Urban Institute of Mental Health

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The Nationwide Vyvanse Shortage: Have We Become Codependent on Our Psychiatric Medications?

Attention Deficit Hyperactivity Disorder, otherwise known as ADHD, while commonly diagnosed, can be extremely overwhelming and debilitating when one does not know how to navigate and/or does not have the proper support and resources to thrive. ADHD is considered to be a disability/disorder due to the common societal expectations that are placed on neurotypical individuals to uphold and fulfill that most neurodivergent individuals (a person whose brain processes information in a way that is not typical of most individuals) would find extremely difficult to uphold or desire to fulfill. Common symptoms of ADHD include; but are certainly not limited to:

Inattention
Difficulty sustaining attention in tasks or play activities
Frequent careless mistakes in schoolwork or other activities
Easily distracted by unrelated stimuli
Forgetfulness in daily activities

Hyperactivity
Inability to stay seated in situations where it's expected
Excessive fidgeting or restlessness
Difficulty engaging in activities quietly
Talks excessively

Impulsivity
Acts without thinking about consequences
Interrupts others' conversations or games
Difficulty waiting for one's turn
Impulsive decision-making

One of the most utilized forms of treatment for ADHD is medication. Vyvanse is a commonly prescribe stimulant for ADHD due its claims of being non-addictive or habit forming such as its counterparts Adderall and Ritalin. As a clinical social worker, I happen to treat patients often who are both diagnosed with ADHD and prescribed medication for it. I am also neurodivergent and was diagnosed with ADHD in my early childhood.

I was initially very hesitant about taking a stimulant drug; not only due to its history of resulting in life altering addictions and other side effects, but to the fear of how the medicine may change my bubbly and out-going personality. After years of battling with inconsistent work habits, lack of productivity, intense emotions that I struggled to regulate, and a roller coaster of ups and downs with my weight and finances, I finally decided to try a stimulant. I was prescribed Vyvanse by my psychiatrist.

I will never forget the first day I took the medication. I was terrified. But then, I felt like my whole life changed. I often wondered “is this how neurotypical people exist?” The medication took my appetite completely away for the most part, but I had lost over 20 pounds and was able to actually keep it off! When I took it, I was so focused that I had to be reminded to get up and use the bathroom. It’s almost like my bodily indicators were not strong enough to force me to stop engaging in whatever task was consuming me at the time. Within 12 weeks, my savings account was stacked. I was not making random impulse purchases as often as I used to. The only time during the day that I was moody and unable to regulate my emotions was between 2pm and 4pm when I would have my daily stimulant crash.

The medicine was literally heaven on earth to me! That was until it was gone. Codependency typically involves one individual who has become emotionally and behaviorally dependent on another individual to have certain needs fulfilled and/or feel satisfied. The one who is being depended on by the codependent individual typically serves as a huge enabler. The enabler is in no way shape or form helping the codependent individual; despite the fact that they will typically believe the opposite. The enabler has good intentions and truly desires to be a system of support that will propel the codependent to self-efficacy and independence. However, the longer the codependent individual remains dependent on the enabler, the more helpless and hopeless they will become.

My last trip to the pharmacy, I found myself silently praying all the way to the counter. As I sat very impatiently waiting for my turn, I overheard the pharmacist telling his customer that her medication cost over $600! That’s when I remembered “Oh shit! Our deductibles restarted because of the new year.” That meant that if they did have the medication, I would be paying over $300 for mine.

As I watched the words “not in stock” leave the pharmacist’s mouth, I sat at the counter trying to figure out what the (bleep) I was going to do. My mind began to race! “How am I going to get any work done?! OMG I am going to gain all of my weight back! I’ll be broke, busted, and disgusted just like before!” There it was. My moment of truth. Vyvanse had become my enabler and I was indeed codependent. The medication was doing all of the work for me.

The current nationwide shortage of Vyvanse has raised concerns and shed light on a broader issue—the co-dependency many individuals have developed on psychiatric medications. Please don’t misunderstand me. I am a strong advocate of the use of psychotropic/psychiatric drugs, but ONLY when they are necessary. Moreover, they should be used as a tool, a stepping stone, or a small part of a much broader treatment plan. This shortage prompts us to question our reliance on these drugs and explore the historical and cultural reasons behind the hesitation, particularly within BIPOC communities, to utilize them in the treatment of their mental health ailments.

Understanding Historical Resistance

Communities of color have historically been resistant to the idea of psychiatric medications due to a number of deeply rooted issues such as medical racism, mental health stigma, and associations of mental health issues as something primarily affecting only White individuals. The BIPOC community is likely to rely on our faith, cultural rituals, and/or alternative healing practices which often greatly contributes to one’s journey to healing . There is no one size fits all approach to mental and emotional wellness. What’s most important is the effectiveness of your approach and whether or not it allows you to exist in liberation, self-determination, self-efficacy, and in your true authenticity.

However, what should we do if our already established support systems or coping mechanisms are not alleviating us from debilitating mental health symptoms and ailments? As we continue to accept the validity of mental health ailments in science and in our culture, we are better able to understand the impact of our environment, experiences, and trauma on our brain functioning. With that being said, there will be circumstances where the use of psychiatric medication is necessary and useful in treating and even alleviating these illnesses.

Capitalism and Healthcare

The capitalist structure of the healthcare system plays a significant role in perpetuating the dependence on psychiatric medications. The different diseases and ailments that often result in our need to utilize these drugs exist because of how we have been indoctrinated and conditioned to exist in ways that are in complete opposition to the true nature of ourselves; thus creating an internal and intrinsic dissonance. It is this very dissonance that results in our lack of wellness.

The ever-present systems of oppression and marginalization continue to afflict pain and cause suffering within BIPOC communities and has resulted in the historical and continual adaption of survival behaviors and mentality that keep us from living a life of meaning, inner-fulfillment and happiness. Our grocery stores are populated with genetically modified food which turns a big profit for an unruly and unethical food company. Our streets are filled with fast food companies that love the idea of feeding poison to our communities for a quick buck or two.

Our minds/souls are interconnected with our bodies. Having both sickness in our minds and bodies, we have become dependent on medication to live. The high cost of prescription drugs, even with insurance coverage, puts a strain on individuals, making them reliant on a system that is profit-driven rather than patient-centered. Overworked healthcare professionals further compound the issue, leading to potential oversights and compromises in patient care.

Taking Back Power and Control Over Our Health and Wellness

As I was leaving the pharmacy without my ADHD stimulants, I found myself questioning whether or not I should continue to utilize medication as a treatment method. I was very aware of the codependency that I had developed on the medication and wanted to take my power and determination for my health and wellness back. I had been on the medication for about 6 months and it had certainly assisted with my ability to be more consistent, disciplined, and intentional. However, I felt that there was no better time to add a replacement support that would aid in my liberation and independence.

When deciding whether or not to incorporate psychiatric medications into your journey to healing, consider the following before making your decision:

1. You must educate yourself and make an informed decision.

Due to the stigma and lack of mental health education and awareness, many of us have no idea that we are suffering with a mental and/or emotional health condition. Prior to considering the use of psychiatric medication, I would encourage you to first engage in mental health therapy at a practice or an organization that is competent in working with and appropriately diagnosing individuals from the BIPOC community. (See the article 6 Steps for the BIPOC Community to get the Most Out of the Therapy Journey to get a better understanding of how to appropriately do so).

Once you have been rendered an official diagnosis, it is imperative that you do your own research on the condition and its treatment options. When considering and researching treatment interventions, be sure to incorporate your own cultural rituals and practices in your journey to healing. If you and your therapist have collaboratively decided that psychiatric medication will be the next step, you must thoroughly research typical drugs prescribed for your condition. Understand the ways in which the medication will work to achieve the most optimal results and what side effects to be aware of. You may also ask your psychiatrist for genetic testing to alleviate yourself from the possibility of trying several different medications before finding the one that will work best with your body.

2. You should plan only to use psychiatric drugs for a short period of time. (This does not apply to individuals who have more chronic and serious mental health ailments).

While psychiatric medications can be essential for stabilizing mental health, we must view them as a temporary solution. One that will bring us enough stability and clear-mindedness to engage in the healing work. Medication alone, without other forms of treatment, will only put a bandaid on a much larger deeply rooted issue. The bandage can only stay on but for so long before it eventually falls off and no longer protects your still very open wound.

3. Know that nutrition plays a major part in successfully treating and healing mental health ailments.

I do not believe in telling my clients what to eat and what not to eat. We have been conditioned and domesticated to view life through a very binary lens. History itself has shown us how erroneous that way of thinking is. I have been taught so many different ways to eat throughout my lifetime that it is ridiculous. I do teach my clients the practice of body intuition.

Body intuition can be defined as the act of enhancing the already profound connection between the mind and body and tuning into the innate ability to sense and interpret the subtle signals and messages from our physical selves. This practice offers insight into our emotional, mental, and physical states; helping us make decisions more aligned with our true needs. Your body will always tell you what it needs to be properly fueled and nourished.

I will; however, BOLDY tell you DO NOT EAT ANYTHING that has been created with the aim of enhancing profits with little to no concern about its impact on the health and functioning of your body. This includes ANY AND ALL processed foods.

4. You must do the healing work!

The most effective form of treatment will incorporate a deeply personal journey that will facilitate healing from the inside out. While the journey is personal, you will need a tribe of support surrounding you. Your tribe may consist of your therapist, psychiatrist, family members, friends, support groups, etc. While on your journey, you will receive insight and understanding of the core issue that is causing your debilitating symptoms. Your tribe will support you as you make each step toward resolving that core issue.

Conclusion

The Vyvanse shortage serves as a wake-up call to reevaluate our relationship with psychiatric medications. By understanding historical resistance, acknowledging the influence of capitalism on healthcare, and adopting empowering strategies, individuals can navigate this co-dependency, making informed decisions about their mental health journey. Embracing alternative healing practices and actively participating in one's mental health can lead to a more sustainable and holistic approach to well-being.