If ADHD isn’t real then why is my brain basically a piece of old cheese because I can’t get my meds?
Hmm? Genius? Riddle me that.
This appeared on my Medium and I felt like it could also go here, mostly because being a writer is a pit of despair wherein we must all shout into not one void, but many voids, and hope that one of them yawns back.
Listen, I was going to write this a couple of weeks ago when Matt Walsh was being Matt Walsh, which is to say a complete cretin who looks like a Great Value Martin Starr if Martin Starr was also rotting from the inside, which I don’t think he is. Martin Starr seems very nice. Actually, I’m sorry I dragged him into this. Can we start over?
The reason I didn’t write this weeks ago is because I haven’t had my ADHD meds for months, due to a shortage that people in charge seem totally fine with for reasons we may or may not get into (will I remember? WHO KNOWS), and as a result I have been playing life on Hard Mode.
Not Super-Hard, mind you. I still have a lot of baked-in privilege and also my other meds are still available. But when, for the better part of a decade, you’ve been helping your brain function somewhat normally with medication and then that medication just…isn’t there, it’s certainly a challenge!
So like, here I am, with a brain that is not only not working as well a it could be, but a brain that is also keenly aware of how well it could be working, which adds an additional layer of shame. And it’s not like I could plan for it, either — it was just that one day, I went to fill my meds and Kaiser said “sorry nope, that’s not available.”
They didn’t offer me any alternatives. They didn’t really explain it. They just sent me a little message that said they couldn’t do it. And then I was expected to just live my life and write my little words and do my little jobs and live my little life and not lose my stupid goddamn keys or forget where my headphones are or be able to make it through a meeting without yawning myself into oblivion. They didn’t provide anything to help with the excruciating exhaustion of going back to non-medicated ADHD sleep.
Wait, why couldn’t you get your meds?
It’s also been brought to my attention that a lot of people don’t know that there has been a shortage of ADHD meds for almost year and that thousands of people around the country are just out here doing an acoustic set in life.
Like people around you are just bumbling through their days, misplacing things and forgetting that time exists and eating chocolate syrup straight from the bottle to get a dopamine rush. And there are people who have lapsed on their sobriety because self-medication is the only medication available. And there are people who are losing jobs and having mental breakdowns because having your VERY REAL AND IMPORTANT medication just snatched away with no warning or replacement or titration is a challenge.
But it’s true. It’s been going on for a while but the FDA just formally announced it this month.
According to the FDA, the initial problem started last fall and has since been resolved, but there are a bunch of OTHER issues that haven’t been. The main issue they cite is the increase in prescribing; a lot more people have been on stimulants in the last year.
Another big issue is that because ADHD meds are controlled — seriously, despite what the Matts Walsh of the world squawk about, it’s actually very hard to get a Ritalin scrip or to get it filled and you have to get it re-upped every single month—which means the DEA limits the amount that can be made.
Seriously. The drug police put an arbitrary cap on the production of medical stimulants. And they don’t adjust it very often! So maybe drug manufacturers just hit their ceiling?
NOPE. NO. THAT DIDN’T HAPPEN. From the FDA (emphasis mine):
…In 2022, manufacturers did not produce the full amount that these limits permitted them to make. Based on DEA’s internal analysis of inventory, manufacturing, and sales data submitted by manufacturers of amphetamine products, manufacturers only sold approximately 70 percent of their allotted quota for the year, and there were approximately 1 billion more doses that they could have produced but did not make or ship. Data for 2023 so far show a similar trend.
So why are drug makers just…not making drugs? Because there are plenty of drugs that get advertised during baseball games for things like psoriasis, so clearly, someone’s making SOMETHING!
I don’t recall there ever being an opioid shortage, do you? Or a boner pill shortage? And fentanyl sure seems every damn place.
It’s kind of like if there’s money to be made then enough drugs will get made. Most of the ADHD meds — you know them by brand names like Ritalin and Adderall— are available in a generic form. That means they’re cheaper for consumers, but they don’t make pharmaceutical companies much money.
The exception here is Vyvanse, a relatively new drug combo that is still under trademark, and thus, more expensive. I tried to get that but my doctor (well, the storefront doctor that Kaiser sent me to after my GP cancelled our appointments twice, two months apart) told me not to bother because it’s really short, too.
So what’s the FDA doing about it?
Lol. It’s cute that you think that a government body can do anything about our beloved private medical enterprise! Didn’t you know that in the United States, medicine is a $$capitalist market$$ and as a result, the government is incapable of doing anything. But don’t worry! The FDA says they will “continue to monitor supply and assist manufacturers with anything needed to resolve the shortage and will update our website with new supply information as it becomes available.”
Wow, thanks FDA! Every single day that I have to do my extremely mentally-taxing job, I’ll rest easy knowing that you’re keeping an eye on things.
I mean, I know it’s not their fault; deregulation has reduced our entire nation into a hellscape where wealthy people—I’m looking at the Sackler family and their ilk—can create a national public health emergency in name of profit and lose precisely nothing.
However, the FDA’s other recommendations are pretty fucked. For example:
The FDA is asking professional groups and healthcare providers to accelerate efforts to support appropriate diagnosis and treatment of ADHD, such as further development of additional clinical guidelines for ADHD in adult
Just don’t diagnose it so much! That’ll help those of us who have been on these meds for like eight years! And also…
FDA has already taken steps to support the development of alternative treatment options. In 2020, for instance, FDA permitted marketing of a game-based digital therapeutic to improve attention function in children with ADHD.
Cool thank you but I am an adult and what I need is the medication that helps my dopamine work properly. But like, neat I guess.
God this just sucks.
Here is my wild idea—and bear with me because I know this is REALLY OUT THERE— but like, what if we just reconfigured American medicine so that instead of seeing patients as customers we saw them as, I don’t know, patients? Because the CEO of Teva Pharmaceuticals, the biggest manufacturer of Adderall, is boo-hooing about a $2 million cash bonus last year and that kind of seems weird when literally tens of thousands of children and adults just don’t have their medication.
The only reason I can come up with as to why this is being allowed to happen — like why it is that everyone is just collectively shrugging about the shortage of an entire major class of medication—is that a lot of people feel like Matt Walsh do, in that they don’t see it as a big deal. Like they just assume that ADHD meds are optional? Or that their impact isn’t really that great? Or that people are just ~ addicted ~ to them and maybe they should quit anyway?
As I’ve written before, these are very bad and wrong notions to hold. Not just because the idea of people getting really high and having fun on ADHD meds is like, not so much a thing or that when used properly, addiction to ADHD medication isn’t a thing. But also because it’s just cruel.
When people tell you “hey this medicine helps me think and remain emotionally regulated and well-rested,” why would you not listen to them? Why would you just assume that they’re making it up or that they’re just trying to have a good time?
If I wanted to do just do drugs the regular way, I would do drugs. Honestly, I love drugs. But I only do the legal ones — cannabis and alcohol — anymore. And I’d be lying if I said that in the last couple of months without my meds, I’d never considered hunting down some amphetamines that *don’t* come from the doctor (but the aforementioned fentanyl kind of makes that a less-good choice for being alive).
If anything, being forced off my meds has made me consider a lot more self-medication than I’ve felt in the years on my meds.
Eventually, I’ll be able to have a doctor’s appointment (I HAVE INSURANCE BUT LOL HAVE YOU TRIED TO JUST SEE A GP IN A MAJOR CITY LATELY) and then maybe she’ll be able to tippy-tap on her little computer and see what meds are in stock. Or maybe not. Maybe I just have to wait for the benevolent pharma gods to sprinkle a little medication into life.
Either way, the moral of the story is: Whenever someone kvetches that ~ socialized medicine ~ would mean long waits and shortages of medications, just gesticulate wildly in the direction of our current system and call it a day.
I have a lot of other writing about ADHD over here on Medium too, in case you’d like to read more about this VERY NOT REAL, EXTREMELY FAKE condition I live with.