Why Is It So Hard to Get Adderall Right Now?

PLUS: the class contradictions of ketamine therapy and a scientific defense of mind-wandering

Welcome to the round-up of stuff that has been swirling through my head this week. We’ve got a critique of the “drug addicts took my Adderall” argument in the wake of Cerebral’s downfall, a look at how class transforms ketamine from a party drug to a therapy, and a nice little paper about the upsides of mind-wandering. Scroll to the end for a couple good videos, a grab bag of links, and an autistic party anthem. 🐌

---

Don’t Blame Drug Users, Blame Prohibition and Corporate Greed

More Cerebral news — I promise this section is going to be about something else, though! The CEO got sacked, CVS and Walmart are declining to fill prescriptions from the company, and even ADDitude Mag turned on them.

This is, of course, making it even harder for people to access drugs that were already a challenge to get, with mental healthcare financially inaccessible to most Americans, and an amphetamine shortage that’s been lingering since 2019.

As usually happens during shortages, blame falls on a bunch of nebulous “drug abusers” who’ve scammed the system and eaten up all the medicine, and the fact that this Cerebral story has become the media’s current favorite pill mill scandal has only strengthened that perception.

Stimulant shortages actually happen kind of often, though, and they have little to do with consumers.

There was a big one in 2011, and this report in Filter Mag from December 2019 looked at the effects of shortage in Philadelphia, speaking to an anonymous source who’d resorted to buying meth on the street because he couldn’t get his Adderall prescription filled.

The FDA keeps a public database of drug shortages, and while the reasons listed for the current one do include increased demand, a few companies are straight up getting out of the stimulant manufacturing game altogether. One company, Mylan Pharmaceuticals, lists their reason as simply “a business decision”.

Because we’ve been taught that life is a constant competition with others for resources, it’s tempting to blame “bad people” scamming away all the medicine, but it’s the combination of massive for-profit companies making “business decisions” and state-regulated drug prohibition that actually causes these problems.

In a piece about the Adderall shortage in LA (that humorously blames rich, hypercompetitive parents instead), Joel Stein explains:

…the Drug Enforcement Administration decides how much can be sold for the entire country. And the DEA has dropped its allowed quotas. In 2016, it allowed 50,000 kilograms to be sold; but for 2022, it has lowered the amount to 41,200 kilograms.

Pharmaceutical companies blame shortages on the DEA, while the DEA points the finger back at pharmaceutical companies.

In the 2011 shortage, Shire actually made more money on brand-name Adderall XR and was accused of manipulating the market. Two other companies sued, alleging that Shire was throttling their chemical supply and keeping them from being able to manufacture generics. The “shortage” was actually just a lack of cheap generic versions, a symptom of a profit-driven medical system.

In 2021, a shortage in Wisconsin was caused by a miscommunicated change in Medicaid coverage meant to save the state money:

“The reason for the change, apparently, was because the manufacturer of brand name Adderall was offering a rebate that would actually, after the rebate, make the the brand name cheaper than the generic for the state,” explains Dr. Rademacher. “The state knew, obviously, about these changes coming. The pharmacy association knew about the changes coming. Nobody remembered to tell the wholesalers that this change was coming.”

“It’s drug abusers eating up the supply” is a classic blaming-the-individual situation, while the systemic-greed-and-exploitation situation sits right there in plain view. The problem is that our access to drugs is contingent on professionals, government officials, and market dynamics, and what we need is free access to healthcare and a paradigm shift in our thinking on drugs, not more shady corporations like Cerebral.