I found out recently that you don't just need a decent government ID; it needs to be from the state you're purchasing the Sudafed from, because apparently each state administers its own database. If you run out and have a persistent cough (weakened immune system from not licking doorknobs the last few years of covid, or so do the doctor says) from a common cold while on vacation, you're shit out of luck unless you go back home or you and an accomplice are willing to procure your cough medicine with their license.
> you don't just need a decent government ID; it needs to be from the state you're purchasing the Sudafed from
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.
The FDA rule doesn't restrict the IDs but the phrase "that is considered acceptable by the seller" lets the pharmacy put any restrictions in place they want. They can tell you it has to be hot pink and glow-in-the-dark and you've got no choice but to deal with it.
While true as long as they're in compliance with the law, wouldn't they want to sell all the Sudafed they can? They can deny service to anyone for pretty much any reason. No shirt, no shoes, no Sudafed or anything else. So yeah, but in reality it isn't aligned with their interests and if they don't want to serve you they can always find a different justification.
Maybe they want that, maybe they don't. Retail drug stores in the US are an oligopoly, that industry may not be a monopoly (yet) but they don't function under perfect competition. Maybe if you're the management or the shareholders of a retail drug chain you're just kind of shrugging your shoulders and working on the next merger at this point since the fewer competitors you have, the less hard you have to work for the customer's dollar.
The “acceptable by the seller” wording only applies if the ID is not issued by “the State” or “the Federal Government”. Wouldn’t the latter option mean that a US passport, a green card, a Global Entry card, or a NEXUS card must be accepted as suitable ID by any seller in any state? All of those are issued by the feds.
States like MA legally only accept MA IDs and federal govt IDs for age verification. That’s why a lot of bars and packies will turn people away or ask for additional proof like CC’s. You’re more likely to be held liable for misconduct if the license you accepted is out of state.
The wallet-sized passport card is a great solution for that case then. It’s much cheaper than the regular passport book (and you are allowed to have both at once), doesn’t invalidate your regular passport book if it gets lost or stolen, and is also usable to go between the US and Canada by land or sea without having to bring the passport book with you. For people with a Global Entry or NEXUS card, that card also works for every case where the passport card does (and more).
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.
Here in Vietnam it's completely impossible to get pseudoephedrine at all and I think it's the same in all Asian countries. I even resorted to trying to buy some ephedra tea (Chinese medicinal herb from which ephedrine was first discovered). I ordered a box of tea bags from Shopee.vn and rather amusingly received an envelope with the amount I had paid including shipping in cash and an apology letter saying they could no longer sell this herb and please don't leave a bad review.
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.
It's readily available in Thailand and Indonesia. You can get it mixed with paracetamol OTC in Singapore, but almost everything in Singapore requires a prescription (even e.g. throat lozenges) so find a doctor if you're staying for a while. In Malaysia you need a prescription.
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.
Once again, big thanks to paranoid "mark of the beast" conspiracy theorists with funny ideas about federal government IDs and digital IDs.
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.
Adderall is a 3:1 dextroamphetamine/levoamphetamine mix.
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.
> Methamphetamine is a whole other level of stimulant.
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"
I thought that (1) meth (e.g. methylphenidate a.k.a. ritalin) blocks reuptake of dopamine, and (2) amphetamine (e.g. dextroamphetamine) stimulates production of dopamine, and (3) methamphetamine (a.k.a. desoxyn) does both. Is that understanding accurate?
“Meth” is methamphetamine, not methylphenidate. Ritalin isn’t the same thing as Meth. Not sure about how Ritalin vs Adderall act different on dopamine.
~~Pharmacists have no ability* to not dispense medicines if a doctor prescribes them.~~
_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.
> I very much resent the people who abuse the meds I need to function ... I resent the meth addicts ... it means I have to pee into a jar every three months to prove I'm not a meth addict who is abusing methylphenidate.
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.
Using telemedicine in New Hampshire, I don't have to take any drug tests for mine, just self-report my blood pressure and pulse on zoom every 3 months.
> Pharmacists have no ability* to not dispense medicines if a doctor prescribes them.
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.
> ~~Pharmacists have no ability* to not dispense medicines if a doctor prescribes them.~~
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 think the parent post is more likely alluding to the abuse of the medication, particularly in higher learning institutions.
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?
Damn, if Schedule II drugs are that bad, Schedule I drugs must be terrible. Let me go see:
> 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?
Schedule I "merely" means:
The drug or other substance has a high potential for abuse.
The drug or other substance has no currently accepted medical use in treatment in the United States.
There is a lack of accepted safety for use of the drug or other substance under medical supervision.
The more interesting take for me is that these meds work roughly the same way and almost as well in people without ADHD (a symptom cluster, not a single disease per se, like everything else in the DSM). As we give them to people with ADHD why not let anyone get a scrip?
People without ADHD already get more than enough benefit from just coffee. Stimulants might be able to benefit them further, but if you let anyone take them, eventually it'd become expected of everyone due to their increased productivity, and the potential consequences of abuse are much higher than coffee.
Chronic use of caffeine blunts the effects, it doesn't do much to regular drinkers. You develop tolerance very quickly. I can drink several cups and get basically no effect. Apparently your body just increases the quantity of adenosine receptors in the brain to offset the caffeine.
I didn't say it's not real. A doctor prescribed me Adderall at 18 after talking to me for 5 minutes because I was having trouble sleeping. It did more harm than good.
Something can have therapeutic uses and still be over-prescribed.
I don’t know why you are being downvoted, adhd medication is insanely overprescribed. Turns out, kids get antsy and hard to control after cramming them into overcrowded rooms for 8-9 hours a day doing slop work. Some schools are now forgoing any form of recess at all. Modern public education is inhuman and dystopian.
It is absolutely not the job of a pharmacist to make decisions about which drugs are being overprescribed, and IMHO it's a dangerous thing to suggest. The pharmacist should assess for drug interactions, but we can't burden pharmacists with knowing the details that went into a prescription, and we shouldn't have them second guessing the diagnosis of a doctor. Down that road lies madness.
I get where you're coming from but pharmacists have the right to refuse to fill a prescription and in fact can be held liable for not doing so. Pharmacists are trained medical professionals and are expected to use their judgement
It's one thing to use their judgement to refuse somebody who is going to get a bad drug interaction, and another for a pharmacist to say "I've given out too many of X prescriptions, I'm going to start cutting off people from their prescription based on my judgement of them," and this latter one is what was under discussion and the one that I'm rejecting.
Another thing is, do you get an actual trained and knowledgeable pharmacist, or a technician?
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.
