1. Adderall shortage: There has been a serious nationwide shortage of Adderall these past few months. Here is my understanding as to why: A major generic manufacturer of Adderall went on strike for a month, and a substantial number of pills were not produced. That has been rectified, and the pipeline is back on track.
Secondly, more people availed themselves of the loosening of regulations due to the pandemic, and some facilities and pharmacies allowed new patients to be evaluated, diagnosed and treated without being seen in-person, so the number of diagnoses and treatments for the medication increased this past year.
Lastly, more people struggled these past few years, and more have come in for treatment, both for depression and other conditions. One adjunct treatment for treatment-resistant depression is to add Adderall to an antidepressant, and that use has also increased.
What I have done with my patients is to have them call around to various pharmacies and, when needed, prescribe other medications to tide them over. From what I have read, we expect the availability of the medications to return to normal within a month or two.
2. Prescriptions for family and friends: When I began my practice, it was not unusual to help out family members and friends with the occasional prescription for an antibiotic or an ear infection or UTI, or some medication for fear of flying.
Over the last few decades, however, our liability carriers have told us that they would not be responsible for covering us if we prescribed out of our specialties, nor would they cover us for treating people who were not patients.
This situation results in our having to say no, not because we don’t know what to do or don’t want to help out, but are restricted because of liability concerns.
It’s a sad but unfortunate reality.
3. Primary care physicians: I have always recommended to all my patients, family members and friends that they have a personal internist or family physician to care for them. Not their gynecologist or urgent care center doc-in-the-box.
Your personal primary care physician gets to know the whole you — your personal history, allergies, surgeries, family history and you as a person. They can provide the bulk of your medical care and treatments.
You can rely on them for medical advice and recommendations, such as vaccinations, referrals to specialists so you don’t need to search when you’re ill, monitoring your care when you see several specialists and coordinating care when necessary. They can recommend preventative care when appropriate, such as mammograms and colonoscopies, as well as referring you to them and helping set up the appointment when you’re reticent to do so.
We look for pediatricians for our children; we need internists as adults.
4. Vaccinations: For those of us on the far side of 50, please look into being up to date with the appropriate vaccinations, such as shingles, pneumonia, high-dose quadrivalent influenza and tetanus. They are generally available at your local pharmacy, can be obtained without appointment, are relatively low-cost and generally have minimal side effects.
As we get older, we have less resilience and are more susceptible to the more serious complications of the viral illnesses than when we were in our 20s and 30s.
Even now, in February, there’s still time to get up to date.
Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas.