The Empty Adderall Factory
nymag.com
nymag.com
Concerta and Ritalin contain methylphenidate, not amphetamine. This is correctly stated elsewhere in the article, so I don't know why they're conflated here.
> In one of these rooms, Ascent’s founder and CEO — Sudhakar Vidiyala, Meghana’s father — points to a hulking unit that he says is worth $1.5 million. It’s used to produce time-release Concerta tablets with three colored layers, each dispensing the drug’s active ingredient at a different point in the tablet’s journey through the body.
Sort of; see "System Components and Performance" in [0]. There's an overcoat which contains an initial dose of methylphenidate that dissolves quickly. Under that, a three-layer core: two drug layers and one pump layer for an osmotic-controlled delivery system [1]. As the pill is processed through the body and into the gut, water is absorbed into the pump layer through a semipermeable membrane which causes the pump layer to gradually expand, pushing methylphenidate from the two drug layers out through a laser-drilled hole over time. It's a cool little mechanism.
[0] https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/02...
[1] https://en.wikipedia.org/wiki/Osmotic-controlled_release_ora...
I disagree. The OP is correct in calling out the bogus languge used in the article.
Saying the difference between Adderall (an amphetamine) and Ritalin (methylphenidate) doesn't matter because they both just boost dopamine is like saying it doesn't matter whether you turn up the volume on your speaker by using a remote or by walking over and pressing a button. Yes, both methods make the music louder, but how they do it is different.
Adderall pushes more dopamine out, while Ritalin makes sure the dopamine that's already there sticks around longer. This matters because, depending on someone's unique brain chemistry and health, one method might be better for them than the other. It's not just about the end result (more dopamine); it's about how you get there and what side effects might come along for the ride. Just like some people prefer the remote for convenience, doctors and patients might prefer one medication over the other based on how well it works for them and how it makes them feel.
Ok, but considering the context your distinction has no relevance.
I mean that ship has already sailed in the form of the "methamphetamine epidemic" but just to be pedantic
If you take a look at the comments on this thread I think you'll see there's also a whole group of people who don't use the medication but have quite strong feelings about whether or not it should be used, why it's used, whether or not life is fair because people use it, etc.
Wouldn't be much of a stretch to infer that the author could also be in that camp.
There's no such sympathy for people unable to function without their meds, sadly.
There's never a smoking gun. And this should be the big takeaway for a lot of people: if you're looking for smoking guns you'll find them everywhere. But if you're looking for killers, they hide in the shadows. Sure, there are some where you do clearly see them standing over the body in clear daylight with the smoking gun in hand and the dead still warm. But that is far more rare. The best way for these people to hide in the shadows is to make it difficult to distinguish good and bad. To create the shadows and fog. The reason this is often easy is because the good and right actions are nuanced and considerate of complexity.
Like truth and lies, truth has a lower bound in complexity but lies do not, they can be infinitely simple. We humans love simplicity and that's what they exploit. It's unfortunate but if everything was half as simple as we pretend they are, we wouldn't have 90% of the problems that exist in the world. We live in a complex world and humans have been solving problems for thousands of years, it's pretty reasonable that the vast majority of simple issues have been solved. So if you want truth, be wary of simplicity.
> But the company has acknowledged that it committed infractions. For example, orders struck from 222s must be crossed out with a line and the word cancel written next to them. Investigators found two instances in which Ascent employees had drawn the line but failed to write the word.
(Wean off those without genuine disability, who are using the drug as a performance enhancer.)
That's a dystopian concept I've never seen explored anywhere.
Except sports, where the government steps in and makes sure that doesn't happen. ;)
There is a lot of recent research on this and it does not agree with you.
https://www.sciencedirect.com/science/article/abs/pii/S00747...
I believe OP was saying that neurotoxicity has only been definitively shown in higher doses. Granted I highly doubt no studies show neurotoxicity at lower doses, but it doesn't look to be a settled matter.
>Amphetamine Treatment Similar to That Used in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder Damages Dopaminergic Nerve Endings in the Striatum of Adult Nonhuman Primates
[1] - https://www.additudemag.com/adhd-life-expectancy-video/#:~:t....
I can also confirm the diminishing returns and will even state that if I take instant dosages around what people say they do, I'm highly non-productive again. Finding the right dosage level and schedule is still a challenge and varies day to day. There's far too common a myth that you just pop 20mg of Adderall and you can focus for 10hrs straight. Maybe that's true for some people, or maybe even for just people without ADHD, but certainly not true for me. For me it is just like turning down the volume on an alarm.
Also, a lot of people with mental health issues can survive without their medication, it can significantly decrease their quality of life or ability to function.
I can survive without my ADHD being treated but I can't work. Fortunately for me, I am on a different type of medication so this shortage doesn't affect me, but I can see what's happening to my coworkers. My team is going to lose people due to this bullshit.
Can I survive? Absolutely. But without it, I am a zombie; a complete shell of myself. Even with concerns over long term side effects, the tradeoff isn't worth it for me.
Why are your coworkers so committed to this work if it suits them so poorly? Are they really unable to perform any work without a drug?
It's a little wild that people would sooner see themselves as "ill" and in need of $xx/mo of side effects and shortages for the rest of their lives than think that maybe the expectations they've put on themselves aren't right.
Maybe the work is not a good suit for them. Maybe their lives are structured poorly. Maybe your whole industry or social class is broken and is demanding more from people than they can deliver without drugs. A shortage is a really good opportunity to look more closely at those possibilities, especially the last one.
It would take a long time to explain adequately. But to summarize, neurodivergence can be a pervasive, debilitating problem for people, and medication is in many ways a miracle cure. And the solutions you suggest require the exact type of executive function that sufferers are lacking.
Of course it would be nice to wave a wand and change society instead, but that's not going to happen.
You wake up and need to make your bed, but then you also have to take a shower, and brush your teeth, there's also laundry to do, and coffee. Maybe breakfast if you are hungry, but there's also mail to pick up, and emails to read, and plants to water, you also need to schedule a thing after work, and there's also a message from your parents to reply.
All of those things are ringing out loud "I need to be done" at the same time, with the same priority, you know you should just start with one thing but you can't, you simply can't, the other things are like loud alarms going in your head to not be forgotten. You feel overwhelmed, you take a shower. One thing done, you make coffee, you drink it and feel you need to go for a walk to clear your head, you come back home and drink a bit more coffee, oh, but I forgot to brush my teeth when I was in the bathroom, and now I know I shouldn't brush right after drinking coffee, you wait a little bit for the sake of your teeth, you forget about it again.
You go through your day, you remember you forgot to pick up the mail, you go to pick up the mail, you see your front yard a bit disorganised, you start putting things in place, you go back inside the house and remember you forgot to pick up the mail.
You don't make breakfast because many distractions took your time, you start working, you force yourself to focus, you do the work even though other things ring in your head all the time, you finish work and now you're exhausted.
You do other day-to-day things, you cook, etc., time for bed, now you remember all the things you forgot to do: you didn't do laundry, you forgot to reply your parents' message, you forgot that you booked an appointment for tomorrow morning. Oh, you also forgot laundry, for the 2nd week in a row, you do it because tomorrow you won't have clothes, so the urgency makes you focus and prioritise it.
It's a constant, never-ending stream of remembering, forgetting, overcommitting, self-guilty, no matter what kind of organisation ritual/system you try you eventually fail, each failure feeds back into the guilty, into the shame.
And it's constant, every single day of your life, in every single activity you do. In conversations, at work, doing daily chores, everything takes a lot of effort to be focused, to do what you are supposed to do.
So maybe life isn't for me, should I just off myself?
My only regret is waiting until my thirties to get diagnosed, I feel like so much of my potential was wasted academically and career-wise.
I can start/stop, take drug holidays, etc. with amphetamine (adderall in my case) at will with no ill effects. Caffeine on the other hard, is brutally unpleasant to miss a day of. Been on the same dose of adderall for a few years now. I was able to reduce my caffeine intake significantly after starting adderall.
I don't take it on the weekends, and I feel a huge difference in my ability to remember what I'm working on around the house.
It gives me some control over my focus, leverage against the executive dysfunction, and the choice to not chase dopamine.
Something you were completely unaware of and unable to access was never an opportunity for you, missed or otherwise.
So while I can of course not predict what would have happened, I can pretty safely say my life path would have been completely different had I had a chance to get treated earlier. I would have gone to college, at least.
I'm not sure what your point is.
This was pretty much me as well. I remember at the start of every new school year promising this time it would be different. I would do my homework and pay attention in classes and get good grades! Each year it spiraled into the same mess. Diagnosed with ADHD in my 30's.
Do you mean that if I had been able to treat my disorder earlier, nothing would have been different? I don't dwell on it, but to say my academic success would have been wildly different medicated is just wrong.
Do you have a guidance counselor your can talk to?
There was definitely a stigma for mental illness with the boomer generation, I suspect my mom did not want to be associated with a child that has a mental condition.
I can honestly say that I wouldn't have been able to hold down a serious professional career without it - ADHD is a very real thing that some people have to deal with, and its effects can be crippling to life outcomes.
I don't like the way stimulant medications feel to actually take, and the long-term health effects do worry me a bit, but it makes it possible for me to live something significantly closer to a normal life than I would ever be able to manage without them. Really can't overstate how transformational it's been for me.
So yes.
Some figures highly esteemed for their talent are noted for extreme focus and diligence, but rarely are these people especially well rewarded with money or comfort. They just get pointed at and receive some "oohs" and "ahhs" while feeling pretty alienated and seeming pretty unbalanced. It's not something most feel themselves aspiring to and it's definitely not what society has set itself up to reward.
Society seems to reward people who get about as much done as they say they can, consistently, on something useful, while not being too unpleasant to be around.
There's plenty of room for neurodivergent people in that society, even without stimuants.
You said yourself, consistently. There's nothing consistent about living with ADHD, you simply can't be consistent, it's one of the major issues with it.
I believe you are speaking out of ignorance, and that's fine, if you also allow yourself to know you are ignorant and try to understand how it is for others, to grow out of your own ignorance.
If you have not lived with ADHD or had a partner with it to understand the many, multifaceted ways it affects someone's life I don't think you can even grasp what it is, it's ok to be ignorant if you are kind enough to acknowledge and try to understand what you do not know about.
So far I've only seen your rebuttals coming from the same place as people telling us we should just do better, that is a simple matter of willpower. Or worse, that society does accommodate for it (it doesn't).
Society rewards consistency, rewards people with good organisational skills who can persist on a task until its completion, no matter how boring or difficult it is. A neurodivergent person has to develop and practice that, every single day, knowing that in many days you'll fail to do it and all that's left is to try again the next day, and the next, and the next, and the next...