Can someone explain the Adderall shortage to me?
August 18, 2023 6:56 AM Subscribe
Also, how to manage it? And a wall of questions.
There has been a shortage of Adderall for almost a year. It's frustrating, but what's especially frustrating is that it's opaque and impossible to navigate.
I get meds from a supermarket in New England. They have been unable to fill my prescription for a month. They say that they do get shipments, they don't know when they are going to get them, they order it every day, they get what they get, and they were oddly tightlipped regarding information about prioritization of outstanding orders -- do the drugs go to the people waiting the longest? They do not. How is it determined where they go?: 'Mumble mumble shrug'. So they order, they get some, it never goes to me. Why?
So:
-What's the deal and why is such a relatively uncomplicated medicine having such insane, truly insane, production problems? How has this gone on for a year?
-How do pharmacies fill or not fill orders when they do get shipments. I was told I need to call the pharmacy every single day to see if my prescription can be filled. Is that what prompts them to fill it? Me being annoying?
-No one, literally no one, advocates for the patient/consumer - the pharmacy doesn't consider it their responsibility to find out if it can be filled elsewhere. The doctor's office certainly doesn't. If I call around to area pharmacies, am I go going to be seen as 'drug seeking'? Is there specific language I should use? I would have to call all local pharmacies, find it, contact the doctors office and ask them to transfer the script to the new pharmacy for just that one order, correct? And then my doctor's office would have to miraculously comply with that request immediately, or the supply at that new pharmacy would be gone in less than a day?
-Is there some weird corporate subtext here?
-Should I switch to a different pharmacy? How would I know which pharmacy to switch to??
-Some people have to pick up paper prescriptions for Adderall or see their doctor X amount of times per year, I don't, because I've been on it a long time and I'm a boring middle aged lady, had the script for a long time, and my doctor doesn't think I'm sharing it with my friends and snorting it in a dorm room and she is correct about that. Or maybe my doctor is lazy. Or maybe my doctor is the problem. But I just call the doctor's office, leave a message asking for it, and they call the prescription in. Another fun wrinkle is that the request ages out after a month, so I have to know when the doctor's office actually called the script in, keep track of it, even if I don't actually get it and then call the doctor's office and re-request the whole process to start again the next month, even if I don't receive it.
I have absolutely no idea, but I am having a really hard time getting things done and it's accumulating and I'm starting to feel panicky.
We are talking about the non-generic version of 20mg XR (I think. Maybe it's XL), but I had the same experience earlier this year with the generic version.
No one seems to have any information or any willingness to help, and it's medication I need to function. The number of things waiting around for me to do them is increasing daily and freaking me out.
(Pls no digressions about overprescribed medications, overdiagnosed maladies, or the demands of late stage capitalism. Not that it isn't worth unpacking somewhere else, but I am trying to get at understanding the practicalities of what I realistically can or need to do to get a particular medicine.)
There has been a shortage of Adderall for almost a year. It's frustrating, but what's especially frustrating is that it's opaque and impossible to navigate.
I get meds from a supermarket in New England. They have been unable to fill my prescription for a month. They say that they do get shipments, they don't know when they are going to get them, they order it every day, they get what they get, and they were oddly tightlipped regarding information about prioritization of outstanding orders -- do the drugs go to the people waiting the longest? They do not. How is it determined where they go?: 'Mumble mumble shrug'. So they order, they get some, it never goes to me. Why?
So:
-What's the deal and why is such a relatively uncomplicated medicine having such insane, truly insane, production problems? How has this gone on for a year?
-How do pharmacies fill or not fill orders when they do get shipments. I was told I need to call the pharmacy every single day to see if my prescription can be filled. Is that what prompts them to fill it? Me being annoying?
-No one, literally no one, advocates for the patient/consumer - the pharmacy doesn't consider it their responsibility to find out if it can be filled elsewhere. The doctor's office certainly doesn't. If I call around to area pharmacies, am I go going to be seen as 'drug seeking'? Is there specific language I should use? I would have to call all local pharmacies, find it, contact the doctors office and ask them to transfer the script to the new pharmacy for just that one order, correct? And then my doctor's office would have to miraculously comply with that request immediately, or the supply at that new pharmacy would be gone in less than a day?
-Is there some weird corporate subtext here?
-Should I switch to a different pharmacy? How would I know which pharmacy to switch to??
-Some people have to pick up paper prescriptions for Adderall or see their doctor X amount of times per year, I don't, because I've been on it a long time and I'm a boring middle aged lady, had the script for a long time, and my doctor doesn't think I'm sharing it with my friends and snorting it in a dorm room and she is correct about that. Or maybe my doctor is lazy. Or maybe my doctor is the problem. But I just call the doctor's office, leave a message asking for it, and they call the prescription in. Another fun wrinkle is that the request ages out after a month, so I have to know when the doctor's office actually called the script in, keep track of it, even if I don't actually get it and then call the doctor's office and re-request the whole process to start again the next month, even if I don't receive it.
I have absolutely no idea, but I am having a really hard time getting things done and it's accumulating and I'm starting to feel panicky.
We are talking about the non-generic version of 20mg XR (I think. Maybe it's XL), but I had the same experience earlier this year with the generic version.
No one seems to have any information or any willingness to help, and it's medication I need to function. The number of things waiting around for me to do them is increasing daily and freaking me out.
(Pls no digressions about overprescribed medications, overdiagnosed maladies, or the demands of late stage capitalism. Not that it isn't worth unpacking somewhere else, but I am trying to get at understanding the practicalities of what I realistically can or need to do to get a particular medicine.)
(Before I dive in, This Vox piece goes into some more details about what I'm about to write, and summarizes much of what I've read elsewhere. It was written back in April but remains accurate as far as I can tell.)
So, unfortunately, we cannot talk about this without talking about overprescription, at least as a topic. I'm taking pains here to use language as neutral as I can - I'm going to try to explain what I understand about the situation, not judge the decisions themselves. I also can't answer most of your actual concrete concerns, like how to decide how to manage pharmacies. What I can do is try to explain one significant part of why you're enduring this problem: Why is supply remains extremely low relative to demand for what is, as you correctly note, a drug that is not hard to manufacture? The answer is: The Federal Government refuses to allow it, because they think it's overprescribed.
Prescriptions for ADHD meds have exploded in recent years - you may consider this BS or not, but it has definitely happened, which means demand has gone up a lot without increased supply. So, why hasn't supply increased to meet demand? Adderall involves controlled substances - amphetamines - which are tightly regulated by the Federal Government. To oversimplify a bit, the Feds thinks it's suspicious as hell that prescriptions have increased so dramatically in recent months, and is resistant to raising the limits on production because they don't believe the increased demand is legitimate. They fear a repeat of the opioid crisis, where pharmaceutical companies and doctors over-prescribed a legitimate drug and caused major issues. Just as shady local doctors handed out Oxy prescriptions, as the ysee it, telemedicine startups were just handing out stimulant prescriptions. There aren't actually many more people with ADHD than there were in 2019, so there's no need to ramp up production very much. So they're keeping a very tight throttle on production, in part as one of their few levers to try to discourage what they see as over-prescription.
posted by Tomorrowful at 7:17 AM on August 18, 2023 [5 favorites]
So, unfortunately, we cannot talk about this without talking about overprescription, at least as a topic. I'm taking pains here to use language as neutral as I can - I'm going to try to explain what I understand about the situation, not judge the decisions themselves. I also can't answer most of your actual concrete concerns, like how to decide how to manage pharmacies. What I can do is try to explain one significant part of why you're enduring this problem: Why is supply remains extremely low relative to demand for what is, as you correctly note, a drug that is not hard to manufacture? The answer is: The Federal Government refuses to allow it, because they think it's overprescribed.
Prescriptions for ADHD meds have exploded in recent years - you may consider this BS or not, but it has definitely happened, which means demand has gone up a lot without increased supply. So, why hasn't supply increased to meet demand? Adderall involves controlled substances - amphetamines - which are tightly regulated by the Federal Government. To oversimplify a bit, the Feds thinks it's suspicious as hell that prescriptions have increased so dramatically in recent months, and is resistant to raising the limits on production because they don't believe the increased demand is legitimate. They fear a repeat of the opioid crisis, where pharmaceutical companies and doctors over-prescribed a legitimate drug and caused major issues. Just as shady local doctors handed out Oxy prescriptions, as the ysee it, telemedicine startups were just handing out stimulant prescriptions. There aren't actually many more people with ADHD than there were in 2019, so there's no need to ramp up production very much. So they're keeping a very tight throttle on production, in part as one of their few levers to try to discourage what they see as over-prescription.
posted by Tomorrowful at 7:17 AM on August 18, 2023 [5 favorites]
Something that might help is switching your prescription to a chain pharmacy that has several locations in your area that you're willing to drive to. If your "home" pharmacy doesn't have what you need, you can request that they call the other locations to see which one has it and then they can very easily transfer your script to that location.
Also, the shortage isn't just because of an increase in prescriptions. There's a problem with the actual manufacturing of the formulation.
posted by cooker girl at 7:33 AM on August 18, 2023 [2 favorites]
Also, the shortage isn't just because of an increase in prescriptions. There's a problem with the actual manufacturing of the formulation.
posted by cooker girl at 7:33 AM on August 18, 2023 [2 favorites]
Best answer: Is that what prompts them to fill it? Me being annoying?
That’s one way to look at it, but another way is “indicating to them that you are definitely about to pick it up.” This feels like a byproduct of the current system in which the vast majority of prescriptions are sent in electronically rather than brought in on paper by the patient. If they fill a called-in prescription for patient X but meanwhile he’s been looking around to try to find it in stock and has had his doctor transfer it elsewhere, or if he doesn’t need it yet and isn’t going to come in to pick it up for a while (or at all, in which case they’ll restock it after 30 days), they can’t give it to you or to any of the dozen other people who are waiting for it.
posted by staggernation at 7:35 AM on August 18, 2023 [1 favorite]
That’s one way to look at it, but another way is “indicating to them that you are definitely about to pick it up.” This feels like a byproduct of the current system in which the vast majority of prescriptions are sent in electronically rather than brought in on paper by the patient. If they fill a called-in prescription for patient X but meanwhile he’s been looking around to try to find it in stock and has had his doctor transfer it elsewhere, or if he doesn’t need it yet and isn’t going to come in to pick it up for a while (or at all, in which case they’ll restock it after 30 days), they can’t give it to you or to any of the dozen other people who are waiting for it.
posted by staggernation at 7:35 AM on August 18, 2023 [1 favorite]
Yes, I can't speak to the specific med, but working with a chain pharmacy with lots of locations has saved my ass a few times with shortages of a different med that's still having pandemic-related-supply-chain-issues, as long as I'm willing to travel to another location.
At least for my situation, my local pharmacy was able to call over to the other place, confirm they still have it, and have them to put a hold on it for me. So I didn't have to worry that the other pharmacy would give it away immediately to someone else before I could get there. My impression was this was a same-day deal, and if I didn't turn up later that day they'd have given it to someone else tomorrow, so there are limits to this.
posted by Stacey at 7:37 AM on August 18, 2023 [1 favorite]
At least for my situation, my local pharmacy was able to call over to the other place, confirm they still have it, and have them to put a hold on it for me. So I didn't have to worry that the other pharmacy would give it away immediately to someone else before I could get there. My impression was this was a same-day deal, and if I didn't turn up later that day they'd have given it to someone else tomorrow, so there are limits to this.
posted by Stacey at 7:37 AM on August 18, 2023 [1 favorite]
Nobody in my house is an Adderall prescribee, but we and other folks we know had similar experiences with Ozempic this time last year.
The problem with Ozempic was that Ozempic is generally prescribed for Type 2 diabetes, but it also melts off weight over time. While a formulation for weight-loss has been released, there was supposedly a problem with the injectors and doctors turned to Ozempic. In actuality, the problem is that insurance covers Ozempic but not the weight-loss formulation (Wegovy). Doctors were already prescribing Ozempic off-label for weight loss and between the rush for Wegovy, whatever production SNAFUs actually happened, and the insurance issue, it was impossible to get Ozempic for months in the way you're describing for Adderall (calling around, all pharmacies out, etc.). A number of folks I know had to get through the shortage with other drugs, which didn't always work as well. Which is a problem when screwing around with diabetes will directly kill you and not always in the long term.
Based on our experience, it's a combination of factors; you should probably consider alternative drugs if you can handle them; and without getting into a late-stage capitalism rant, there are some issues across the health care/insurance industry and regulation that are combining to make your situation worse. Good luck finding meds and relief!
posted by gentlyepigrams at 7:43 AM on August 18, 2023
The problem with Ozempic was that Ozempic is generally prescribed for Type 2 diabetes, but it also melts off weight over time. While a formulation for weight-loss has been released, there was supposedly a problem with the injectors and doctors turned to Ozempic. In actuality, the problem is that insurance covers Ozempic but not the weight-loss formulation (Wegovy). Doctors were already prescribing Ozempic off-label for weight loss and between the rush for Wegovy, whatever production SNAFUs actually happened, and the insurance issue, it was impossible to get Ozempic for months in the way you're describing for Adderall (calling around, all pharmacies out, etc.). A number of folks I know had to get through the shortage with other drugs, which didn't always work as well. Which is a problem when screwing around with diabetes will directly kill you and not always in the long term.
Based on our experience, it's a combination of factors; you should probably consider alternative drugs if you can handle them; and without getting into a late-stage capitalism rant, there are some issues across the health care/insurance industry and regulation that are combining to make your situation worse. Good luck finding meds and relief!
posted by gentlyepigrams at 7:43 AM on August 18, 2023
My doctor always writes me paper prescriptions for adderall specifically so I can take them to any pharmacy that has it in stock
posted by Jacqueline at 7:53 AM on August 18, 2023 [3 favorites]
posted by Jacqueline at 7:53 AM on August 18, 2023 [3 favorites]
the pharmacy doesn't consider it their responsibility to find out if it can be filled elsewhere. The doctor's office certainly doesn't.
Actually just talked about this a few days ago with my doctor. He (independent practitioner) said he gets calls from patients about CVS being out of this that and the other thing so often that he simply couldn't be finding different pharmacies for everyone. He just doesn't have time.
For you when calling around: "hi, my usual pharmacy is out of my prescription and I'm calling to find out if you have stock" them: "sure, what's the medication?" you: "Adderall [type] [number] mg"
Should I switch to a different pharmacy? How would I know which pharmacy to switch to??
CVS generally sucks. The people are often great as individuals, but seem to always be overworked. And sometimes you have to be like "are you sure you're out, I was told a shipment was coming in today" and they'll be like "yeah, it's weird that it's not in the system. I, the third person you've spoken with, will check. Oh here it is"
ANYWAYS. My doctor has his office in a big building and a pharmacy opened recently-ish (sometime after the pandemic was cancelled?) on the first floor. They're independent and heckin awesome. My doc gave them a call, asked how much of a med they had left, and recommended they order more soon.
What I'm getting at is the rapport between doctor and pharmacy was super helpful. Not every independent pharmacy is awesome of course, but your doctor (or their office staff) may be a good source of info. You could try asking your doctor/doctor's staff what pharmacies they like, or which ones they don't hear complaints about.
If your doc is in a large healthcare group, there's a possibility they've got a pharmacy within the brand, might be worth checking out.
If you've got any independent or smaller/local chain pharmacies nearby, you could call or just go in and talk to them. Maybe say something like, "Hi, I'm looking to get away from [name] pharmacy, could you tell me if you're typically able to stock my medication?" They say, "yeah, what medication", you say "Adderall [type] [number] mg. I know a lot of places are struggling with shortages..." and then they tell you either they've been struggling with shortages too or they haven't had too much trouble.
I mean, ideally. That's how I'd expect the conversation to probably go.
In your shoes, if possible, I'd switch to a different stimulant that's not suffering from shortages. I am not saying YOU should because switching meds is a whole big thing with a lot of factors to consider. But if I was on Adderall, I would look at my med history, how I've done on various things, and ask my doc about switching to [other stimulant I spent hours researching instead of doing laundry probably]
I'm sorry, I know how hard this is. It seems SO unfair that in order to get meds so you can function, you have to do a whole lot of the kind of functioning that is typically difficult without meds
posted by Baethan at 7:54 AM on August 18, 2023 [6 favorites]
Actually just talked about this a few days ago with my doctor. He (independent practitioner) said he gets calls from patients about CVS being out of this that and the other thing so often that he simply couldn't be finding different pharmacies for everyone. He just doesn't have time.
For you when calling around: "hi, my usual pharmacy is out of my prescription and I'm calling to find out if you have stock" them: "sure, what's the medication?" you: "Adderall [type] [number] mg"
Should I switch to a different pharmacy? How would I know which pharmacy to switch to??
CVS generally sucks. The people are often great as individuals, but seem to always be overworked. And sometimes you have to be like "are you sure you're out, I was told a shipment was coming in today" and they'll be like "yeah, it's weird that it's not in the system. I, the third person you've spoken with, will check. Oh here it is"
ANYWAYS. My doctor has his office in a big building and a pharmacy opened recently-ish (sometime after the pandemic was cancelled?) on the first floor. They're independent and heckin awesome. My doc gave them a call, asked how much of a med they had left, and recommended they order more soon.
What I'm getting at is the rapport between doctor and pharmacy was super helpful. Not every independent pharmacy is awesome of course, but your doctor (or their office staff) may be a good source of info. You could try asking your doctor/doctor's staff what pharmacies they like, or which ones they don't hear complaints about.
If your doc is in a large healthcare group, there's a possibility they've got a pharmacy within the brand, might be worth checking out.
If you've got any independent or smaller/local chain pharmacies nearby, you could call or just go in and talk to them. Maybe say something like, "Hi, I'm looking to get away from [name] pharmacy, could you tell me if you're typically able to stock my medication?" They say, "yeah, what medication", you say "Adderall [type] [number] mg. I know a lot of places are struggling with shortages..." and then they tell you either they've been struggling with shortages too or they haven't had too much trouble.
I mean, ideally. That's how I'd expect the conversation to probably go.
In your shoes, if possible, I'd switch to a different stimulant that's not suffering from shortages. I am not saying YOU should because switching meds is a whole big thing with a lot of factors to consider. But if I was on Adderall, I would look at my med history, how I've done on various things, and ask my doc about switching to [other stimulant I spent hours researching instead of doing laundry probably]
I'm sorry, I know how hard this is. It seems SO unfair that in order to get meds so you can function, you have to do a whole lot of the kind of functioning that is typically difficult without meds
posted by Baethan at 7:54 AM on August 18, 2023 [6 favorites]
Best answer: To oversimplify a bit, the Feds thinks it's suspicious as hell that prescriptions have increased so dramatically in recent months, and is resistant to raising the limits on production because they don't believe the increased demand is legitimate.
in 2022, the manufacturers of amphetamine medications produced about 1 billion fewer doses than they were permitted to make, according to government records. They did not fully meet their quotas in 2020 or 2021 either.
posted by praemunire at 7:59 AM on August 18, 2023 [12 favorites]
in 2022, the manufacturers of amphetamine medications produced about 1 billion fewer doses than they were permitted to make, according to government records. They did not fully meet their quotas in 2020 or 2021 either.
posted by praemunire at 7:59 AM on August 18, 2023 [12 favorites]
Best answer: Not sure why or how your doctor is the problem. I’m coming at this from the perspective of a physician who prescribes stimulants often:
1. I simply do not have time to call pharmacies for my patients to find out what they have in stock. That is literally hours of work a day, and there are patients to see.
2. Yes, you need to call. No, there’s no way to know. In the past, before the shortage, there may have been concern about phone calls to pharmacies asking about adderall in stock or other controlled substances (happening much less now, but pharmacies have been robbed for controlled’s many times over). But with the stimulant shortage for over a year now, seems they are less concerned and answer questions more readily.
3. As for your doctor being lazy because she doesn’t provide you with paper scripts—in my state i legally cannot write prescriptions for controlled substances on paper scripts. They must be sent electronically, and with extra security measures as compared to non-controlled substances. The pharmacies here will not fill anything controlled on a paper script, and I appreciate that. And yes, they expire after 30 days. Thank the DEA.
4. I don’t know what kind of corporate subtext would be happening. Stimulants are not the only medication in short supply. Certain antibiotics for example needed inpatient are impossible to come by right now.
5. When you are due for a refill, you could call pharmacies to see if they have it in stock, then call your doctor’s office and ask them to send it to that pharmacy.
6. The shortage is not as simple as: this is overprescribed.
6.5 From my experience, no pharmacies do not just fill back orders first, the way perhaps Amazon would. As someone said above, they need to know someone is coming to pick up the medication. So yes, you need to call and ask them to fill it.
7. You are the patient advocate here. It’s not because your doctor and pharmacies don’t care, it’s because our healthcare system is overburdened on almost every level and most people working in healthcare—working with patients that is—are doing their best to keep their heads above water.
posted by namemeansgazelle at 8:23 AM on August 18, 2023 [13 favorites]
1. I simply do not have time to call pharmacies for my patients to find out what they have in stock. That is literally hours of work a day, and there are patients to see.
2. Yes, you need to call. No, there’s no way to know. In the past, before the shortage, there may have been concern about phone calls to pharmacies asking about adderall in stock or other controlled substances (happening much less now, but pharmacies have been robbed for controlled’s many times over). But with the stimulant shortage for over a year now, seems they are less concerned and answer questions more readily.
3. As for your doctor being lazy because she doesn’t provide you with paper scripts—in my state i legally cannot write prescriptions for controlled substances on paper scripts. They must be sent electronically, and with extra security measures as compared to non-controlled substances. The pharmacies here will not fill anything controlled on a paper script, and I appreciate that. And yes, they expire after 30 days. Thank the DEA.
4. I don’t know what kind of corporate subtext would be happening. Stimulants are not the only medication in short supply. Certain antibiotics for example needed inpatient are impossible to come by right now.
5. When you are due for a refill, you could call pharmacies to see if they have it in stock, then call your doctor’s office and ask them to send it to that pharmacy.
6. The shortage is not as simple as: this is overprescribed.
6.5 From my experience, no pharmacies do not just fill back orders first, the way perhaps Amazon would. As someone said above, they need to know someone is coming to pick up the medication. So yes, you need to call and ask them to fill it.
7. You are the patient advocate here. It’s not because your doctor and pharmacies don’t care, it’s because our healthcare system is overburdened on almost every level and most people working in healthcare—working with patients that is—are doing their best to keep their heads above water.
posted by namemeansgazelle at 8:23 AM on August 18, 2023 [13 favorites]
Should I switch to a different pharmacy? How would I know which pharmacy to switch to??
I've had very good luck with the mail-order pharmacy through my insurance. It used to be that you couldn't get Adderall via mail-order, but I guess that changed once they started requiring electronic prescriptions anyways. I get a 90 supply and have had it mailed out within 1-2 days every time. I'm on regular, not XR, not sure if that's part of it, but maybe check to see if your insurance/pharmacy benefits had something similar?
posted by matildatakesovertheworld at 8:51 AM on August 18, 2023
I've had very good luck with the mail-order pharmacy through my insurance. It used to be that you couldn't get Adderall via mail-order, but I guess that changed once they started requiring electronic prescriptions anyways. I get a 90 supply and have had it mailed out within 1-2 days every time. I'm on regular, not XR, not sure if that's part of it, but maybe check to see if your insurance/pharmacy benefits had something similar?
posted by matildatakesovertheworld at 8:51 AM on August 18, 2023
On transferring prescriptions: this has been mentioned, but I just want to clarify for you that if you are still in that month period where the script is still valid, this is a between-pharmacies thing and doesn't require getting a new prescription from your doctor. So if you call Pharmacy B and they have your med in stock, you can tell them you want to transfer your prescription to them. Typically they'll contact Pharmacy A for you and pull the prescription over. If that script is good for multiple refills, then, yes, it remains at Pharmacy B until/unless you ask them to transfer it back to Pharmacy A. In my brief experience as a pharmacy tech, it was super easy to transfer a prescription over to/from another pharmacy in our system. Not instant if it's going to a totally separate pharmacy; in my experience it's usually quick but YMMV. But yes, at least it doesn't rely on an instant response from your doctor.
posted by mandanza at 8:56 AM on August 18, 2023 [1 favorite]
posted by mandanza at 8:56 AM on August 18, 2023 [1 favorite]
I had this issue in April and we were going to run out of the Adderall while on vacation. I was like...no worries...I can just try and fill it while were on vacation...maybe the shortage there isn't such an issue...WRONG. Here is what I learned after many hours on the phone.
- pharmacies are hesitant to tell you other locations that have stock of high demand drugs because this tactic is being used by thieves to know which locations to rob.
- pharmacies fill existing pharmacy customers first before they will fill transferred in scripts...so calling a single script into a different pharmacy might not help. The Florida pharmacies flat out told me that they would never fill the script for me.
- I don't think these pharmacies have any idea of when they are getting the shipments of these in demand drugs. So, drug arrives, pharmacy fills the scripts they're allowed to fill (I don't know if they can fill scripts before they are due when it comes to controlled substances) and then...if you call right then, they might have to stock to fill yours. Then you immediately need call your doctor to ask them to call in the script to that location and then touch base with the pharmacy to make sure they received it and still have the stock to fill it.
- If you are a regular customer of this pharmacy, I'm not sure why they are filling other prescriptions and not yours...maybe your dosage is a little unusual and they are prioritizing filling more prescriptions at a lower dose...or filling more prescriptions for children versus adults.
One CRITICAL thing I learned is the dosage is a major issue...so when you call and ask about your current prescription and they say they don't have thirty (30) 20mg pills you need, then ask them if they have sixty (60) 10mg pills or one hundred and twenty (120) 5mg pills. If they have the different pill amount then you can call your doctor to ask if they can write the script for your regular dosage using that pill level.
Good luck...it's a mess out there.
posted by victoriab at 8:56 AM on August 18, 2023 [2 favorites]
- pharmacies are hesitant to tell you other locations that have stock of high demand drugs because this tactic is being used by thieves to know which locations to rob.
- pharmacies fill existing pharmacy customers first before they will fill transferred in scripts...so calling a single script into a different pharmacy might not help. The Florida pharmacies flat out told me that they would never fill the script for me.
- I don't think these pharmacies have any idea of when they are getting the shipments of these in demand drugs. So, drug arrives, pharmacy fills the scripts they're allowed to fill (I don't know if they can fill scripts before they are due when it comes to controlled substances) and then...if you call right then, they might have to stock to fill yours. Then you immediately need call your doctor to ask them to call in the script to that location and then touch base with the pharmacy to make sure they received it and still have the stock to fill it.
- If you are a regular customer of this pharmacy, I'm not sure why they are filling other prescriptions and not yours...maybe your dosage is a little unusual and they are prioritizing filling more prescriptions at a lower dose...or filling more prescriptions for children versus adults.
One CRITICAL thing I learned is the dosage is a major issue...so when you call and ask about your current prescription and they say they don't have thirty (30) 20mg pills you need, then ask them if they have sixty (60) 10mg pills or one hundred and twenty (120) 5mg pills. If they have the different pill amount then you can call your doctor to ask if they can write the script for your regular dosage using that pill level.
Good luck...it's a mess out there.
posted by victoriab at 8:56 AM on August 18, 2023 [2 favorites]
Please feel free to totally ignore this, as my experience is just mine, but I used to take Adderall and I do find Vyvanse more effective and convenient for me. Vyvanse is technically a long release version of Dexedrine, but doctors do not like to prescribe Dexedrine. Some people prefer it to Adderall.
I wanted to mention in case you are willing to switch, something might be better than nothing.
One psychiatrist's perspective:
I wanted to mention in case you are willing to switch, something might be better than nothing.
One psychiatrist's perspective:
My patients love Vyvanse. I try hard to convince people to take older, less expensive medications unless they're absolutely sure that the newer flashier one works better, but my patients are very convinced Vyvanse works better than Adderall. I used to think this was because something about the complicated timed release mechanism makes it "smoother". This is definitely what the pharma company that designed it wants me to think, and I admit there is some evidence for it.posted by lookoutbelow at 11:08 AM on August 18, 2023 [1 favorite]
But one neglected perspective is that once you take away the lysine, Vyvanse is basically Dexedrine, not Adderall. Almost everyone likes Vyvanse better than what they were taking before. But usually they were taking Adderall before. If Dexedrine is really better than Adderall - and common sense and the patient rating websites say it is - then that goes some of the way to explaining Vyvanse's superiority before we even get to the complicated timed release stuff.
Best answer: On transferring prescriptions: this has been mentioned, but I just want to clarify for you that if you are still in that month period where the script is still valid, this is a between-pharmacies thing and doesn't require getting a new prescription from your doctor.
Maybe this varies depending on where you live, but my experience (in several New England states), is that this is not the case for controlled substances like Adderall. With my ADHD meds (Vyvanse and dextroamphetamine), they will not transfer the prescription b/w pharmacies. I always have to get a new prescription.
I always make sure to just call the pharmacy right before I ask my doctor for the refill. If that pharmacy doesn't have it available, I call around until I find one that does. Then I make sure to call and ask them to fill the prescription as soon as my doctor sends it over.
I have found Vyvanse is the most likely to be in stock. I prefer Vyvanse to dexedrine, but my insurance won't cover it. Dexedrine hasn't been as bad as Adderall seems to be in terms of the shortage, but for several months, no pharmacy anywhere around me could get my dosage of dexedrine in stock. They weren't running out - it just wasn't being delivered.
posted by litera scripta manet at 11:36 AM on August 18, 2023 [6 favorites]
Maybe this varies depending on where you live, but my experience (in several New England states), is that this is not the case for controlled substances like Adderall. With my ADHD meds (Vyvanse and dextroamphetamine), they will not transfer the prescription b/w pharmacies. I always have to get a new prescription.
I always make sure to just call the pharmacy right before I ask my doctor for the refill. If that pharmacy doesn't have it available, I call around until I find one that does. Then I make sure to call and ask them to fill the prescription as soon as my doctor sends it over.
I have found Vyvanse is the most likely to be in stock. I prefer Vyvanse to dexedrine, but my insurance won't cover it. Dexedrine hasn't been as bad as Adderall seems to be in terms of the shortage, but for several months, no pharmacy anywhere around me could get my dosage of dexedrine in stock. They weren't running out - it just wasn't being delivered.
posted by litera scripta manet at 11:36 AM on August 18, 2023 [6 favorites]
I take the same medication and have had zero problem filling it at a major university in-hospital pharmacy. I was told by pharma rep that distributors basically have priority tiers and that actual hospitals are first tier, then standalone pharmacies, then grocery stores and others - there is never enough to go around and they don't want hospitals to be shorted is my understanding.
I'm not sure if this is accurate or not but it does seem to match my experience. I tried to originally get it filled at a Kroger pharmacy and they weren't even willing to take me on as a "new patient" for the prescription despite all my other meds being filled there.
Hope you can get it figured out, this type of stuff is super frustrating.
posted by _DB_ at 11:57 AM on August 18, 2023
I'm not sure if this is accurate or not but it does seem to match my experience. I tried to originally get it filled at a Kroger pharmacy and they weren't even willing to take me on as a "new patient" for the prescription despite all my other meds being filled there.
Hope you can get it figured out, this type of stuff is super frustrating.
posted by _DB_ at 11:57 AM on August 18, 2023
Response by poster: Thanks everyone. This has been helpful.
As for your doctor being lazy because she doesn’t provide you with paper scripts
I actually didn't mean she was lazy for that reason; I'm grateful I don't have to drive there and get a new physical script every month. Some patients at that practice do and have to jump through other hoops; it's at the discretion of the doctor, or was, the last time I spoke to my doctor. It's just not a quality doctor/patient relationship and I'm stuck with it. It's a whole future Ask thing if I can stand it, but my view of the whole American medical system is that every facet of it is so overburdened we are all our own doctors now and maybe that comes across as lazy but on the other hand maybe everyone is frustrated and exhausted, including my doctor, from whom I get a real 'two seconds from quitting' vibe of indifference.
Is that what prompts them to fill it? Me being annoying?
That’s one way to look at it, but another way is “indicating to them that you are definitely about to pick it up.”
Yes! Such a good call. Because guess what, I called today and said I had been told I had to call every day until they had it and after some 'checking the system' and 'asking the pharmacist' and being told they might be maybe able to fill part of it, could I just hold for a few minutes...they had it, and filled it fully. (They were perfectly nice, it's just that it's frustrating.)
I'm not uninterested in switching to something else it's just for the reasons above I sure would like to avoid seeing her...but maybe I'll get desperate enough.
Thanks for the info everyone, and thanks to all who commiserated.
posted by A Terrible Llama at 12:54 PM on August 18, 2023 [2 favorites]
As for your doctor being lazy because she doesn’t provide you with paper scripts
I actually didn't mean she was lazy for that reason; I'm grateful I don't have to drive there and get a new physical script every month. Some patients at that practice do and have to jump through other hoops; it's at the discretion of the doctor, or was, the last time I spoke to my doctor. It's just not a quality doctor/patient relationship and I'm stuck with it. It's a whole future Ask thing if I can stand it, but my view of the whole American medical system is that every facet of it is so overburdened we are all our own doctors now and maybe that comes across as lazy but on the other hand maybe everyone is frustrated and exhausted, including my doctor, from whom I get a real 'two seconds from quitting' vibe of indifference.
Is that what prompts them to fill it? Me being annoying?
That’s one way to look at it, but another way is “indicating to them that you are definitely about to pick it up.”
Yes! Such a good call. Because guess what, I called today and said I had been told I had to call every day until they had it and after some 'checking the system' and 'asking the pharmacist' and being told they might be maybe able to fill part of it, could I just hold for a few minutes...they had it, and filled it fully. (They were perfectly nice, it's just that it's frustrating.)
I'm not uninterested in switching to something else it's just for the reasons above I sure would like to avoid seeing her...but maybe I'll get desperate enough.
Thanks for the info everyone, and thanks to all who commiserated.
posted by A Terrible Llama at 12:54 PM on August 18, 2023 [2 favorites]
"I'm grateful I don't have to drive there and get a new physical script every month."
My doctor just writes me three paper prescriptions at a time and post dates the other two. Multiple doctors over the past two decades have always done it this way, so it seems like a standard process. Then I only need to see them 4 times a year.
posted by Jacqueline at 4:59 PM on August 18, 2023
My doctor just writes me three paper prescriptions at a time and post dates the other two. Multiple doctors over the past two decades have always done it this way, so it seems like a standard process. Then I only need to see them 4 times a year.
posted by Jacqueline at 4:59 PM on August 18, 2023
It's allowed for schedule II drugs (in at least some states?) but to clarify, they aren't postdated, they say something like "do not fill until".
But not all states are cool with paper prescriptions for scheduled meds unless the doc has a good reason for it. Even if there's no legal problem, a doctor may not want to give scripts for more than 30 days of a sched ii drug, for CYA reasons if nothing else. So it's not a common practice in my experience
posted by Baethan at 1:22 AM on August 19, 2023 [1 favorite]
But not all states are cool with paper prescriptions for scheduled meds unless the doc has a good reason for it. Even if there's no legal problem, a doctor may not want to give scripts for more than 30 days of a sched ii drug, for CYA reasons if nothing else. So it's not a common practice in my experience
posted by Baethan at 1:22 AM on August 19, 2023 [1 favorite]
I can't speak to Adderall, but I was getting super frustrated trying to get Sudafed. The good stuff, where you have to get it from the pharmacist and they check your ID. There was always a shortage, no matter what pharmacy I went to. Many times, I left empty-handed.
Called our family doctor and got a prescription for it, they transmitted the scrip to Amazon Pharmacy, and it gets delivered to our door for the whopping cost of $2/month.
I'm generally team Fuck Amazon and all that, but this just plain works.
posted by xedrik at 9:45 AM on August 19, 2023
Called our family doctor and got a prescription for it, they transmitted the scrip to Amazon Pharmacy, and it gets delivered to our door for the whopping cost of $2/month.
I'm generally team Fuck Amazon and all that, but this just plain works.
posted by xedrik at 9:45 AM on August 19, 2023
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posted by bluloo at 7:13 AM on August 18, 2023 [1 favorite]