9 ms·

The Empty Adderall Factory

45 points by ughitsaaron 3y ago

janice1999 3y ago
The author was clearly sweet-talked by the company lawyers and PR people. It's so pandering in places it's embarrassing. If a company manufacturing amphetamine is discovered to have been keeping two sets of books I'd want them investigated pretty vigorously, especially considering the ongoing human hellscape of the opioid epidemic.
- throw18376 3y ago
  adderall use is pretty widespread in the media industry, a lot of journalists seem to think it's great stuff and find the shortage annoying. i think there's likely some natural sympathy here too.
  - Implicated 3y ago
    > i think there's likely some natural sympathy here too. 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.
- saltminer 3y ago
  You can keep operations going while still investigating the company. Imagine if Marathon Oil was discovered to be smuggling crude oil from Russia into their refineries and splitting the difference with Putin so Russia could bypass international sanctions, and an agency completely shut down Galveston Bay and Garyville (the two largest oil refineries in the US) in response - as soon as the news hit, prices for gasoline, propane, LNG, new plastics, etc. would go through the roof and runs on gas stations would begin. The public outrage would be swift and Congress would force whoever shut them down to let them resume operations while the case was underway. There's no such sympathy for people unable to function without their meds, sadly.
  - Slava_Propanei 3y ago
    [dead]
  - godelski 3y ago
    This. And this is tempered response is generally considered a mark of a good journalist. Someone who sees the whole picture. I can't call the journalist here (James D. Walsh) a good journalist though, because I personally don't know the track record. What's hard is that it is difficult to distinguish these two concepts of pandering or tempering. A track record is really all there is. 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.
- fallingknife 3y ago
  No one said anything about keeping two sets of books. The issue is some stupid DEA form. And I don't think the DEA should even exist. So I am 100% on the company's side.
diogenescynic 3y ago
Somehow the world existed before all these amphetamines. I'm kind of okay with this. It's probably all not necessary and this will show it.
- kayodelycaon 3y ago
  The world also existed before antibiotics... 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.
  - chuckhendo 3y ago
    This right here. I'm prescribed Adderall off-label for excessive daytime sleepiness, and have been for over a decade. I have tried multiple times to come off of it because of my concerns with long term effects (especially with my heart). 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.
  - swatcoder 3y ago
    That some "work" requires lifelong consumption of a stimulant with a fragile supply chain maybe reflects a deeper problem than any shortage itself. 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.
mintplant 3y ago
> No one doubts ADHD stimulants’ potential for abuse and addiction. Adderall’s active ingredient is amphetamine, a drug that functions in some ways like cocaine. Both deliver excess dopamine to the brain, enhancing motivation and concentration, and the cocainelike effect of stimulants is enhanced when they’re snorted. Hence the long-standing nickname for Concerta and Ritalin: Diet Coke. “There is a fear that the overuse of prescribed amphetamines could lead to the equivalent of another opioid epidemic,” said Dr. Joshua Sharfstein, who served as the FDA’s principal deputy commissioner under Barack Obama. 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/2007/021121s014lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/02... [1] https://en.wikipedia.org/wiki/Osmotic-controlled_release_oral_delivery_system https://en.wikipedia.org/wiki/Osmotic-controlled_release_ora...
- DinoCoder99 3y ago
  You're just reading a mildly ambiguous sentence in poor faith. Not only is the amphetamine comment clearly applying to Adderall—which is true—methylphenidate also delivers an uptick in dopamine, which is why it's effective at all. The difference between the two drugs—which is meaningful in many contexts—is not substantial in this context.
  - gzer0 3y ago
    > You're just reading a mildly ambiguous sentence in poor faith. Not only is the amphetamine comment clearly applying to Adderall—which is true—methylphenidate also delivers an uptick in dopamine, which is why it's effective at all. The difference between the two drugs—which is meaningful in many contexts—is not substantial in this context. 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.
shrimp_emoji 3y ago
What if we had cognitive performance enhancers that were deleterious to your health? Let's say they made you twice as smart but cut your lifespan in half. You might not choose to take them. But others would. And now you find yourself functionally retarded compared to those people. Think about how many advantages they get in hiring and personal success for their Faustian bargain. You might just cave and start doing them yourself. And then say even more powerful ones come along -- these make you four times as smart but are even worse for your body. Everyone just game theoretically spirals into the most extreme Faustian bargains. 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. ;)
- downrightmike 3y ago
  Flowers for Algernon already did it.
- reaperman 3y ago
  Hopefully a bunch of people who were four times as smart could get together and invent one that does that without reducing your lifespan.
- operatingthetan 3y ago
  Amphetamines including Adderall are mildly neurotoxic, but that doesn't seem to bother those that take them.
  - jdefr89 3y ago
    That is not true. All studies have shown they are only neurotoxic if abused and by abused I mean taking nearly 10x of a normal dose. At that level Of abuse anything is neurotoxic.
    - operatingthetan 3y ago
      >Adderall may have neurotoxic effects in doses higher than the recommended therapeutic dose; however, it may also potentially be neurotoxic in prolonged regular doses over a long period of time. There is a lot of recent research on this and it does not agree with you. https://www.sciencedirect.com/science/article/abs/pii/S0074774215000070 https://www.sciencedirect.com/science/article/abs/pii/S00747...
fallingknife 3y ago
Here is how stupid some of these DEA regulations are: > 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.
neilv 3y ago
If we get to the point of having to ration it, priority is to the people who genuinely need it for normal range of functioning. (Wean off those without genuine disability, who are using the drug as a performance enhancer.)
- morkalork 3y ago
  How do you propose that? Afaik, everyone who has access to it has a prescription for it. And the predicate for having a prescription is a diagnosis. On paper, everyone genuinely needs it.
  - neilv 3y ago
    (I said "genuinely" to distinguish from "on paper".) I don't know how to execute on reducing the juicing use of these meds. One idea is to start going after pill-mill doctors, like for opioids?
Slava_Propanei 3y ago
[dead]
da39a3ee 3y ago
[flagged]
- fragmede 3y ago
  ADHD's pandemic uptick may be relatively newer and thus a bit more questionable, but "dylexia isn't real" is very much a fringe belief.
  - da39a3ee 3y ago
    No, in fact you're quite wrong there. It's a hotly debated topic with sufficient numbers, and respectability of protagonists, on the side that questions dyslexia for it to be wholly inaccurate to refer to it as a fringe belief. Of course there is real variation in people's abilities to read and perform other cognitive tasks. But the idea that a clearly diagnosable, discrete medical condition can be identified has substantial opposition within the community of experts in the relevant subjects. https://www.theguardian.com/news/2020/sep/17/battle-over-dyslexia-warwickshire-staffordshire https://www.theguardian.com/news/2020/sep/17/battle-over-dys... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455059/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455059/ https://www.google.com/books/edition/The_Dyslexia_Debate/4lz2AgAAQBAJ?hl=en https://www.google.com/books/edition/The_Dyslexia_Debate/4lz... https://www.dur.ac.uk/resources/education/research/DyslexiaDebateResearchBriefing.pdf https://www.dur.ac.uk/resources/education/research/DyslexiaD... https://qz.com/2166242/what-is-dyslexia-and-why-is-defining-it-so-controversial https://qz.com/2166242/what-is-dyslexia-and-why-is-defining-... It's fairly obvious that terms such as "ADHD" and "dyslexia" are just referring to regions within a multidimensional space of cognitive abilities and psychological characteristics, and that it's misleading for the medical/psychological community to encourage people to think that they "have" dyslexia or "have" ADHD, almost as if they're talking about "having" a malarial infection or a broken leg.
    - fragmede 3y ago
      Theres an overwhelming amount of educational and psychological research that supports the existence of dyslexia as a specific learning difficulty that affects reading. It’s recognized by reputable medical, psychological, and educational organizations worldwide. Disbelief in dyslexia goes against well-established scientific evidence and consensus. The existence of a handful of books and articles and papers to the contrary doesn't do much for the notion that it's on the fringe. Flat Earthers have plenty of books.

45 points by ughitsaaron 3y ago

janice1999 3y ago

The author was clearly sweet-talked by the company lawyers and PR people. It's so pandering in places it's embarrassing. If a company manufacturing amphetamine is discovered to have been keeping two sets of books I'd want them investigated pretty vigorously, especially considering the ongoing human hellscape of the opioid epidemic.

throw18376 3y ago
adderall use is pretty widespread in the media industry, a lot of journalists seem to think it's great stuff and find the shortage annoying. i think there's likely some natural sympathy here too.
- Implicated 3y ago
  > i think there's likely some natural sympathy here too. 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.
saltminer 3y ago
You can keep operations going while still investigating the company. Imagine if Marathon Oil was discovered to be smuggling crude oil from Russia into their refineries and splitting the difference with Putin so Russia could bypass international sanctions, and an agency completely shut down Galveston Bay and Garyville (the two largest oil refineries in the US) in response - as soon as the news hit, prices for gasoline, propane, LNG, new plastics, etc. would go through the roof and runs on gas stations would begin. The public outrage would be swift and Congress would force whoever shut them down to let them resume operations while the case was underway. There's no such sympathy for people unable to function without their meds, sadly.
- Slava_Propanei 3y ago
  [dead]
- godelski 3y ago
  This. And this is tempered response is generally considered a mark of a good journalist. Someone who sees the whole picture. I can't call the journalist here (James D. Walsh) a good journalist though, because I personally don't know the track record. What's hard is that it is difficult to distinguish these two concepts of pandering or tempering. A track record is really all there is. 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.
fallingknife 3y ago
No one said anything about keeping two sets of books. The issue is some stupid DEA form. And I don't think the DEA should even exist. So I am 100% on the company's side.

diogenescynic 3y ago

Somehow the world existed before all these amphetamines. I'm kind of okay with this. It's probably all not necessary and this will show it.

kayodelycaon 3y ago
The world also existed before antibiotics... 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.
- chuckhendo 3y ago
  This right here. I'm prescribed Adderall off-label for excessive daytime sleepiness, and have been for over a decade. I have tried multiple times to come off of it because of my concerns with long term effects (especially with my heart). 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.
- swatcoder 3y ago
  That some "work" requires lifelong consumption of a stimulant with a fragile supply chain maybe reflects a deeper problem than any shortage itself. 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.

mintplant 3y ago

> No one doubts ADHD stimulants’ potential for abuse and addiction. Adderall’s active ingredient is amphetamine, a drug that functions in some ways like cocaine. Both deliver excess dopamine to the brain, enhancing motivation and concentration, and the cocainelike effect of stimulants is enhanced when they’re snorted. Hence the long-standing nickname for Concerta and Ritalin: Diet Coke. “There is a fear that the overuse of prescribed amphetamines could lead to the equivalent of another opioid epidemic,” said Dr. Joshua Sharfstein, who served as the FDA’s principal deputy commissioner under Barack Obama. 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/2007/021121s014lbl.pdf https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/02... [1] https://en.wikipedia.org/wiki/Osmotic-controlled_release_oral_delivery_system https://en.wikipedia.org/wiki/Osmotic-controlled_release_ora...

DinoCoder99 3y ago
You're just reading a mildly ambiguous sentence in poor faith. Not only is the amphetamine comment clearly applying to Adderall—which is true—methylphenidate also delivers an uptick in dopamine, which is why it's effective at all. The difference between the two drugs—which is meaningful in many contexts—is not substantial in this context.
- gzer0 3y ago
  > You're just reading a mildly ambiguous sentence in poor faith. Not only is the amphetamine comment clearly applying to Adderall—which is true—methylphenidate also delivers an uptick in dopamine, which is why it's effective at all. The difference between the two drugs—which is meaningful in many contexts—is not substantial in this context. 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.

shrimp_emoji 3y ago

What if we had cognitive performance enhancers that were deleterious to your health? Let's say they made you twice as smart but cut your lifespan in half. You might not choose to take them. But others would. And now you find yourself functionally retarded compared to those people. Think about how many advantages they get in hiring and personal success for their Faustian bargain. You might just cave and start doing them yourself. And then say even more powerful ones come along -- these make you four times as smart but are even worse for your body. Everyone just game theoretically spirals into the most extreme Faustian bargains. 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. ;)

downrightmike 3y ago
Flowers for Algernon already did it.
reaperman 3y ago
Hopefully a bunch of people who were four times as smart could get together and invent one that does that without reducing your lifespan.
operatingthetan 3y ago
Amphetamines including Adderall are mildly neurotoxic, but that doesn't seem to bother those that take them.
- jdefr89 3y ago
  That is not true. All studies have shown they are only neurotoxic if abused and by abused I mean taking nearly 10x of a normal dose. At that level Of abuse anything is neurotoxic.
  - operatingthetan 3y ago
    >Adderall may have neurotoxic effects in doses higher than the recommended therapeutic dose; however, it may also potentially be neurotoxic in prolonged regular doses over a long period of time. There is a lot of recent research on this and it does not agree with you. https://www.sciencedirect.com/science/article/abs/pii/S0074774215000070 https://www.sciencedirect.com/science/article/abs/pii/S00747...

fallingknife 3y ago

Here is how stupid some of these DEA regulations are: > 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.

neilv 3y ago

If we get to the point of having to ration it, priority is to the people who genuinely need it for normal range of functioning. (Wean off those without genuine disability, who are using the drug as a performance enhancer.)

morkalork 3y ago
How do you propose that? Afaik, everyone who has access to it has a prescription for it. And the predicate for having a prescription is a diagnosis. On paper, everyone genuinely needs it.
- neilv 3y ago
  (I said "genuinely" to distinguish from "on paper".) I don't know how to execute on reducing the juicing use of these meds. One idea is to start going after pill-mill doctors, like for opioids?

Slava_Propanei 3y ago

[dead]

da39a3ee 3y ago

[flagged]

fragmede 3y ago
ADHD's pandemic uptick may be relatively newer and thus a bit more questionable, but "dylexia isn't real" is very much a fringe belief.
- da39a3ee 3y ago
  No, in fact you're quite wrong there. It's a hotly debated topic with sufficient numbers, and respectability of protagonists, on the side that questions dyslexia for it to be wholly inaccurate to refer to it as a fringe belief. Of course there is real variation in people's abilities to read and perform other cognitive tasks. But the idea that a clearly diagnosable, discrete medical condition can be identified has substantial opposition within the community of experts in the relevant subjects. https://www.theguardian.com/news/2020/sep/17/battle-over-dyslexia-warwickshire-staffordshire https://www.theguardian.com/news/2020/sep/17/battle-over-dys... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455059/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455059/ https://www.google.com/books/edition/The_Dyslexia_Debate/4lz2AgAAQBAJ?hl=en https://www.google.com/books/edition/The_Dyslexia_Debate/4lz... https://www.dur.ac.uk/resources/education/research/DyslexiaDebateResearchBriefing.pdf https://www.dur.ac.uk/resources/education/research/DyslexiaD... https://qz.com/2166242/what-is-dyslexia-and-why-is-defining-it-so-controversial https://qz.com/2166242/what-is-dyslexia-and-why-is-defining-... It's fairly obvious that terms such as "ADHD" and "dyslexia" are just referring to regions within a multidimensional space of cognitive abilities and psychological characteristics, and that it's misleading for the medical/psychological community to encourage people to think that they "have" dyslexia or "have" ADHD, almost as if they're talking about "having" a malarial infection or a broken leg.
  - fragmede 3y ago
    Theres an overwhelming amount of educational and psychological research that supports the existence of dyslexia as a specific learning difficulty that affects reading. It’s recognized by reputable medical, psychological, and educational organizations worldwide. Disbelief in dyslexia goes against well-established scientific evidence and consensus. The existence of a handful of books and articles and papers to the contrary doesn't do much for the notion that it's on the fringe. Flat Earthers have plenty of books.