FDA crackdowns and a shortage of staff in the pharmaceutical industry are making it harder to get controlled substance prescriptions filled.
On October 12, 2022, the FDA announced a shortage of instant-release Adderall. Like many companies, Teva pharmaceuticals, the leading manufacturer of generic Adderall, has had trouble hiring people resulting in shortages of medications in pharmacies. The Adderall shortage has led to shortages of other stimulants as patients switch to other medications as replacements. Many psychiatrists are now counseling patients over amphetamine withdrawal symptoms, which include mood swings, irritability, depression, headaches, jitteriness, intense fatigue, and GI pain.
Teva expects the shortage to continue at least until March 2023.
Meanwhile, other factors are affecting people receiving controlled substance prescriptions.
During the pandemic, online practices like Cerebral and Done took advantage of the relaxed prescribing laws to offer easy access to controlled substances. Clinicians at these practices blew the whistle to the Wall Street Journal, with tales of pressure from upper management to prescribe stimulants and benzos without a proper evaluation. The Department of Justice and the Drug Enforcement Agency have been investigating those companies, and last month they took a step that might limit access to controlled substances beyond this supply shortage.
On December 15, 2022, the DEA began investigating practices and pharmacies like TruePill that filled those prescriptions. The DEA has had guidelines to alert pharmacists to suspicious prescribing for years, and pharmacists are starting to pay more attention to it. Some refuse to fill controlled substances to avoid triggering an investigation. The DEA says they should watch for patients on high doses of controlled substances or who get early refills or medications from multiple doctors, patients who change pharmacies often, pay privately to avoid insurance review, or take multiple controlled substances (especially combinations of stimulants and sedatives like benzodiazepines.
As a reminder, if you are a Gateway Psychiatric patient and receive controlled substance prescriptions, you should be aware that refills of controlled substance prescriptions require a conversation. It is essential that you get your prescriptions during your appointments with Dr. Forster.
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