Dead!

Adult literacy is low.

Child literacy is low.

Information literacy has shifted dramatically in the last decade, but reputable information sources like research journals and factual news reporting have been unable to keep pace.

We are genuinely in a crisis of media literacy, with ever fewer genuinely factual resources available in the style and language used by contemporary audiences.

It may sound condescending, but we genuinely need to remind people, or worse, explain to them for the first time that art is not evidence of real world behaviour.

So, thank you, for this reminder. Genuinely.

You're correct:

Art does not need to feature exclusively morally pure characters. Art is not proof of the creator's secret, violent desires.

so great! your quality of life has fucking dematerialized! within the span of this week, your apartment is a pigsty. you keep having racing thoughts that slam you awake at 2 in the morning, and then the next day you collapse in a brain fog by 3PM. but you need to go to your fucking job anyway so that you can have the insurance to pay for the meds that you're not even getting but you need the meds so you can do your fucking job! you need to make money to pay for the apartment you can barely afford as it is! so good luck. your negative coping mechanisms have started to creep back in. you find yourself loud, annoying, vapid. you fucking hate it.

and here's the thing - these meds are life changing, but not necessarily life saving. it's like going through life without your glasses on - you're struggling, but it probably won't kill you. it's just fucking annoying because the solution exists, and you can't obtain it. and the whole time you are begging the pharmacist to please just fucking fill the prescription all you can think is - holy shit. i'm so fucking lucky that i don't need these to actually survive.

like, are you miserable, sinking quickly into suicidal? sure. but you keep picturing the people who aren't okay-without-it, and it makes you so fucking sad and angry and disgusted with the whole thing that fire-and-static start running up and down your limbs because of course you want to help, of course you'd cut your hair off and hold out your own body, but what are you going to do about it? because fuck! remember the first time they accidentally filed your insurance wrong and said that your meds would be three hundred fucking dollars per-fucking-month? you stood there, shaking, your hand on your credit card, thinking - i have no idea how to make that work. and how you felt like the world was laughing, big and loud and long.

because it didn't matter! they can just say whatever fucking number they want! they could say any number, and you'd pay it, because you have to pay it. they figured out long ago what the landlords are just-now starting to recognize: profiteering in the age of capitalism isn't ever punished. if it's food or housing or medicine, you're going to pay for it, aren't you, darling.

god bless america! does it hurt? does it hurt, are you going to cry about it, in one massive, horrible sob?

and of course this is an incredibly busy week at your job. of course your life is currently falling apart. the life you're fighting so hard to cling to is in a world where it's an obscene luxury to own a fucking dog. you still have outstanding medical debt because you dared to experience hardship. don't mention the student debt. don't mention the price of groceries. don't mention how we have been through at least two life-changing recessions and nobody in the middle class has actually recovered from that yet.

be good, be an adult, handle your shit. call them again. feel like you want to scream, don't scream. feel your brain getting further and further from you. god, how the fuck did you ever live like this?

you tell your mom on the phone today while you drive to the fucking pharmacy again for the third time in the last 24 hours: if they don't have it i'm just hopping the counter and grabbing the first arm i see with my teeth. i'm going full alka seltzer with this one. they're going to need a rabies shot. and you realize you're not even mad you're just fucking desperate; the kind of beg that sounds like a whimper.

home of the free and the brave! it's not that you feel trapped, it's that they've taken you hostage.

There are four medications that are both hard to find in forms I'm not allergic to and pretty essential to my quality of life.

Metformin.... Every pill version I could take was recalled years ago and never came back to market. I went from very well controlled prediabetic to needing insulin to failing insulin to extremely insulin resistant and needing liraglutide. We eventually found a compounded topical version because liraglutide alone wasn't enough.

Liraglutide was an insurance battle. There, but so expensive i couldn't afford it out of pocket. Six months without it damaged me permanently.

There is one form of duloxetine that I've found that does not contain inactive ingredients I'm allergic to. One tiny pharmacy was willing to order it for me.

But the worst is fondaparinux.

See, I need anticoagulants to live. I have three different clotting issues. And I don't process warfarin correctly. The amount of lovenox I would have to take is so high that i was having to do two syringes per dose twice a day and the volume burned like fire. I'm allergic to something in the oral anticoagulants and so fondaparinux is the only med that works consistently for me without horrible side effects and no one carries it normally and every once in a while the pharmacy that orders it can't order it and then I have to find a new one to order it but most pharmacies flat out can't even get it from their wholesaler. I've had four pulmonary embolisms. Going without anticoagulants is terrifying.

Multiple drugs I've taken for ra have been approved for use in covid and that's its own brand of terrifying because it means supply issues happen. Hell, oxycodone supply issues mean filling that is chancy and fraught.

But the ADHD thing is happening specifically by design because of government action, which makes it even more frustrating. (Oxycodone has the same issue. These are not difficult drugs to make and supply except for artificially imposed volume limits that primarily hurt legitimate users.)

Most medication is regulated by the FDA- the guys in charge of making sure food and drugs are consumed safely.

But Adderall, and anything else considered a scheduled drug (testosterone, for example; which I am also on), is controlled by the people whose job it is to make sure people don't get drugs.

The DEA strictly regulates how much of a medication can be manufactured, and when ADHD diagnoses increased during the pandemic (because telehealth made healthcare as a whole more accessible), manufacturers were not allowed to keep up with demand.

They still aren't. The DEA has blamed just about everything they can for the shortage, from one manufacturer's issues with production now years ago, to the accused "overdiagnosis" of ADHD.

The DEA has also, more recently, set restrictions on how much pharmacies are allowed to dispense. These numbers are not adjusted for local population counts, and they are also not being communicated to the pharmacists, so often pharmacies are running into those limits suddenly and without warning.

Just to say that it's the "war on drugs"; not pharmacies, and not even really manufacturers, causing these problems.

Also, just because I've been dealing with this too: the best way of navigating this issue I've been able to find has been to, in this order:

Call pharmacies until you find one with your meds in stock. Make sure they have the right dose and enough to fill the whole scrip. (Call big pharmacies first; Costco has been a safe bet for me so far. Then the rural ones, if you can get to them.)

Call your doctor to refill your meds, and tell them they need to send it to that pharmacy, ASAP, or you will not be able to get your meds. Communicate how much you have left/how long you've been off your meds. (But y'know, be cool about it)

If your doctor's office isn't responding to your calls, show up in person, if you can. This goes for your pharmacy as well. My experience has been that they rarely respond to anything in text, they usually respond to calls, and they can't ignore you if you're physically there.

Get a timeframe from them on when you can expect that the pharmacy will have heard from them.

Call your pharmacy after that amount of time and ask if they have the scrip, and when you can pick it up if so.

If they don't have it yet, call your doctor again.

Repeat steps 5 & 6 as needed.

I doubt most of this is super new to most people, but figuring this out has been a nightmare, and this is how I've been able to get my partner's and my own scrips filled relatively quickly these last few months. Hopefully it saves someone some trouble.

I personally think that people don't always need medication for ADHD, but it's so life changing when needed that the only reason someone wouldn't take it is in my mind entirely related to the war on drugs, one way or another.

Since being on ADHD medication my depression has lifted. My anxiety and meltdowns are better managed. I'm happier and more sociable. Most of my anthropophobia went away. A bunch of physical stiffness and pain improved. I even fall asleep more easily now! And I can recognize my autism symptoms better now that the fog of ADHD brain has lifted. I'm still ADHD, but now I can experience the positives of it, less of the negatives. Because dopamine isn't a neurotransmitter that only helps with attention, it's a neurotransmitter that's involved in near EVERYTHING you do. The human body is holistic, not separate systems that can function just fine with vital missing parts in another.

A lot of things happened out of my control over those 15 years, so it's not all my fault and I can sympathize a lot when the system has made things so difficult or impossible for people. But I kept skeptical now because the war-on-drugs contributes so much to people's attitudes about "drugs" that I think we all really need to ask ourselves if we're avoiding or giving up on an ADHD diagnosis faster than others in part because we think there's something extra scary or wrong with that medication or diagnosis?

The war on drugs is directly related to puritanical ideals of medicine and drug use. Some puritans see all medication or body augmentation as sinful. They're focused on physical and spiritual "purity". So, the logic goes God made you as you are, if you can't pull your boot straps up and work yourself to death, you're wasting your god given vessel - and drugs are cheating. The puritans are very anti-pleasure. Anything that would make work less painful is a naughty bad thing. Work/being alive is MEANT to be painful. Pleasure is a reward for suffering and should only happen by god's grace, you rewarding yourself is sin.

So I do understand and sympathize when drugs are a nightmare situation or out of reach for someone, I haven't been able to take testosterone for 10 years because finding one I don't have a bad reaction to has been nightmarish- But we need to ask ourselves if we see ADHD medication as "drugs" - as "cheating" - or as "scarier" than other medications. Because that's puritanism talking. There is nothing less pure about any particular kind of medication. There are some that are more risky than others in certain ways, but there is nothing immoral about it. If we're willing to pursue all other kinds of potential-side-effect-causing medications, but not one for ADHD, it's probably because the war on drugs makes us think, frankly, that it's basically street coke, and street coke is dirty, wrong, immoral, lazy, etc- all things that only make sense in a puritanical world view. We can see then how this puritanical mindset looks down on an blames even street drug users for their drug use instead of seeing it as self medication. It's "cheating" and a choice, by this logic. They're being lazy and immoral for seeking pleasure or medication in a fucked up evil world. And so you would be too, getting an ADHD diagnosis or treatment, because that would mean you wouldn't be living in hard-mode anymore. You have a choice to suffer, and puritans believe suffering is the more moral choice.

There's a million other ways the war on drugs impacts things like ADHD meds, Nothorses pointed out how the DEA is controlling a bunch of medications because the US government has decided to define certain drugs as extra scary and needing to be controlled. I don't want to get into how stupid and fucked the DEA is because that's a whole other essay and Nothorses already laid a bunch of it on the table.

But I really want to see more people start to recognize how anti-medication attitudes towards pain meds, ADHD meds, anxiety meds, all of that is an extension of the war on drugs and actually benefits a changing capitalist market, too. This wellness body and mind crap is capitalism trying to adapt to the war on drugs to keep selling you a new product. First, capitalism was way into drugs. Because drugs had the possibility of making workers work more. It's true happy people work more and more productively- But capitalism wants infinite growth, and now recognizes that it can't make as much money as it wants to on real drugs and treatments. What if they become public domain? What if one single real treatment means you won't buy more bullshit to self medicate and self sooth in all your suffering? Suffering = money. So puritanism and capitalism make decent bedfellows. Capitalism can make WAY more money on you through snake oil than real medicine. They can sell you rosewater and useless bullshit for days for your ADHD if you're too afraid to ever pursue an effective drug for it. Look at the long list of ailments I had I would do anything to alleviate before I got on ADHD medication.

I don't want to keep rambling too much more here on this, but I'll toss out two more thoughts:

If you want to burn it down and rage against the machine, look at what the machine is telling you is illegal and ask why. Is it illegal for a good reason, is it controlled for a good reason, or is it trying to control YOU for it's own gain? Taking ADHD medication, or even self medicating for ADHD, both fly in the face of the machine right now. It is a radical thing to pursue an ADHD diagnosis or medication proudly and unashamed and undeterred. Because there's the whole ableism aspect of shame associated with ND, too. There are a lot of ableist stupid doctors gatekeeping, though, so it's not as if the psychiatrist or doctor is always on our side even when we get the diagnosis. But it's still a radical thing to accept about ourselves and seek treatment for.

Nicotine is a stimulant. Caffeine is a stimulant. Some antihistamine drugs are used to treat ADHD. Just random facts I'm throwing out for no particular reason.

so great! your quality of life has fucking dematerialized! within the span of this week, your apartment is a pigsty. you keep having racing thoughts that slam you awake at 2 in the morning, and then the next day you collapse in a brain fog by 3PM. but you need to go to your fucking job anyway so that you can have the insurance to pay for the meds that you're not even getting but you need the meds so you can do your fucking job! you need to make money to pay for the apartment you can barely afford as it is! so good luck. your negative coping mechanisms have started to creep back in. you find yourself loud, annoying, vapid. you fucking hate it.

and here's the thing - these meds are life changing, but not necessarily life saving. it's like going through life without your glasses on - you're struggling, but it probably won't kill you. it's just fucking annoying because the solution exists, and you can't obtain it. and the whole time you are begging the pharmacist to please just fucking fill the prescription all you can think is - holy shit. i'm so fucking lucky that i don't need these to actually survive.

like, are you miserable, sinking quickly into suicidal? sure. but you keep picturing the people who aren't okay-without-it, and it makes you so fucking sad and angry and disgusted with the whole thing that fire-and-static start running up and down your limbs because of course you want to help, of course you'd cut your hair off and hold out your own body, but what are you going to do about it? because fuck! remember the first time they accidentally filed your insurance wrong and said that your meds would be three hundred fucking dollars per-fucking-month? you stood there, shaking, your hand on your credit card, thinking - i have no idea how to make that work. and how you felt like the world was laughing, big and loud and long.

because it didn't matter! they can just say whatever fucking number they want! they could say any number, and you'd pay it, because you have to pay it. they figured out long ago what the landlords are just-now starting to recognize: profiteering in the age of capitalism isn't ever punished. if it's food or housing or medicine, you're going to pay for it, aren't you, darling.

god bless america! does it hurt? does it hurt, are you going to cry about it, in one massive, horrible sob?

and of course this is an incredibly busy week at your job. of course your life is currently falling apart. the life you're fighting so hard to cling to is in a world where it's an obscene luxury to own a fucking dog. you still have outstanding medical debt because you dared to experience hardship. don't mention the student debt. don't mention the price of groceries. don't mention how we have been through at least two life-changing recessions and nobody in the middle class has actually recovered from that yet.

be good, be an adult, handle your shit. call them again. feel like you want to scream, don't scream. feel your brain getting further and further from you. god, how the fuck did you ever live like this?

you tell your mom on the phone today while you drive to the fucking pharmacy again for the third time in the last 24 hours: if they don't have it i'm just hopping the counter and grabbing the first arm i see with my teeth. i'm going full alka seltzer with this one. they're going to need a rabies shot. and you realize you're not even mad you're just fucking desperate; the kind of beg that sounds like a whimper.

home of the free and the brave! it's not that you feel trapped, it's that they've taken you hostage.

There are four medications that are both hard to find in forms I'm not allergic to and pretty essential to my quality of life.

Metformin.... Every pill version I could take was recalled years ago and never came back to market. I went from very well controlled prediabetic to needing insulin to failing insulin to extremely insulin resistant and needing liraglutide. We eventually found a compounded topical version because liraglutide alone wasn't enough.

Liraglutide was an insurance battle. There, but so expensive i couldn't afford it out of pocket. Six months without it damaged me permanently.

There is one form of duloxetine that I've found that does not contain inactive ingredients I'm allergic to. One tiny pharmacy was willing to order it for me.

But the worst is fondaparinux.

See, I need anticoagulants to live. I have three different clotting issues. And I don't process warfarin correctly. The amount of lovenox I would have to take is so high that i was having to do two syringes per dose twice a day and the volume burned like fire. I'm allergic to something in the oral anticoagulants and so fondaparinux is the only med that works consistently for me without horrible side effects and no one carries it normally and every once in a while the pharmacy that orders it can't order it and then I have to find a new one to order it but most pharmacies flat out can't even get it from their wholesaler. I've had four pulmonary embolisms. Going without anticoagulants is terrifying.

Multiple drugs I've taken for ra have been approved for use in covid and that's its own brand of terrifying because it means supply issues happen. Hell, oxycodone supply issues mean filling that is chancy and fraught.

But the ADHD thing is happening specifically by design because of government action, which makes it even more frustrating. (Oxycodone has the same issue. These are not difficult drugs to make and supply except for artificially imposed volume limits that primarily hurt legitimate users.)

Most medication is regulated by the FDA- the guys in charge of making sure food and drugs are consumed safely.

But Adderall, and anything else considered a scheduled drug (testosterone, for example; which I am also on), is controlled by the people whose job it is to make sure people don't get drugs.

The DEA strictly regulates how much of a medication can be manufactured, and when ADHD diagnoses increased during the pandemic (because telehealth made healthcare as a whole more accessible), manufacturers were not allowed to keep up with demand.

They still aren't. The DEA has blamed just about everything they can for the shortage, from one manufacturer's issues with production now years ago, to the accused "overdiagnosis" of ADHD.

The DEA has also, more recently, set restrictions on how much pharmacies are allowed to dispense. These numbers are not adjusted for local population counts, and they are also not being communicated to the pharmacists, so often pharmacies are running into those limits suddenly and without warning.

Just to say that it's the "war on drugs"; not pharmacies, and not even really manufacturers, causing these problems.

Also, just because I've been dealing with this too: the best way of navigating this issue I've been able to find has been to, in this order:

Call pharmacies until you find one with your meds in stock. Make sure they have the right dose and enough to fill the whole scrip. (Call big pharmacies first; Costco has been a safe bet for me so far. Then the rural ones, if you can get to them.)

Call your doctor to refill your meds, and tell them they need to send it to that pharmacy, ASAP, or you will not be able to get your meds. Communicate how much you have left/how long you've been off your meds. (But y'know, be cool about it)

If your doctor's office isn't responding to your calls, show up in person, if you can. This goes for your pharmacy as well. My experience has been that they rarely respond to anything in text, they usually respond to calls, and they can't ignore you if you're physically there.

Get a timeframe from them on when you can expect that the pharmacy will have heard from them.

Call your pharmacy after that amount of time and ask if they have the scrip, and when you can pick it up if so.

If they don't have it yet, call your doctor again.

Repeat steps 5 & 6 as needed.

I doubt most of this is super new to most people, but figuring this out has been a nightmare, and this is how I've been able to get my partner's and my own scrips filled relatively quickly these last few months. Hopefully it saves someone some trouble.

I personally think that people don't always need medication for ADHD, but it's so life changing when needed that the only reason someone wouldn't take it is in my mind entirely related to the war on drugs, one way or another.

Since being on ADHD medication my depression has lifted. My anxiety and meltdowns are better managed. I'm happier and more sociable. Most of my anthropophobia went away. A bunch of physical stiffness and pain improved. I even fall asleep more easily now! And I can recognize my autism symptoms better now that the fog of ADHD brain has lifted. I'm still ADHD, but now I can experience the positives of it, less of the negatives. Because dopamine isn't a neurotransmitter that only helps with attention, it's a neurotransmitter that's involved in near EVERYTHING you do. The human body is holistic, not separate systems that can function just fine with vital missing parts in another.

A lot of things happened out of my control over those 15 years, so it's not all my fault and I can sympathize a lot when the system has made things so difficult or impossible for people. But I kept skeptical now because the war-on-drugs contributes so much to people's attitudes about "drugs" that I think we all really need to ask ourselves if we're avoiding or giving up on an ADHD diagnosis faster than others in part because we think there's something extra scary or wrong with that medication or diagnosis?

The war on drugs is directly related to puritanical ideals of medicine and drug use. Some puritans see all medication or body augmentation as sinful. They're focused on physical and spiritual "purity". So, the logic goes God made you as you are, if you can't pull your boot straps up and work yourself to death, you're wasting your god given vessel - and drugs are cheating. The puritans are very anti-pleasure. Anything that would make work less painful is a naughty bad thing. Work/being alive is MEANT to be painful. Pleasure is a reward for suffering and should only happen by god's grace, you rewarding yourself is sin.

So I do understand and sympathize when drugs are a nightmare situation or out of reach for someone, I haven't been able to take testosterone for 10 years because finding one I don't have a bad reaction to has been nightmarish- But we need to ask ourselves if we see ADHD medication as "drugs" - as "cheating" - or as "scarier" than other medications. Because that's puritanism talking. There is nothing less pure about any particular kind of medication. There are some that are more risky than others in certain ways, but there is nothing immoral about it. If we're willing to pursue all other kinds of potential-side-effect-causing medications, but not one for ADHD, it's probably because the war on drugs makes us think, frankly, that it's basically street coke, and street coke is dirty, wrong, immoral, lazy, etc- all things that only make sense in a puritanical world view. We can see then how this puritanical mindset looks down on an blames even street drug users for their drug use instead of seeing it as self medication. It's "cheating" and a choice, by this logic. They're being lazy and immoral for seeking pleasure or medication in a fucked up evil world. And so you would be too, getting an ADHD diagnosis or treatment, because that would mean you wouldn't be living in hard-mode anymore. You have a choice to suffer, and puritans believe suffering is the more moral choice.