shoulders of Big Pharma and the US gov't as well as doctors Another way to look at it is that no medication whether prescribed or over the counter should be viewed with caution. Even Aspirin has potential side effects that can be
Re:Controlled Substances (Score:5, Interesting)
The wave of death can be laid at the feet of drug warriors like you and the CDC who were told that laundering the DEA's non-medical policies would cause one, yet doing it anyway.
There were ways to address the abuse without making things universally worse for everyone, but that's not what people are interested, they're interested in mindless crackdowns because they don't understand anything more than 'drugs are bad, mmkay?'. So now we have a crisis of untreated medical issues (including pain related suicides where people just take their own life before even getting a chance to OD on fent) and a illegal drug abuse problem that's soared orders of magnitude worse than our former prescription abuse problem.
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The gov't has coarse-grained controls to deal with things but I think largely too we had doctors in most cases writing Rx that the patient didn't need. I agree that there are patients with valid needs but how do you sift through that when you have potentially millions now addicted from a system that just turned a blind eye to it. "oh shit we have to fix this" just somehow doesn't seem to cut it in my book. I have a friend that broke her ankle 4 years ago, after two surgeries to repair the damage she's facin
Seems like everyone is on one or more drugs today. (Score:2)
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https://hpi.georgetown.edu/rxd... [georgetown.edu]
Sadly, yes, half to 2/3 of the country is on something.
Furthermore, "Data suggests that among those who take prescription medications, the average number of medications taken is four. More than 131 million Americans take at least one prescription medication."
https://www.singlecare.com/blo... [singlecare.com]
And this explains why my Dr lost interest in me so quickly when I went in to have a skin something looked at, (it wasn't cancer). Not on any drugs, no profits for him, on to someone more
Authority (Score:2)
I note that the suffering due to lack of medication is preferred over the suffering from inappropriate access to medication. That is a sick goal, but authoritarians have to authoritate. It is a sacrifice we must all make to live in a society.
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Smoke Some Weed (Score:3)
Best anti depressant is weed. The law in this country needs to be reworked, because the natural drugs that occur including mushrooms, weed, coca, and various plant extracts can be used for these purposes. The government is so caught up in their own control laws, that they have developed a stigma about anything that they think may be bad for you and the population just goes along with it like sheep.
I stand for the Partnership of Drug-Full America.
Re:Smoke Some Weed (Score:4, Informative)
I'm very pro weed myself, but this is very bad as blanket advice. Marijuana can interact very badly with some mental health conditions. If you are suffering from a serious chronic mental health condition, please be very carefulw ith all psychoactives including weed and booze.
Re:Smoke Some Weed (Score:4, Funny)
Well, it seems weed definitely didn't help your paranoia.
The War on Drugs (TM) ... (Score:4, Insightful)
... seems to have completely passed by the US domestic Drug Lords. It's almost as if they're protected and incentivized by law.
Mhmmm, I wonder how that could happen in 'The Land of the Free'(TM)
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FDA is Greed (Score:2)
People can say all kinds of platitudinous things about the FDA but the real, rubber-hits-the-road fact is:
The FDA is an organization that ensures that only expensive drugs can make it to market and simultaneously an organization that ensures high prices and availability scarcity in the market.
This serves the needs of the pharmaceutical corporations just fine. The same corporations that also provide a majority of the working funds for the FDA, so - shocker.
The biggest problem is that Americans are taught in
The DEA interviewed me last year... (Score:2)
Over-prescribed? (Score:3)
Maybe this is because Xanax and Aderall are being over-prescribed and people don't really need it. The companies see how badly Purdue Pharma and others got effed from oxy being abused and are wary of the same thing happening to them.
By design (Score:3)
Maybe if our medical system was structured so that you could spend more than a few minutes with an actual doctor, then perhaps doctors could actually make an informed judgement on their patients and what they need. As it stands, unless you have a condition that can be accurately diagnosed in under 3 minutes, you will be getting diagnosed with a best guess. If they come up with a educated guess in the first 30 seconds, that's even better (for the doctor's office). I don't blame the doctor, it's just how the math of student loans, malpractice insurance, and patients and insurance companies who can't or won't pay works out - if their office doesn't see a certain number of patients a day, it goes out of business. Excluding dentistry (which I will only have done in Costa Rica now), I don't think the total combined time I've seen doctors in my adult life is a full hour. And I'm over 50 now.
A side effect of this is that it is difficult to tell from the outside if the doctor is doing their best in a completely screwed up system, or just giving their patients whatever prescription the patient wants. I know I've done an online doctor's visit where I told them what I had and what I needed and they just sent the prescription over - not a narcotic, but there was literally zero diagnosis on the part of the doctor and he asked zero non-insurance related questions.
The drug companies love that this current system is screwed up. The complaints are music to their ears, and the problems are probably by their own design in their settlement. Now watch as every safeguard is slowly dismantled in a series of unrelated bills over the next few years to "help the suffering people". And they will be serious about wanting to reduce suffering - you can't imagine the pain and anguish that occurs when a CEO's stock options vest and the stock price is not at an all time high.
Comment removed (Score:4, Informative)
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My side effects lasted longer than I was on antidepressants too.
Re:Time for other drugs (Score:4, Informative)
I have used 6 different antidepressants throughout the last decade: sertraline, bupropion, mirtazapine, moclobemide, milnacipran and agomelatine. I was easily able to drop any of them cold turkey and the worst withdrawal symptoms were headaches for a couple of weeks after stopping taking sertraline. Headaches are bearable. So yes, not that addictive.
There is some seriously addictive shit when it comes to psychopharma but the run off the mill antidepressants aren't.
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Getting off Citalopram, I felt nothing. But getting off Bupropion caused me to spend three days in bed hallucinating pulsating colored triangles so vividly I could barely drink water.
The plural of anecdote is not data.
People’s bodies and brain chemistry are different.
Re: Time for other drugs (Score:2)
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They have and this is why antidepressants can be prescribed so easily. Actually addictive medicine results in far more paperwork.
Stopping cold turkey is, by the way, not how antidepressants are supposed to be dropped. Just because I did it this way it doesn't mean everyone should since some people can cope with pain better than others.
According to the German cilatopram leaflet,
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2 of the SSRIs I've been one were fine. But the 3rd, citalopram, when I stopped taking it cold turkey I would become too dizzy to even stand up, along with severe nausea and headaches that were decidedly not bearable. But thanks for your anecdote. Maybe actual studies with large numbers could settle this? Oh, wait...
Yes, SSRIs shouldn't be quit cold turkey, thank you Captain Obvious, and the guy who prescribed it to you told you that, but you chose to ignore his advice. Nevertheless they are NOT addictive, as in, you don't feel an irresistible compulsion to get another dose. And if you slowly taper them off, like your doctor told you to, there's no problem getting off them.
Re:Time for other drugs (Score:5, Interesting)
Seconded. My GP wouldn’t prescribe Wellbutrin until everything else he could try had been tried, since dependence was so bad.
I can’t remember what it was that I was on, but it had me hallucinating music or not-quite-audible talk radio whenever there was silence. I was instructed to crash off it, not taper (I was at the minimum dose anyway) and after about a very apprehensive week, I spent three days in bed, drenched with flop sweats, consuming only water and vividly hallucinating throbbing searing-bright triangles with all my senses. It took more than three days to be “okay” but it was three days before I could consume anything but water, because it took a supreme effort of will to shuffle to the bathroom, fill and drain a glass, and take a leak because of the sensory overload inflicted upon me by withdrawal symptoms.
My mother is on something which I fucking hope ain’t scheduled, because if she doesn’t carry out a VERY careful and gentle taper, it will trigger a massive heart attack.
Drug cessation needs to be carried out under controlled circumstances for anything more interesting than Tylenol. I was going to use Advil as my example because that’s less toxic than Tylenol, but that has serious implications when combined with blood thinners or Aspirin, so no, even that has to be managed carefully too, in some subset of patients.
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Buproprion was one that my GP was hesitant to prescribe because the withdrawals sucked in everyone he tried to taper off the stuff, and most people he tried to get off it simply had to go on a low maintenance dose indefinitely.
Re: Time for other drugs (Score:3)
Same, I've had no problems with it.
Re:Time for other drugs (Score:4, Informative)
Re:Time for other drugs (Score:4, Interesting)
Bullshit Zoloft is non addictive. Go cold turkey from it and tell me how you feel in a few days when every time you look around you brain gets zapped and studders.
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Which is physiological addiction. Your body is addicted to the effect. There's just no instant response for your body to associate that effect with an action such as taking an SSRI since there's no instant response.
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Anti depressants do work and are not that addictive.
Those of us with treatment-resistant depression might beg to differ. Staying in your own lane of competence regarding medical issues is an art YOU may have to master.
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Those of us with treatment-resistant depression might beg to differ
Does not sound like you have the wherewithal, and your doctors may be incentivized to keep you believing you are so afflicted. Maybe it is time we give therapy and in bad cases, commitment to a mental facility for treatment. We have drastically reduced mental institution use, and I am starting to think we overshot the mark on how much we should use of these treatments. Medication is not always the answer.
Re:Time for other drugs (Score:4, Insightful)
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Re:Time for other drugs (Score:5, Interesting)
If a pill a day keeps the asylum away, I think the pill is probably a winner.
Having said that, you should look into the difficulties of treatment resistant depression. You can’t just check into rehab for some therapy and leave in a month. First off, American health care. You wouldn’t have insurance the moment you needed to use it, for starters! Because a month or two of inpatient treatment will get your ass fired from most jobs. And if you’ve got the rare boss that respects FMLA, wellthat’s still a couple months of unpaid leave, and the average American can’t make an unexpected $400 payment.
But to end on a note of hope, ketamine is beginning to look more and more like a one-and-done cure for many cases of depression, and for those who aren’t completely cured they’re often left with permanently improved symptoms. Likewise, psychedelics combined with talk therapy seem to make permanent inroads into curing or reducing symptoms of depression, PTSD, phobias, and anxiety. So one day, a few rounds of intensive therapy may be the one-and-done cure you’re implying should be available to all.
And frankly it should be, fuck Nixon and his war on drugs.
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Antidepressants are extremely addictive, the worst withdrawal I've ever felt.
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You’re being pedantic, and I suspect you know it.
People can easily become dependent on SSRIs and suffer withdrawals with a poorly managed discontinuation.
Re: Time for other drugs (Score:2)
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There are other drugs to deal with these things. Anti depressants do work and are not that addictive.
The other drugs are only adequate in some cases and being used when they are sufficient.
If other options would suffice, or the patient's prognosis if Not using a drug wasn't more severe than expected side effects, then they would be prescribing these. Prescription opioids are a last resort, but still very necessary.
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Preventing people who are not abusing anything from filling legitimate prescriptions by artificially restricting supply to retailers is not a solution, it's a new problem we didn't need.
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Anti depressants do work and are not that addictive
Anti depressants do not work for everyone, and you are not supposed to go off of any of them suddenly, in many cases even if they are not working for you.
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I went off one suddenly on medical advice, because shortly after starting it I had begun to hallucinate music.
It was medically necessary, but it was also one of the most unpleasant experiences of my life. Three days without sleep, in bed, flop sweats, unable to eat, while I vividly hallucinated throbbing technicolor triangles. Not just with my eyes. Full fucking synesthesia. Kept going for most of a week, but I could sleep on the fourth night.
I agree with you, but I don’t think you’re really do
Re:Time for other drugs (Score:5, Insightful)
But from what I've heard from people who are taking them and stopped for whatever reason (side effects can reduce quality of life a lot), they do can have some severe withdrawal symptoms.
Turns out that brain chemistry is complex and that there's no one-fits-all type of medication for everything. Effective therapy often has to be determined on an individual basis.
Also I'm not sure what alternative drugs there are other than stimulants for people with severe concentration problems due to ADHD for example.
In these cases, stimulants like amphetamines or methylphenidate (both of which can get you high if taken in large enough doses and are therefore abused recreationally as well) are the only known treatment to be effective there.
Maybe in the future something will be found, and we should certainly be keeping an open mind for effective treatments and follow the evidence, but for now such limits imposed on pharmacies do not seem like a sensible idea.
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Why the hell is this marked "troll?" I'm on antidepressants and it's absolutely correct. Using them instead of addictive substances: Correct. Slow to kick in: Some of them, not all. Suffering is something to master: Hell don't I know it.
It's a little off-topic, but antidepressants can absolutely be used to treat anxiety, and addictive stimulants are a bad way to beat chronic fatigue or depression.
The mods must be crazy.
Re: Time for other drugs (Score:2)
Then I mentioned suffering, which is a very uncomfortable topic. Makes us all nervous, while it is a part of everyone's life.
Did post the comment since I have some experience in the field as a patient. Confrontation should not be avoided. Also posted the comment si
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... Suffering is an art that others have to master.
FIFY
Re:Here you go again, pooh-poohing the problem! (Score:5, Interesting)
Anxiety disorders can't be dealt with by talking therapy and can't be just "dealt with". The difference between regular anxiety and a disorder is that, with a disorder, it's totally paralyzing, highly persistent, and has no external cause. It's due to brain chemistry and brain wiring. Only by changing the chemistry can you get rid of such disorders. Self-medication, often with alcohol, is the only viable alternative to drugs. And it doesn't stay viable for very long.
Re:Here you go again, pooh-poohing the problem! (Score:4, Insightful)
There are plenty of coping mechanisms and cognitive behavioral therapy that works for anxiety, even if it's not a "cure." But medication helps greatly with the process. I don't think you would have the capacity for treatment without the medication.
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It's like you didn't read what I said. There are mental strategies that help you avoid creating the anxiety but you have to reduce the anxiety enough to work on it first. That would be an end goal of getting off the medication or greatly reducing the dose at the very least.
If you have a tooth with an abscessed cavity, it needs removed. But in order to remove it, they prescribe antibiotics and pain medication first. For one, inflammation causes anesthetics not to work as well. And let me tell you from e
Re:Here you go again, pooh-poohing the problem! (Score:5, Informative)
> Just because Xanax helps your anxiety doesn't mean your anxiety is caused by "chemical imbalance",
Uh, you're completely wrong. Sometimes. The problem with anxiety disorders is that there is no "root cause." Everyday things that most people ignore cause huge amounts of anxiety in some people because their neurological biasing is just faulty. No amount of "talk therapy" is going to fix that. It simply can't be rationalized away.
As an amusing example, I suggest you find your local meth addict going through a paranoid delusional episode and try and "talk" them out of it. The effects of neurological biasing will become quite obvious. You can try it with drunks too. Equally ineffective.
Yes, these are extreme examples and the biasing agents are external. Know what? THAT DOESN"T MATTER. Neurochemistry doesn't care about source.
Re: Here you go again, pooh-poohing the problem! (Score:5, Interesting)
Re: Here you go again, pooh-poohing the problem! (Score:3)
This probably explains why it has been such a pain in the ass for me to get Adderall filled. The pharmacist told me that it was due to a national shortage, which never really made any sense to me. I've been prescribed that to manage ASD.
Re: Here you go again, pooh-poohing the problem! (Score:5, Interesting)
I've run into that: pharmacists giving me completely wrong statements about why they can't provide me a medication. This was not anything psychoactive or addictive, just a very common medication. They told me it was backordered with the manufacturer. It was not until weeks without it that I found out it was actually being denied by the insurance company because they were demanding a prior authorization.... Then that turned out to not actually be quite true either. What it actually was is that they wanted my prescription changed from the 5 mg pills to 10 mg pills that I could split in half because it was cheaper. I find the way this all works to be very disturbing. In my case, I didn't need the pills to live per se, but it makes me really feel for people who absolutely depend on their prescriptions to stay alive or not suffer horribly or have permanent damage done to their organs, etc.
Re:Here you go again, pooh-poohing the problem! (Score:4, Informative)
"Aspirin insufficiency" is some funny shit. I'm going to remember that one and use it as often as possible.
Re:Here you go again, pooh-poohing the problem! (Score:5, Insightful)
BULLSHIT. Any doctor who says that should have his licence revoked. Just because Xanax helps your anxiety doesn't mean your anxiety is caused by "chemical imbalance", anymore than aspirin helping your fever signals that the fever is caused by "aspirin insufficiency" or whatever, rather than infection.
Your view on this seems wrong. Anxiety and depression are known to have, as one set of causes hyper- and hypothyroidism respectively. So, how will talk therapy fix that as opposed to treating the thyroid condition? The thyroid condition could be caused by cancer. Does talk therapy cure cancer? What you're doing here sounds like one of those pathological rants about diabetes being the domain of slothful, obese people whose condition is essentially a moral punishment for their failure to be decent people.
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There is no one size fits all solution. Some people have chemical imbalances, other people could probably benefit from talk therapy.
Absolutely true. The brain is a very complex system with loads and loads of feedback loops. So called "chemical imbalance" can be the cause of psychological issues but pure psychological issues can also lead to chemical imbalances. Causation for problems is hard to pin down because it's circular and cyclical. Tools like anti-anxiety medications and anti-depressants certainly have effects, but they are also blunt instruments and frequently ineffective because all they are doing is crudely following symptoms.
As a medic (Score:5, Interesting)
As a medic I was trained to reassure the patient, because one of the problems with someone undergoing trauma is that panic can induce shock, which greatly complicates treatment. But the fact that I "talk someone down" and the fact that this can prevent a bad situation from getting worse, does not mean the underlying problem is not medical in nature.
It is irritating to deal with people who believe that because talking about something made them feel better, that it will make everyone feel better. It's like saying that someone with a fever can't have Covid because you had a fever when you had the flu. Such large generalizations are not helpful and do not help those who have a legitimate, albeit poorly understood, medical condition.
Re:Here you go again, pooh-poohing the problem! (Score:4, Insightful)
Maybe this is a good thing. We are disgustingly, outrageously overmedicated. We need to get back to talking through, rationalizing away, and dealing with our suffering. Not every bad feeling in your brain has to be medicated away with psychotropics. It's absurd how many people rely on these drugs
No, this is NOT a good thing. Not even close.
Everything you said following those first words is completely true, is decidedly a problem, and unarguably needs solutions.
However denying the people who do need medications, for real and physical problems, conditions completely unrelated to psychotherapy, is NOT an answer and NOT a good thing!
Just because two example drugs get tossed into the story title should not be read as the only problem.
These are just two more examples in a very long list of casualties resulting from this massive overreach.
You point out "dealing with our suffering", yet this solution really is only trading one kind of suffering for another, in a (likely vein) attempt to change who suffers.
Yea, I'm sorry people that got addicted to opioids are suffering from that, and yea I know not everyone in that situation is at fault for it.
All this "solution" is doing however is causing pain and suffering in other people with non-opioid related conditions.
No, I don't have an answer, I never claimed to. Yet inducing new suffering in people who have already found an end to their past pain and suffering can't possibly be viewed as a good thing.
Re: Here you go again, pooh-poohing the problem! (Score:3)
I don't know about you, but when I see a big row of tents along a sidewalk, I'm sure as shit not going to walk in that direction. Particularly when I've been warned by the locals that it's dangerous to do so. Likewise, I doubt any reasonable shopkeeper is going to want random people just sleeping in front of their store scaring away potential customers or accosting them for change. Besides, where they lay those spikes down is private property, they're fully within their rights to limit who can stay there.
Re:Here you go again, pooh-poohing the problem! (Score:4, Insightful)
We need to stop people from the FDA/CDC/NIH from transitioning into the Pharmaceutical industry after they leave their gov't roles. There's too much of a chance of ignoring serious issues when you're trying to regulate your future employer. I'd even extend that further, federal employees should be able to transition into an industry that they were responsible for regulating.
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This is called "ableism." You sound like a person outside of the situation trying to dictate or tell somebody within the situation how to deal with it.
Consider your same explanation, except for somebody who is blind: Just try rationalizing away and dealing with your blindness, you don't need special concessions or even tools.
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Then they wonder why funding is a problem when the medications denied are cheaper than the non-medicated results.
I was just denied a specific and simple medical checkup until they see if the meds I was prescribed fix my problem but the checkup is to see if I have cancer from my pre-medicate state and has nothing to do with the medication which stops the symptoms but doesn't cure prior damage.
So now I have to play the "wait 8 weeks on new meds then ask again" game because they're dumb and don't understand ba
Re:Here you go again, pooh-poohing the problem! (Score:4)
Not every bad feeling in your brain has to be medicated away with psychotropics. It's absurd how many people rely on these drugs.
Well then, let me instead make an appeal to your "conservative" side: some people need their medications to be able to get through school and/or hold a job.
We give kids Adderall and Ritalin because counseling and discipline doesn't get them to sit quietly in class and do their work. Yes, if you believe you can restructure society so people can still lead productive lives even if they don't fit within the existing paradigm of education and employment, by all means do so. In all likelihood though, you'll just come back to the conclusion that the drugs are an easier solution.
Re:Here you go again, pooh-poohing the problem! (Score:5, Interesting)
We give kids Adderall and Ritalin because counseling and discipline doesn't get them to sit quietly in class and do their work
With kids, these medications can help them "grow out" of ADHD - it helps steer brain development back on track. Adults who get diagnosed can manage the condition with the same drugs, but it never gets better.
I sat quietly in class, so I never got diagnosed as a kid - in fact, not until last year. ADHD is not always outwardly visible - my mind doesn't sit still. It never has, but I always made sure I structured my life so that I had enough free time to "catch up." That worked fine until two kids.
Does hyperstimulation with electronics cause ADHD? Maybe. But that abnormal brain development is still real/physical.
But in regards to the post above, brain medication has changed the world. The number of people who used to be locked up in mental institutions who are able to have any semblance of a normal life at all is huge. Some end up in jail or homeless, but it's actually a pretty small number relatively speaking.
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With kids, these medications can help them "grow out" of ADHD - it helps steer brain development back on track.
Doctors loved telling people that, and the one about it "correcting a chemical imbalance", too.
More recent studies have demonstrated that the drugs do not result in an improved aptitude towards learning. [fiu.edu] The drugs certainly do help make kids more manageable for the one-size-fits-most public school system, but they do so by masking the symptoms rather than correcting the underlying issue. Furthermore, even without treatment, some kids grow out of it. [consumerreports.org] Folks with adult ADD/ADHD are unfortunately, the ones w
Re:Here you go again, pooh-poohing the problem! (Score:4, Insightful)
What is it that you think the underlying issue is if it's not the symptoms that are "masked"?
An improved aptitude toward learning in a traditional school environment is not a good indicator of success, especially if by your own words the school systems are one size fits most.
As someone who is adult diagnosed and self employed, nobody cares what the drugs do but me. And what it does is make me feel normal - to me, not some predefined societal definition. Reducing my executive dysfunction to levels as it existed before adulthood stress and time constraints eliminated my ability to cope.
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Are you sure the kids need drugs and don't need more time running around outside burning off their excess "kid energy"?
If you let a kid with ADHD run around until they've worn themselves out, you don't end up with a kid who wants to do their classwork, you just end up with an exhausted kid who is still easily distracted. You've essentially just turned an ADHD kid temporarily into an ADD kid. It actually makes sense once you realize that stimulant medicines wouldn't be of very much use if the problem was actually just an excess of energy.
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Anything that alters brain chemistry can have a recreational use by those who don't have the initially distorted brain chemistry to begin with or who have discovered recreational drug interactions with other substances.
Indeed, it's now the recreational drugs that are being looked at to treat things like depression, as noted on Slashdot repeatedly. Angel Dust and Magic Mushrooms being two that are taken very seriously by psychiatrists.
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They were being used in clinical practice with good effect when they were banned by the Nixon administration. They weren’t recreational drugs until they were banned, ffs.
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...what ever will we do.
That was my first reaction, too. If that were the only casualty of the manufactured opioid crisis, I would be fully on board with blocking access to them. However, I suspect that the schools will be the only ones with easy access, and only adults with an actual medical need for them will be stymied.
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Literally my life story.
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But how do you expect them to become upstanding citizens if we don't sedate them the second they dare to want to actually run around and act like kids?
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This might be covered by "first come first served, but I'll add:
Refills need to take priority over new scripts - by keeping stock scheduled to be on hand for regular refills.. Discontinuing medication suddenly just because the pharmacy is "out of stock" is dangerous and completely unnecessary.
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Yes the problem seems not so much to be poor intentions but rather a hamfisted implementation.
I would have thought it possible to track prescriptions back to patients and doctors and to deliver sufficient supplies to pharmacies to cover the demand and perhaps to leave a small "float" for contingences without disrupting the bone-fide distribution of drugs.
Are the companies doing this in the most lame way possible to make a case that they need subsidies to track their distribution ?