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Adderall Shortage Sparks Fears of Opioid-Like Crisis

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Experts specifically have expressed concerns that the lack of legal Adderall will force people to turn to black markets as they did when the supply of opioids was cut off.


Ongoing Shortage

Public health experts watching the ongoing Adderall shortage in the U.S. have raised concerns about the possibility that it could cause a major health crisis.

In mid-October, the Food and Drug Administration (FDA) announced that there was a nationwide shortage of immediate-release Adderall. The agency specifically noted that Teva Pharmaceuticals, which is the biggest manufacturer of the drug, was “experiencing ongoing intermittent manufacturing delays.”

Since then, the FDA has also reported that there are other manufacturers experiencing similar problems as well. In statements to the media, Teva has explained that the supply disruptions were triggered by a combination of a since-resolved labor shortage on its packing line this summer, as well as increased demand for the drug.

Adderall prescriptions have skyrocketed over the last two decades. From 2006 to 2016, the prescription of stimulants more than doubled in the U.S., and those numbers have grown since the pandemic. According to figures from the data analytics firm IQVIA, from 2019 to 2021, Adderall prescriptions alone rose by about 16%, surging from 35.5 million to 41.2 million.

Experts say the big spike over the last few years has been driven by the fact that more people are seeking these drugs to help cope with stress and distraction. Telehealth regulations that were relaxed during the pandemic also made it much easier for people to get diagnosed and prescribed in shorter periods of time.

A growing number of new start-ups have been taking advantage of lax rules, flooding social media — and specifically TikTok — with advertisements telling people to get ADHD meds if they feel distracted or tired. Many professionals say these apps pose issues because they are designed for such quick diagnosis so it can be hard to tell if ADHD is actually the problem people who present those symptoms are dealing with.

The resulting effect has been renewed speculation that stimulants are being overprescribed — a factor some believe could also be driving this shortage.

Additionally, Adderall is a Schedule II controlled substance, so it is highly regulated by the Drug Enforcement Administration (DEA), meaning there are caps on how much each company can produce so they can’t just ramp up production to make up for the backlog. It is also difficult for pharmacies to just pivot and start carrying new brands because of the regulations on this drug.

Potential Crisis

Leo Beletsky, a professor of law and health sciences at Northeastern University and faculty director of the Health in Justice Action Lab, worries all these elements could create the perfect storm for a full-blown crisis.

In an interview with Rogue Rocket, he outlined two overarching concerns.

 “One is that you have lots of people who had access, sort of regular access to medication that they may not now have access to, and there are individual-level risks that sort of cascade from that,” he said. “Insomnia, depression, in some instances, you could even see suicidal ideation. So all of these are kind of, you know, health risks that result from rapid tapering or discontinuation, discontinuation of taking Adderall.”

“What is an even bigger concern or, an equally important concern, is that lots of people without access to the pharmaceutical supply will turn to the illicit market and counterfeit Adderall is readily available on the illicit market and other forms of unfettered means. Specifically, methamphetamine is available, widely available on the illicit market 24/7. You know, there’s no shortage in that market,” he continued.

Beletsky explained that there are a number of harms that can come as a result of people turning to the black market — and there is first-hand evidence of this from the opioid crisis. As he noted, opioids were also widely criticized as being overprescribed, and so when access was cut for prescription opioids, people turned to illegal markets and there was a massive spike in the use of heroin, counterfeit opioids, and fentanyl contamination.

“The public health, sort of population-level concern is that we might see similar patterns here where lots of folks are being pushed into the market and they’re, you know, it’s the Wild West. Counterfeit Adderall oftentimes does have methamphetamine,” he stated. Counterfeit Adderall can also be cross-contaminated with other dangerous drugs like fentanyl.

“Methamphetamine is even cheaper than counterfeit Adderall pills, and so the concern is that folks might start smoking meth and even injecting meth, which is, you know, increasingly common,” Beletsky continued. “It would be a huge public health disaster if thousands or even millions of people started taking methamphetamine in or trying to replace this pharmaceutical supply.”

Prevention Options

Beletsky pointed out a number of tools the FDA has at its disposal to address the possible crisis and clear up the shortage, including encouraging other competitors to create new sources of production, as well as encouraging the importation of Adderall from abroad.

However, while the agency would have the power to fast-track these actions to skirt regulatory hurdles, so far, they have not taken any of these steps. In response to questions as to whether the FDA will intervene and speed up the process, a spokesperson told Rogue Rocket  that the agency “evaluates all its tools and determines how best to address each shortage situation based on its cause and the public health risk associated with the shortage.”

When asked when the FDA thinks the shortage will be resolved, the spokesperson said it is “expecting the supply issues to resolve in the next 30-60 days.”

But Beletsky said he does not buy that timeline.

“I’m afraid that they may be over overly optimistic given the scale of the problem,” he told Rogue Rocket. “My guess is it’s going to take months to resolve. And I hope that, you know, most folks are able to kind of make do and not start kind of purchasing alternatives from the illicit market.” 

The professor emphasized that the current shortage is a symptom of broader problems with America’s overall system for drug regulation that goes beyond the FDA and centers on the powers granted to the DEA. 

Unlike the FDA, the DEA is a law enforcement agency, and Beletsky notes it has a long history of focusing on controlling the supply of these kinds of drugs rather than ensuring there is adequate access for the people who need them.

As a result, the DEA has very little control over both the legal and illegal markets for controlled substances. Because of this, people lack proper access to the prescriptions they need while the massive, unregulated black market is thriving.

Beletsky argued it is imperative that we use this latest shortage as yet another wake-up call to highlight the need for rethinking how drug access is structured in America.

“I think that it’s really important to highlight the failures of the DEA in this context, because the DEA, much more than the FDA, is responsible for finding that balance between access and control,” he said. “I think that we really need to reevaluate the role of the DEA in our drug regulatory system. And the FDA, on the other hand, probably could use additional authority.” 

“When it comes to essential medicines, we really need much more authority for governmental regulation to step in and sort of help to stabilize access to these particular medications, as well as many others.” 

How to Seek Help

Beletsky noted that there are several steps people who need Adderall can take until the shortage clears up.

“I think it’s important to note that there are other alternatives in the pharmaceutical supply that are not in shortage,” he explained. “And so talk to your provider about what additional tools may be available, you know, other stimulants that you can […] try to kind of bridge the gap.” 

“I think it’s also important to note that if you do turn to, you know, folks are turning to buying Adderall or other alternatives on the illicit market, it’s really important to test that supply, especially for fentanyl.”

For more information on obtaining test strips and other harm reduction tools, Beletsky recommended visiting Next Distro or finding your local harm reduction agency, which can be done on the National Harm Reduction Coalition website.

For those suffering the impact of the Adderall shortage, The Washington Post has a guide with helpful tips and ideas from professionals.

See what others are saying: (WIRED) (The New York Times) (Axios)

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College Board Changes AP African American Studies After Backlash From DeSantis Amid Education Culture War

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As requested by DeSantis, the College Board removed lessons on contemporary topics including Black Lives Matter, queer studies, and reparations.


College Board Rolls Out Curriculum

The College Board, which oversees Advanced Placement high school courses, announced an official curriculum framework for its new, landmark Advanced Placement African American studies on Wednesday.

The announcement, made on the first day of Black History Month, has faced scrutiny for seeming to scale back a number of relevant subjects that Florida Gov. Ron DeSantis (R) and other state education officials had criticized.

In January, DeSantis said that the new course would be banned in Florida unless changes were made, arguing that a draft version of the course was “woke.” 

Education officials claimed that the class, which had been in the making for nearly a decade, violated a recent state law dubbed the Stop WOKE Act. The legislation regulates public school instruction on race by banning critical race theory and any education that describes some groups as oppressed and others as privileged based on race or sex.

Democrats denounced DeSantis’ action as a political stunt and urged the College Board to maintain its principles.

According to reports, many historical topics like slavery largely remain intact from the previous draft. However, important contemporary issues like Black Lives Matter, affirmative action, queer studies, reparations, and intersectionality — all of which Florida leaders objected to — were removed from curriculum requirements and are no longer part of the AP exam.

Instead, those areas of study have been downgraded to be part of a list of options students can pursue for a mandatory research project. The College Board also added a new research project idea to that list that will certainly please the right: “Black conservatism.”

It has additionally been reported that the organization pulled names of multiple Black authors the state education officials had flagged as problematic, including many famous and pioneering Black scholars who wrote about critical race theory, the queer experience, and Black feminism. 

The College Board defended itself against criticism in a press release announcing the changes, claiming that the process of developing the framework “has operated independently from political pressure.”

DeSantis’ Ongoing Culture War

DeSantis’ attempts to influence the national curriculum of an AP course are just his latest in a much broader effort to control what is and is not taught in public schools.

Just one day before the College Board announced the revised course, the governor outlined what The New York Times described as “his most aggressive swing yet at the education establishment.”

Specifically, he proposed a massive overhaul to higher education in the state that would defund and eliminate diversity and equity programs, mandate courses on Western civilization, and reduce tenure protections that are essential to ensure professors have freedom of expression.

Furthermore, the effects of another law DeSantis signed last year are now just beginning to materialize. The policy, which went into effect this July, requires every school book to be age-appropriate, “free of pornography,” and “suited to student needs.” 

To follow those guidelines, school books have to be approved by a certified media specialist who has undergone specific training.

Notably, the law also states that teachers can be charged with third-degree felonies if they “knowingly or unknowingly” give students access to a book that the specialists say is harmful — meaning that they could face up to five years in prison and a $5,000 fine.

Last month, the state education department clarified that the rule does not just apply to school libraries, but also to any books a teacher keeps in their classroom too. 

Multiple outlets reported this week that records they obtained show at least two school districts have now directed teachers to either remove their books or hide them until review to avoid the possibility of going to jail.

See what others are saying: (The New York Times) (The Washington Post) (The Associated Press)

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Biden Announces Plan to End COVID Emergency in May

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The decision would drastically change the government’s long-standing pandemic response and shift Americans’ access to COVID-related services.


Emergency Declarations at an End

In a statement Monday, The White House announced that it would be ending the COVID national emergency and public health emergency declarations on May 11.

The move will entirely restructure the federal government’s response to the pandemic to treat it as endemic and upend policies that have been in place for the last three years. Although more than 500 people in the U.S. are still dying from COVID on average each day — which is around two times the number of daily deaths during a bad flu season — life has largely returned to normal.

Most Americans are vaccinated, and even President Joe Biden himself said the pandemic was “over” back in September. The new announcement comes in part as a response to resolutions Republicans brought to the House floor last week that would end the declarations immediately.

“An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans,” the White House argued.

Lapses in Coverage and Care

Federal officials decided that a phase-out would make more sense because the U.S. has come to rely on several systems and benefits under the emergencies.

One of the most significant changes that will have the biggest impact on Americans in their day-to-day lives is access to COVID tests, treatments, and vaccines that have been free throughout the pandemic.

Once the emergencies end, a very complex wave of changes will take place that differs from person to person depending on their insurance — or lack thereof — and even possibly what state they live in.

Currently, people with private health insurance or Medicare coverage have been allowed eight free COVID tests a month and insurers had to cover those tests, even if they were administered out of network.

Once the emergency ends, some Americans will have to pay out of pocket, as well as for antiviral COVID treatments like Paxlovid. 

Notably, it has been reported that vaccines will still be included for all those people covered by both private and public insurance. That, however, may not be the case for those without insurance — a group that is also more likely to be the most affected by rising costs for tests and treatments.

Jen Kates, a senior vice president at the Kaiser Family Foundation, told The Washington Post that when the emergency declarations end, states that opted to provide Medicaid coverage for tests, treatments, and shots will lose the federal funds that matched costs at 100%.

“To me, that’s the biggest issue for the general public to think about,” she said. “The uninsured and underinsured have no guaranteed access to covid vaccines, tests or treatments.”

When it comes to vaccines, those costs could be significant. Moderna and Pfizer have both said they might charge as much as $130 per dose of vaccine once the federal government stops paying and the shots are transitioned to the private market. That figure is nearly quadruple what federal offices have paid for the doses.

The shift to the private market could happen fairly soon, especially because Republicans have refused Biden’s request that they put billions of dollars towards additional free COVID testing and shots to extend those efforts.

There could also be a spike in the number of uninsured or underinsured Americans because the $1.7 trillion spending bill passed last year ends a rule that banned states from kicking people off Medicaid, leaving millions at risk of losing coverage.

Other Possible Outcomes

Ending the declarations could also set up a battle around immigration because the Biden administration has said the move will bring an end to Title 42 — the Trump-era public health measure that placed restrictions on border crossings and other migrant policies.

Biden has previously tried to cut the program, but the Supreme Court kept it in place. House Republicans rejected the White House’s claim that the program would be terminated, arguing it is not tied to the public health emergency.

Beyond that, the termination of the declarations would require health providers to make numerous adjustments because many of the flexibilities they were allowed in a number of areas would be cut. 

As a result, the administration says a phase-out of those policies over the next few months is necessary, arguing that hospitals and nursing homes “will be plunged into chaos” if they are cut immediately. House Republicans, however, are insistent on moving forward their legislation that would do just that, though the Democratic-controlled Senate could block their proposals.

See what others are saying: (The New York Times) (The Washington Post) (The Associated Press)

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Conservatives are Mad at “Woke” Xbox for Minor Climate-Related Updates

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The fury comes after Xbox announced it was slightly altering existing consoles to better utilize and save energy.


Same War, New Battlefield

Mere days after M&M canceled their “spokescandies” due to backlash from the right, led largely by Fox News’ Tucker Carlson, conservatives have found a new front for their ongoing culture war: Xbox.

Carlson spent months complaining that small character redesigns were “woke” because they made the animated anthropomorphized M&M’s — in his own words — “less sexy.” His campaign finally proved successful on Monday when the company announced it would be doing away with the spokescandies and replacing them with actress Maya Rudolph.

Conservatives, now facing a sudden dearth of non-issues to complain about, quickly found a new issue to rage against. Xbox announced in a blog post earlier this month that it is making minor updates to lower its environmental impact as part of an effort to reach Microsoft’s goal of being carbon-negative by 2030.

Now, instead of having an Xbox wake up to update games, apps, and software during random times of the night, it will do that at a time of night when a user’s local energy grid is generating the most power it can from renewable sources. 

Xbox also said it would automatically update some older consoles to a power-saving mode that aims to reduce electricity consumption when it is turned off — a feature that is already the default on newer consoles.

According to The Verge, the only difference for users is that an Xbox in power-saving mode takes around 15 seconds to boot up instead of doing so immediately as the console does in “sleep” mode. The change is a small price to pay for what the outlet described as “significant” energy savings.

Xbox Under Fire

To many leading conservative voices, the minimal shifts were just another example of “woke” culture. 

While discussing M&M’s spokescandies Tuesday morning, “Fox and Friends” co-host Ainsley Earhardt brought up Xbox’s new changes with Fox radio host Jimmy Failla.

“So Xbox has also announced that they’re going woke too, you know, because of climate change,” Earhardt said.

“I mean, it’s crazy what they’re doing, but we understand what this is. It’s not that it’s actually going to offset emissions, okay — the level of reduction is infinitesimal,”  Failla claimed, without evidence. “But they’re trying to recruit your kids into climate politics at an earlier age; make them climate conscious now.”

“Yeah, I didn’t think of that — you’re right, they’re going after the children,” Earhardt agreed, despite the fact that internal data from Microsoft shows just around 10% of Xbox owners are under the age of 18.

Other prominent conservatives also did their part to bait Americans into anger on social media, including America’s Foundation, which posted a tweet stating that “the woke brigade is after video games.”

The post linked an article from the right-wing website TheBlaze, which asserted that “Xbox will force gamers to power down to fight climate change.”  That, however, is false — Xbox has said users can switch back and change the settings any time they want

Still, top lawmakers continued to share the article and spread its false claims, including Sen. Ted Cruz (R-Tx.).

“First gas stoves, then your coffee, now they’re gunning for your Xbox,” he wrote in the post, which was flagged by Twitter and given an “added context” warning.

The same warning, however, was not placed in a very similar post by Rep. Troy Nehls (R-Tx.), who also shared the article.

“They want to take your guns. They want to take your gas stoves. And now they want to take your Xbox. What’s next?” he wrote.

See what others are saying: (The Washington Post) (The Daily Beast) (VICE)

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