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gerneric Adderall Unavailability
I am a Doctor of Pharmacy who was diagnosed with Post Traumatic Stress Disorder with a co-morbidity of ADHD in December of 2003. I had been dealing with Fibromyalgia and Chronic fatigue Syndrome for several years but still somehow managed to work 50 - 60 hours a week in administrative positions in hospitals around the country. Unfortunately the diagnosis of PTSD and ADHD put a premature abrupt end to my passion to provide the best pharmaceutical care to all patients in the hospital I was currently working at. I was forced to retire at the age of 51 and currently receive SSDI. My family lived below the poverty level when I was a child and I made a vow to myself at the age of four that somehow someway I was going to obtain a full scholarship to a University and study to become a pharmacist. I had two reasons to make that vow: I desperately wanted to escape from the poverty conditions I was forced to live in; my plan was to obtain a position in which I would earn enough money to enable me to never ride on a bus again and shop anywhere for clothes other than K-Mart. I was also quite sickly as a child with multiple episodes of bronchitis and pneumonia (I was living in a town that was the home of a steel company in the fifties 11 miles south of Pittsburgh, PA. There were no systems in place to control toxic emissions from the steel mill at that time - over a 24 hour period about 3/4 of an inch of soot colored dust would find its way into every nook and cranny in your home). I realized at the age of 4 that when I was sick, my mom would take me to see a man who used some object to listen to my heartbeat and chest. He would talk to my mom and give her some pieces of paper. We would then go to a place that had a soda fountain where I sipped at a milkshake while my mom went to the back of the store and gave the pieces of paper to another man. About 15 minutes later he would give her several bottles of "candy" and when we went back home she would give me the "candy". At the age of four I realized that the first man was called a "Doctor" and the second man was called a Pharmacist". The pharmacist gave my mom medications that would make me well. I had already decided that i would work in a hospital when I grew up to help make patients well again. It was the pharmacist, not the doctor, who provided the medications to make me healthy again. My passion to provide pharmacy services to sick patients grew stronger over the years; I graduated from high school as the class valedictorian with a GPA of 4.00. I was awarded a full 5 year scholarship at Duquesne University in Pittsburgh, PA to attend the college of pharmacy which completely paid for my tuition, my room and board, all the books I was required to purchase, along with my lab fees. My off the charts IQ, photographic memory, and passion to become a pharmacist were a gift from God that I would be a fool to ignore. When I graduated from pharmacy school I had already been chosen to fill one of the two highly coveted positions to attend graduate school to become a Doctor of Pharmacy Over the course of my 29 year career as a pharmacist my entire life revolved around pharmacy practice - I would have paid money for the opportunity to fulfill my passion. But God gives, and God takes away, for reasons known only to Him. After my psychiatric evaluation for three hours by the most competent, nationally recognized psychiatrist in West Texas (another gift from God) was finished, and his diagnosis of my mental issues were PTSD and ADHD, he gently told me that I would never be able to fulfill my all consuming passion to practice pharmacy again. I was totally overwhelmed and immediately became completely numb mentally and physically by this information; I instinctively knew that my life would never be the same again. After this psychiatrist gave me some time to absorb this traumatic event, he reminded me that I had gone to college for 5 years, went to graduate school for three years to obtain my doctorate in pharmacy, along with doing a 3 year internship and a two year fellowship in critical care and cardiac care; - it took him the same number of years to achieve his lifetime dream of becoming a psychiatrist. He considered me to be an equal of his; he told me he wanted me to work with him and freely discuss my opinions about my treatment options and goals. Together we would come up with a plan to achieve stabilization of my PTSD to enable me to eventually gain happiness and contentment in my new life. The psychotherapy style we chose was a combination of behavior modification and discussing my problems dealing with mental illnesses and how to address them. for medication we chose Adderall XR 60 mg daily, Klonopin 2 mg 4 times a day, and Trazadone 450 mg at bedtime. I qualified for Shire's Patient Assistance Program and was able to obtain 60 Adderall XR 30 mg capsules monthly at no cost to me. I started taking the Adderall in the third week of December 2003 and since the Adderall helped me stay on task and concentrate on whatever I was doing we immediately achieved one of our goals. I took Adderall XR 60 mg daily until June of 1998 when i received a letter from Shire informing me that they were dropping Adderall from their list of meds available through their PAP. The letter suggested that i talk to my doctor about switching Vyvanse - a new ADHD med that was available through their PAP at no cost to me. My psychiatrist and I have the same conservative, skeptical ideas about newly released medications - wait for some statistically significant data to accumulate over a few years; then decide on whether we would recommend trying that medication. But my options were extremely limited: the amphetamine class of medications are the only medications statistically proven to work in Adult Onset ADHD. Both of us independently reviewed articles published in peer-reviewed journals and we both arrived at the same conclusion: 287 mg of Vyvanse was the equivalent dose of 60 mg of Adderall XR. But the maximum FDA approved dose was 70 mg daily. I reluctantly agreed to take Vyvanse 70mg for 60 days; after the 60 days had passed we would re-evaluate our decision. After 10 days I told my psychiatrist that Vyvanse 70mg daily had absolutely no effect on my ADHD - instead it made me extremely sleepy. But I had made a agreement with my psychiatrist to take this med for 60 days; I fulfilled this agreement. But on 09/12/08, the 61st day, I begged him to search his extensive mental knowledge of psychiatric medications and come up with some other options - and I already knew they were limited. We decided that I would try taking Dexedrine 15 mg Spansules - 30 mg every morning. It was immediately apparent to m after a week that they were better than Vyvanse, but only approached 40% effectiveness compared to Adderall. I also had an issue with Dexedrine's effectiveness varying daily. On 02/23/09, at my weekly appointment with my psychiatrist, I suggested adding D-amphetamine 10 mg IR tablets to boost the effectiveness of taking 30 mg of Dexedrine Spansules in controlling my ADHD. This did help me cope with my ADHD a little bit better, but it was not even close to the effectiveness of Adderall XR 60 mg. On 09/19/09 we both read the same article on the internet announcing the availability of generic Adderall. My next appointment with him was on 09/21/09 - when I walked in the door and checked in with the receptionist, my psychiatrist was standing at the reception desk impatiently waiting for me to arrive. Both of us were jumping for joy that generic Adderall was finally available. but before he wrote a prescription for Adderall, I asked him if Ii could borrow his laptop and research the websites of the various pharmacies in town for prices. The average price I found for 60 generic Adderall ER 30 mg capsules was around $176 - way beyond what I could afford to pay. But the average price I was quoted for 60 generic Adderall IR tablets was $61.41 - I could afford to pay that if I cut back the food budget from $80 weekly to $65 weekly. 09/21/09 through 10/10/11 I had an Rx filled for an average cost of $71.00. When i brought my Rx for Adderall to be filled at my pharmacy I literally passed out cold when they told me that not only were all strengths of generic Adderall 30 mg IR tablets unavailable indefinitely, they also have been having difficulty obtaining any strength of Adderall ER tablets. But it was my "Lucky Day": they happened to have 82 generic Adderall ER 30mg capsules available in stock today. The cost for 60 capsules was $328.29. I was unable to think clearly but it was obvious that I had to purchase those capsules or do without. I have spent the last 60 hours trying to find out what is going on. All the previous comments and opinions about what is going on are all true in some way. The FDA, under a mandate from the DEA, has severely restricted the total monthly manufacturing of the raw ingredients of the four different variations of amphetamine that Adderall is composed of. This cruel decision will not even make a teeny weeny dent in the demand for amphetamine products in the USA; folks this is straight from the textbook for Economics 101 - Supply must equal demand to maintain price stability. When demand overwhelms supply prices WILL go as high as the market will pay. Without Adderall, I cannot even gather the strength to get out of bed, let alone cope with any of my ADHD symptoms. Once I am finally able to crawl out of bed within two hours I have started at least 10 tasks that I quickly lose interest in. Stay on task and concentrate/focus - it just does not happen! I am a neat freak; but without my Adderall by the end of the day my apartment looks like a disaster took place that day. Every day I go without Adderall the disaster increases in severity - I am having nightmares of becoming a hoarder! My advice to all of us that truly have the nasty version of ADHD is (and believe me I know firsthand how hard this will be) is to torture your state and national congressman, President Obama along with his wife Michelle, and all of your local elected officials (this is an election year!) as often as you can by writing long letters about the hardships they have permitted the government to impose on us. Contact the news media relentlessly until it becomes a national story of hardship and discrimination. Severely restricting the supply of raw amphetamine is NOT the right way to approach the multi-headed dragon of abusive use of drugs in our country. I do not have the answers to that problem; all I know is that I cannot afford to pay $328.29 one more time; I did not have the money to pay for it this month. I am going to have to skip paying this months bills for everything except rent, utilities, and a small amount of food. I have a retired service dog and an active service dog; both of them are certified in mobility impairment and psychiatric impairment; and their needs will always come ahead of mine. They can survive without me, but Ii cannot survive without them. I live with my husband who for the first 11 years of our marriage was the kindest, most affectionate, fun loving person who could make me laugh until I got the hiccups; but when I was diagnosed with PTSD and ADHD he turned into his evil twin brother. We are currently totally estranged - he has not spoken a word to me for 8 long years and is totally indifferent to my presence and my needs. he stays in MY apartment for two reasons: technically, according to psychiatric standards of practice, I must have a 24/7 caregiver who lives with me. The second reason is that he has never even looked for a job since I was forced to retire - why should he when he can live off my SSDI? My family does not communicate with me at all, and all my so-called friends disappeared when I was diagnosed with mental illness. The only time I am able to communicate with someone is at my weekly appointment with my psychiatrist. I am responsible for everything involved in running a household including the monthly budget - my husband will not get off his lazy butt and do anything except play online poker day and night. Even with my Adderall I have extreme difficulty juggling all the balls in the air; I have told my mind not to even dwell on the fact that I may no longer be able to obtain generic Adderall - just thinking of it will make what my husband calls me: "Crazy Lady" become true. I do have a few things I can depend on; my core skill is problem solving, I am a 3rd generation Russian American - my grandmother was 4 years old when she stepped off the boat at Ellis Island - and I have inherited all of her stubbornness, strength, and incredible will to survive anything. But I have deteriorated rapidly mentally since I picked up my Adderall Rx on October 10th; I am unable to do anything except sit in my recliner and mindlessly watch TV at this time. My heart and prayers are with all of you in this incredible dilemma - unfortunately it is up to us to solve it because nobody else gives a da.. about people with mental illnesses.
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