Refused sale of Sudafed because my license was expired. Apparently I accidentally tossed my new license and kept the old one. Doh! However they happily refilled my schedule III meds with the expired license.
As I said WAT.
Methamphetamine is a whole other level of stimulant.
> amphetamine habits in kids that have trouble focusing in school.
1) Do you have evidence that Adderall at therapeutic dosages is anywhere near as addictive as methamphetamine at recreational dosages?
2) Yeah, ADHD makes it real hard to focus at school. I never graduated from high school, and I dropped out of university as an adult student without even completing one year, thanks to untreated ADHD. Not to mention the impulsive behaviour, the inability to stick at boring things etc. etc. It's not great in our society.
You're implicitly minimising the very real impact of ADHD, that's not super great.
In fact, one of the biggest issues for people finally being treated for ADHD as adults is the grieving process around "What my life could've been if my parents hadn't believed that ADHD wasn't real and my issues in school and my 'disruptiveness' was solely due to 'food intolerances', because my Mom read a magazine article about it once, then paid a quack to stick a probe in my ear, one on my finger, and then rub food on my skin while looking at a galvanometer making 'hmmm' noises sagely."
3) You know there's been Adderall shortages in the USA recently due to DEA manufacturing limitations right? So it's not like they're just throwing out to kids like it's a lolly scramble.
Anyway, it's about as ironic as 10,000 spoons when all you need a knife. That is, not at all.
The extra methyl group that differentiates it from regular amphetamine salts mainly serves the purpose of crossing the blood-brain barrier quicker. However, during this process it loses that extra methyl group. So whether you're taking meth or adderal, the chemical that actually reaches your brain is ultimately the same
In fact, methamphetamine is available as a prescription ADHD medicine under the brand name "Desoxyn"
https://psych.wisc.edu/news/easy-access-pressure-on-students....
Aderrall is a Schedule II drug. This is the same category as oxycodone and fentanyl.
https://www.therecoveryvillage.com/adderall-addiction/adhd-a...
_Edit: I am told I'm wrong on this front, and I stand corrected_
The fact that doctors are prescribing them too freely is definitely worth looking into.
But severely restricting medication that is used to effectively treat disease because it has abuse potential only harms legitimate users. But definitely worth auditing prescriptions to ensure that they're being issued for valid diagnoses.
But as for illegitimate users? You ban it, they'll find something else.
And as someone who needs ADHD meds to do things like "remember I have a todo list, remember where I left it, and remember to use it", I very much resent the people who abuse the meds I need to function in our society to pass their law degrees easier.
I resent the meth addicts who try to get an ADHD diagnosis for their kids so they can abuse (or sell...) their children's ADHD meds when they can't afford meth, because it means I have to pee into a jar every three months to prove I'm not a meth addict who is abusing methylphenidate.
(My country uses methylphenidate / Ritalin / Concerta (the slow release form) as the first treatment for ADHD, Adderall is not prescribed here that much, if ever, but it is possible to be prescribed dexamphetamine if you're bad enough).
But I really do object to glibly implying that every child who is prescribed a treatment for ADHD is actually a case of pharmacists gleefully overmedicating, it's naïve, unsympathetic, and, tbh, rather unfair to pharmacists.
As for what schedule a drug is... ...is the harm of Adderall abuse the same as the harm of fentanyl abuse?
Drug schedules aren't a good way to determine harm, IMO. They're a good way to discern moral panics though.
E.g., in my country, Class A, the drugs that attract the highest penalties, include magic mushrooms, mescaline, DMT, and that one you get from licking toads, bufotentine or something, alongside classics like heroin and cocaine.
Fentanyl is Class B, alongside opium, morphine, amphetamine, methylphenidate, MDMA, and one that always amuses me, hashish.
* There's probably some dumb-ass rules around declining to dispense abortifacients because of religious beliefs, I'm sure.
It's important to remember that no addict did this to you. An addict doesn't force Kaiser to charge me $20 when they demand I piss in a cup in order to receive my legally prescribed medication. It's fucking Kaiser, and the DEA, and the mad cap conservative politicians and their shitty fucking values. Drug addicts are suffering from a health problem, just like you and I are with our ADHD. None of us have the power to influence the massive engine of carceral drug policy and the promotion of mass moral panic about people taking medication that helps them.
It's important to point the anger at the right people.
As others said, it's not true. Pharmacists are also trained to spot any possible adverse drug interactions with other medications that you might be taking.
It more often happens in the clinical setting, rather than at retail pharmacies, but it still is a possibility.
I was definitely wrong.
This is not true. Pharmacists have the right to not fill a prescription for a number of reasons, and in fact can be held liable for not doing so.
If they feel the use of the drug is medically inappropriate they can decide not to fill it. If they feel the patient is taking it for a non-medical reason (abuse) they can choose not to fill it.
Pharmacists are medical professionals who are expected to use their judgement to make sure medicines are not used inappropriately.
P.S., have edited that statement after your correction, much obliged :)
It's kind of weird that people are calling this "abuse" when it's apparently using the drug in the same context and dosage as it's prescribed therapeutically, plausibly by people who actually have ADHD but don't have the time or insurance to get a prescription.
It's an interesting case study in what would happen if it was more widely available in a pharmaceutical form with a known dose and purity. What percentage of these college students are actually getting addicted to amphetamine vs. just taking a therapeutic dose here and there?
> Some examples of Schedule I drugs are: lysergic acid diethylamide (LSD), marijuana (cannabis)
Oh damn, marijuana is worse than this drug? I hope they arrest anyone selling marijuana. What’s that you say? Legal? In California? Oh, in lots of states?
In Poland, pharmacies are required by law to have a MSc in pharmacy present during operating hours - that is, no less than one pharmacist with a Masters degree. One is enough. Which means that's all you get. You may not even see them unless you're buying ADHD meds, which need MSc to sign off on them. Otherwise, you're almost always dealing with a pharmacy technician. Some are pretty knowledgeable[0], others could be replaced by GPT-3.5[1] with net benefit to the customer. The latter type, if they're going to notice anything about you, it's whether you're likely to buy some useless supplement or homeopathic product.
--
[0] - Probably on their way to MSc in Pharmacy, which is a mistake if they're looking for a pharmacy job - pharmacies don't want people with MSc, there's enough of them around already; they want the cheap technician labor.
[1] - Yes, not even 4.
Something can have therapeutic uses and still be over-prescribed.
The FDA rule on this [1] doesn't appear to be quite that strict: it says the ID can be "a photo identification card issued by the State or the Federal Government or a document that is considered acceptable by the seller". It doesn't explicitly say it has to be from the same state as the one in which you are buying the medication, and it leaves the seller some latitude in what to accept.
Possibly some states have more restrictive rules. Or particular sellers might be more leery about what they are willing to accept.
[1] https://www.fda.gov/drugs/information-drug-class/legal-requi...
Of course all of this is stupid in a world where the real junkies use fentanyl and there's other easy ways to make meth.
Green card holders also have a convenient wallet size for their green card, and they’re legally required to carry it with them at all times while in the US anyway.
However, a few months earlier due to a Google translate mixup where I thought I was ordering peppermint oil, I got 100ml of sassafras oil [0]. It's a precursor to MDMA and at least as restricted as pseudoephedrine.
edit: my bad, no it's codeine linctus that was banned, there was talk of making pseudoephedrine prescription only but that hasn't gone through.
We have the technology. "Behind the counter" could just mean a vending machine with good ID tech instead of queuing up for an overworked pharmacist behind a dozen people.
Pseudoephedrine should be easy and plentiful to obtain. I don't care if people use it to make meth. What they do in their private time doesn't concern me. Not being able to get Sudafed when I'm sick kills me. It's not like those people won't be able to get meth some other way.
We let people buy cars and cause 43,000 automobile deaths a year. People should be able to live life without stuffy noses. Maybe license people to buy meds and take it away if they abuse it? That's better than the draconian system we have now.
And don't get me started on ADHD medication and their shortages.
Edit: and there are 178,000 alcohol related deaths per year in the US. If you're going to allow that without prohibition, then please let us unstuff our noses.
I'm tired of living in a nanny state when we let people buy and own guns and swords and flamethrowers. Simply hiking on a mountain can kill you. Must we install guardrails on all the high places?
It's not that bad of a negative externality. Honestly. Not relative to all the other ones we've deemed acceptable. This is weird picking and choosing that doesn't make sense.
I sympathize with your broader point, but... how is that better? "Sorry, you were buying too much nasal decongestant a decade ago, so no cancer medication for you"?
Not that different from current situation: we have all our "license" to buy scheduled compounds revoked, but we still can get a lot of other compounds.
People were still trying to claim the program was a success because they had stopped gangs getting pseudo as a precursor.
But so what? it's done literally nothing to stop criminals profiting, nor to stop people getting addicted to meth, with all the associated public health and petty-criminal consequences of that. And now it's harder for ordinary people to get effective decongestant.
It just seems that nobody is willing to admit the whole thing was pointless.
The end result? The gangs just started importing pseudo, before later just switching to importing methamphetamine directly (something that Australia's deportation policies really helped with as the "501s" as we call them that were deported back to NZ often had existing connections that could facilitate the direct importation of meth).
It's a really interesting supply chain that involves organised crime groups in multiple countries, often starts in India for the precursors, then clandestine labs in Laos/Vietnam/Thailand overseen by Chinese groups in conjunction with local groups, then smuggled via the Pacific Islands, notably Fiji and Samoa where the Chinese groups have established transshipment facilities, before being smuggled into Australia and NZ by local groups who then distribute and supply it.
A new development has been the Central American cartels branching out from cocaine to meth so there's been a bunch of meth coming directly from the Americas.
>Maybe license people to buy meds and take it away if they abuse it?
I'm a bit confused, because you can buy it already with an ID, correct? You don't even need a purchasing license, just a drivers license or other government ID.
I just travelled there few weeks ago, and the government websites made it sound like it’s best to just not bring any pills at all (or chewing gum).
- Tool you can to use to check active ingredients and whether its allowed: https://www.hsa.gov.sg/personal-medication/check-requirement...
- Anything that might be controlled/require prescription, have to apply for permit it to bring it: https://www.hsa.gov.sg/personal-medication/submit-applicatio...
- They provide a tool to show illegal health products. Better not bring one of them: https://oscar.hsa.gov.sg/Publication/ahpdm/faces/AHPPublicat...
You can only buy from a pharmacist (behind the counter) and you need to provide your national ID number. Your purchase is put in a database that any pharmacist can see.
What's even worse, modern pseudoephedrine is produced in a form that makes meth synthesis from it extremely tedious and generally impossible in home conditions: https://pmc.ncbi.nlm.nih.gov/articles/PMC3793278/
I remember the video of the pharma rep or cop or whoever trying to make meth out of the new pills and the product getting squishy. Months later, a different video was published, where some household solvent was used to easily pull the very-dissolvable pseudoephedrine salts from the paste.
Anything that isn't directly physically addictive (e.g. opiates) or subject to a tragedy of the commons (e.g. antibiotics) should be over the counter.
Then, because the black market is already in violation of the law, there are no purity standards. The customer who thinks they're getting Adderall or codeine is actually getting fentanyl because fentanyl's much higher potency makes it easier to smuggle, but for the same reason makes it much more prone to addiction and overdose, especially when careless street dealers get their proportions wrong. All of which is avoided if you just let them buy it from the pharmacy.
Notice that there is no thriving black market for antibiotics propping up international drug cartels, because they're not addictive.
There is no thriving black market for antibiotics, because they are accessible when you need them (and most people need them very infrequently for a short duration). In contrast, I believe there is a black market for insulin in the US, and that's because of how ridiculously expensive it is. Exuberant pricing is a form of restricting access, too.
You want to control the general population’s access to physically-addictive substances to control addiction. Managing addicts is not a pharmaceutical matter.
Just yesterday on Reddit there was a thread that went viral for "cutter" reviews on Shein razor blades, with cutesy language like "beautiful beans for my followers" (referring to subcutaneous dermal appearance when deeply cut open). Every product can be abused in horrible ways. It's the nature of the stochastic bubble we're in. People will find every nook and cranny of the human experience.
You can't stop this stuff from happening. So at least let the normal use cases that benefit society through. Don't put everyone else in the same straight jacket. We don't deserve to be punished for the bad gradients some people fall into.
0: https://www.nhs.uk/medicines/pseudoephedrine/about-pseudoeph...
You ever seen a meth lab that blew up?
> Other side effects may include violent urges or, similarly, the urge to be successful in business or finance. ... > We expect that the simultaneous trends of restricting pseudoephedrine sales while N-methylamphetamine becomes less expensive and of higher purity will make the methods presented here increasingly attractive.
https://www.science.org/content/blog-post/other-methamphetam...
This is a satirical paper. Because pseudoephedrine (i.e. the good decongestant) is very difficult to obtain due to restrictions, but "N-methylamphetamine can be procured at almost any time on short notice", the paper describes how to synthesize pseudoephedrine from meth with a procedure that looks valid.
[1] https://improbable.com/airchives/paperair/volume19/v19i3/Pse...