of medication, which is made up of amphetamine sauce. so uh, really the active ingredient is that it's an inside of me. so it's, it gives the recipient who abuses the drug, kind of a re see feeling and also the feeling of things going faster, experiencing more of a high as compared to, let's say valley i'm or other bends. it's, i is pains to which are more suited for people who want to have more of a kind of a laid back kind of high. so you have some people who prefer more of a racy high and other ones who want to kind of be more of a laid back kind of like thinking like people who uh, who enjoy cocaine versus people who enjoy hair with the the recipients. the experience of those drugs is a,

is diametrically opposed. so a hair when paying people not out on here. when whereas cocaine, people, you know, often associate that as a party drug or more of a re see drug, you know, something, you know, they may do at parties to stay of all night long. that kind of thing. and same thing with uh, add roll. it's uh, it's in the stimulated class, and that's why people of people like to to go for that drug because it gives them, it gives them a feeling of having more energy than they normally would have. and what percentage of arrow prescriptions are actually mis diagnoses of people who don't actually have age be, but want to abuse the prescription and what percentage are people who are getting the prescription that may not necessarily need them? okay, and that's difficult to say, and that's something that as a non prescribing clinician who works in a,

in tandem with the prescribing physician, who would probably be a psychiatrist or a family physician or a pediatrician. as the non prescribing clinician, we would be the ones that would be seen those patients more, more regularly. that would be the prescribing physician. so that'd be something we'd be on the look out for. is this a situation where a parent is falsely getting this medication, supposedly for their children, and they aren't even given it to their children and they're using themselves? or is it something that as an adult somebody's trying to do the same thing. so it's something that a vigilant doctor or counselor is always on the look out for my own personal experience. or to have to say that if you really do a thorough diagnostic work up prior to prescribing or making

a referral for a prescription to prescribing doctor. if you do a thorough diagnostic work up, you're going to be able to catch these people. and and usually you're not going to say that, look, i think you're just doctor saab me, then you're trying to get this drug. normally what you'd be saying is, hey, i have good news for you. you don't have attention deficit disorder, but maybe you, maybe you have some problems maintaining concentration of attention. and we can, we can attempt to use other non medication methods to improve your attention concentration. if you have somebody who's truly experiencing those difficulties. and they're told that they'll be happy to hear that and they'll, they'll be accepting of what you have to offer uh people who are shopping for adderall, for uh, for misuse purposes. they,

they usually are not pleased to hear that kind of response from the doctor. and they'll, they'll usually go off and try and find somebody else who yeah. who is going to be more accepting of being able to give them the diagnosis and, and get the medication. are adults more likely to become dependent on adderall, if they start using as kids? no, not necessarily. and um and now a adderall is, is available in an extended release form. so it is that makes it less likely to be addictive. and also there is another drug called by bands which is x, which is an extended release of stimulant medication, which is also used for attention deficit disorder. and physicians will often prescribe that. and during the recent shortage with that are all in the past year

of ideas was often turn to a by physicians as an alternate to prescribing at all. and do you think that we as a society, are funneling to many of these drugs out into the world for an easy short cut so that kids will behave and get good grades? well, we are, i mean, we're definitely culture and i can't speak outside of the united states, but it certainly seems to me that as an american culture we're offering quick to find a solution in a bottle. and, and that's unfortunate because people are really willing to put into work to improve upon their situation in life. they are often looking for a quick fix, you know, through a pharmacist or through a, through a physician. thank you so much, dr. henry kotch, but please stick around. dr. henry kotch will be joining us back after the break. and when we come back, what segment of the population is abusing arrow the most and how our pharmacy is

controlling the supply of medication? the the the, [000:00:00;00]

the welcome back to the cost of everything. 80 h d is actually a hard wired pattern of brain functions. national data suggests that one in 10 school age children needs this criteria. while 4 percent of adults continue to have symptoms. and at the college go study of 20 countries from the world health organization surveys found that across high upper middle and lower middle income countries, the prevalence rates of 80 in children and i lessons for the highest in the us at 8 point one percent lowest in poland at point 3 percent and romania point 4 percent data. also it suggests that adheres greater in males than females across all racial ethnic groups. non hispanic,

asian boys and girls. according to the journal of attention disorder study or prevalence of h. d was 11.3 percent among non hispanic white children and 10.7 percent on non hispanic black children, which is significantly higher than the $2.00 prevalence rate found among non hispanic asian children and study of studies has also shown that prescription stimulants have little to no effect on the cognitive performance of adults without adhd. but what it does give them is an elevated mood like a high, unlike all things that give people highs, this can be extremely addictive. and that is why amphetamine method instead of dates are scheduled to controlled substances in the us. which means that it is an accepted practice for medical use, but has a high potential for abuse. the fat at the a has announced a shortage of 80 age the medication at a role in october of 2022. and so far there had been no relief for patients. the at

the indicated that there is not an adequate supply to meet us consumer demand. meanwhile, people with adhd a have been forced to endure the shortage. and unfortunately that population is growing. and making more tablets isn't as easy as just flipping a switch. most age, the medications fall into a class of controlled substances called central nervous system stimulants. these medications have a well documented history of abuse and addiction. so the f, b a n d e a limits how many pills of pharmacy can dispense at once, and how frequently patients can refill their prescriptions. adderall is scheduled to controlled substance, which means but the limits how much of the drug the manufacturer can produce per year the, the quota is limited through ad roles, addictive ingredient amphetamine, and because of this, manufacturers are blaming and re in scarcity is for the shortage and in order to

set these quotas, the d a must estimate how much ad roll patients will require the following year. if the agency under estimates demand and fails to increase its quota, the result can be a wide spread shortage. however, the announce last month that it will not be increasing the manufacturing quotas for 2023. despite the shortage again, without providing a reason one, congress woman even wrote the b a and update demanding an explanation last december . but there has been no response. after the agency decides annual production quotas, manufacturers and distributors must set limits on how much of the meds each pharmacy can buy. pharmacies must guard the substance under lock and key and fill out forms even if they lose a single pill. they can also refuse and report any suspicious orders of unusual size frequency or deviating substantially from

a normal pattern. many pharmacies also have monthly limits on how much of a controlled substance they can order from their full seller supplier. and this creates local bottlenecks at the retail level. this is a conservative system that is designed to keep just enough medication flowing to patients while also minimizing the risk of a legal diversion. and these quotas have been troublesome for many companies, including no virus or bystanders, which makes the generic admiral and consider the shortest, started as a production issue, a tough one of the world's largest drug makers, which makes both generic and brand name at all. the official explanation has offered little clarity as the announcements simply mentions, intermittent manufacturing delays. a tele, reportedly having issues with some of its arrow dosage, particularly in the more expensive brand new versions and its fast acting tablets. the pharmaceutical industry shortages have also been caused by the dependents on

china for raw materials. they're almost $50000.00 factories in china that support a global network of companies and millions of ra, an intermediary parts, which can disrupt any and all supply chains. and this not only applies to adderall and acetaminophen, but also all. 6 critical drugs like a mock cell and diabetes drugs and for more let's bring in again dr. henry kotch, clinical psychologist, specialist. so doctor, do you think people that abuse adderall, are the culprits of the shortage and when do you think the shortage will end up? well, that's a supply chain problem. it seems, i don't know if it's really something that's tied to the the cobra difficulties and, and also the war ukraine. if somehow those are, are contributing to the supply problems or not. i really don't know what is causing

the supply difficulty, the manufacturer for adderall is tampa t, e b a. and you'd have to look really into where they are, where their main production is occurring and, and what's involved with that as far as their being able to get the material. ready they need to be able to put together the adderall compound and what do you think about the rise in telemedicine? is this a good thing or a bad thing as regulators are trying to clam down on tele health prescriptions to? well, telemedicine, i think, is very helpful for a lot of people over a variety of reasons that we really don't need to get into it. but as far as the, the the message of your question, the doctors are still required to practice under the same

rules and regulations with respect to providing a prescriptions. so it's, it really, probably, telemedicine probably puts more of a challenge to the prescribing physician to be able to, we doubt whether somebody is looking to receive a prescription for abusive purposes. because when you have somebody in the office with you and you can, you're getting much more information from them by their body language and, and how they are speaking to you and looking at you, which is qualitatively different from what your, um, what, what your experience over over it, you know, a telephone or is do more, you know, that kind of a medium for being able to meet with a patient. so the, so the, the responsibility is for the physician are,

are the same. and i think the tell a mess and makes it more challenging for them. and well, this increase and add roll prescriptions, cause any long term effects on society. and is it harmful, that all these prescriptions are just out there without any verification or control as well? that there is control in the sense that uh uh, especially um in the past 10 years when we were having uh the oh boy crisis in this country which we still have. but um, with the uh, with the intervention of the federal government requiring a database to be to be established by prescribing physicians. there, there is now a better and more secure way to be able to track people as they attempt to get

medications. it used to be this used to be without this database that an attic to go from one doctor to the next and get, you know, a handful of prescriptions without one physician knowing what the other one was doing these days. it's much more difficult for that to occur and, and physicians are required to be knowledgeable of that and into practice accordingly. so i would hope that with the introduction of this requirement that there would be less opportunity for abuse. however, having said that, it have worked with enough addicts, they are very resourceful people and they will often find what they're looking for based on their hunger force medications. and i mean, dr shortage is bad, but just how bad is this and are we in panic mode right now? well, there are, there are other similar acting medications. uh, i think,

you know, do the, with the greatest difficulty is that people who are searching for the medication either, rightly or wrongly they, uh, they are and so aware that there are other medications available. and so they, they may uh, unduly panic when they hear that there is a shortage thinking that this is the only medication that's available to, to treat h d. of course, if they then follow up and go to their doctor, the doctor will be able to assure them and say no there are. there's still riddle and that's available. there's still the extra dream that's available just by being sets available. and there's probably others that i'm not thinking of at the moment, but there are, there are alternatives that are all within the same amphetamine class. and then um, and usually it's a, that's sufficient. uh,

the only difficulty you might have. somebody may have a specific kind of biological system that only works well with the adderall and it would not work well with these other medications. but that would, that would be a very, very small number of people. thank you so much dr. henry college clinical psychologist specialist the winters here are the drug makers, which are very similar to the opi or crisis where millions of adults are now hooked on these prescriptions stimulants. the global adhd, the drug market is expected to reach over $25000000000.00 by 2025 with more than $6000000.00 children in the us alone diagnosed with adhd as well. this is absolutely a real condition and disease, the american trying to obtain the short cut and pushing pills to treat the symptoms rather than the cause is making this a much bigger deal than it actually is. and it's causing the subsequent addiction problems. much of this is thanks to the campaign,

a efforts of big pharma elsewhere and the world in places like europe and asia, governments and cursing use of a comprehensive approach for the treatment of adhd, which includes behavior management skills, academic support, psychological support, and medicine. as a measure of last resort. i'm christy. i thanks for watching and we'll see you right back here next time on the cost of everything the oh, what i would show seemed wrong. just don't

you have to shape house to come after kids and engagement because the trail when so many find themselves will support we choose to look so common ground the the stories of this almost growing houses of them was about private men's, the company now for the controls that the dunbar to leave hall to most a k a's, but what i will have is positions over the russian movie in the next few days. and as always, the shape of the week, a lot of between the to the top candidates in to this year's presidential election is confirmed and neither can tend to tools enough votes in reply from the head. the head product will take place in sunday time for the 1st time as you it has the, the next day of class. the national priority has officially been commemorative. it

comes as in regards. the law of the victim to this month is really affecting the good job you company today for the latest global news roundup. i'm gonna look at the stories of shared the week. i'm runtime i'll be and this is a t. as i mentioned, this is the body of us in the boss, a k, a box. what has already come under russian control local into most of those defense ministry. it went on to say that the mission was carried out by the bug and a private movie company with flanking assistance from the russian army. in the technical area, hard to almost cause the result of the actions by the walk in their private military company campaign with the support of artillery navigation from the southern group of russian military troops. the liberation of the city of a toe musk has been completed, a lot of apples and some glass sledge at the very bottom. the rest,

the most useful of his folder success. according to the statement from the president on site today, the leader of the management company said the city was finally under russian control off of 224 days of letting me fighting. according to ministry, i am confident expert, as on the 7 of the feet in altima represents a significant set back for teeth. i'm, it's west and simple is, is like use region you are in the is single see shows where the western country is, was able to try using my hold as a main goal or to control. busy and to, to use the offensive types of farm moment festival. i'm talking about the main metals tearing so that now off in the, you know, great in forces, but you don't see them. we don't see the status of that are being used in any operation in the front line. if you're out talking about the ration that uh,

for example of these 2 almost now doesn't play any role. first of all, would have to understand that now the fall off of premium choices is really low because the main troops that were participating in the search, even this protection of the bottom of the and now are to almost world the best ones representative. so why with military companies? so the western countries, so according to this to, to stay so and the information i have about 4 to solve and oh, from the printer and watch was last. it was very high. he brought talking about the possibility of, for example, organizational dish, quanto attack, or wildly promoted into wisdom need. so there's a whole set of models, a yes, as the russian forces to control of another hotspot, the city of maribelle in may 2022, the russian m o d. and now the surrender of the last few claims soldiers and

nationalists unit. so they've been holding out at the vault as of the font, the bible for the coastal city left much of it in ruins. now, 12 months on all decency sweeney travel that to see how the locals are recovery. one year ago, the city of my report was liberated, but it remains under attack from ukrainian policies with shedding overnights and even right now as we hit allow booms across the city. faced by thing took place for every district for every street, for every inch of the city, matter you pull remain the same for more than 2 months until come on just for me as all fatality and surrender. here are the hours of sale still. floats. progressives in western media portray these people as heroes, with whom we obviously, they wouldn't neo nazis who had 10 arise of books, should the citizens of matter you vote for at least a is on you up to the scene, is it cool? in 2014 was made by the united states and europe. you know,

to put there people in and bring in this new analysis. everything started from this time during the fighting people who didn't basements. it was hard for people. there was no food, no water costs and shelling came from the side of the ukrainian neo nazis. the for of course, it was hard to run the russian scheme it told became much better. yeah, it's me, shit that you get. i don't consider them here is. can you tell me who you think they are? i consider them nothing. i didn't see them. they didn't come up to me. they didn't know for me any help of support. they didn't save me nothing. my daughter and i lived without water, without food, without hate and all that in any case, we risk their lives for watching for him. i still don't know the bones and destroy lands. how people ukraine just didn't give it down about us. according to the united nations, at least 90 percent of civilian housing was destroyed during the fighting along

with schools and hospitals. but the rates of reconstruction has been remarkable with infrastructure rebuilds, and many more view for residents for saving key. so new appointments like these on behind me, many people that we've spoken to have said that they've seen rates of investment higher over the past few months and they did doing more than 30 years of ukrainian room. was over the of to be liberated from the nazis. of course our life became much better, easier because whitfield, that our people, russians are here, where it turned to our historical homeland. the city was completely destroyed. now everything is being completely rebuilt. schools sort of hospitals came to gardens, houses, it has become much calmer than before. varies and just feel calmer. all is well with security. i think over time it will be even better than any ukraine. i beckett . a 100 percent of the people of matthew pole will never forget the owners of the financing. the sheer scale of the destruction of the city is simply beyond

comprehension. one moving i spoke to compared it to ross from a she aust, wherever is that your opinion? where although it was a claim to support ukraine, instead she said the supplying palms may solve a weapons that will be used against the people of the city. in fact, a dependencies have been working overtime, not just here across towns and cities in the don't. yes, for the public as a crazy and attack, seek to destroy the entire don't by region. but they face iras vivian. people who say they will never give up. this is steve sweeney and matthew poll for all to says load. com for the next to his president concluded last sunday. the country's election colleagues will say that a runoff election wouldn't be necessary. the ball which is scheduled for may the 28th is required, is need the form kind of this receive more than 50 percent of the vote in the 1st

round. i strongly believe that we will continue to serve our nation for the next 5 years. was that to me, we will absolutely, absolutely. when these elections in the 2nd round, every one will say the laptop and the bylaws in round one, it was incumbent president, origin type outdoor of a 49 and a half percentage point is main opponent. the sense of the less come out colors are all with around 5 percentage points less now while the 3rd kind of in the field, the right way and position sitting on on that he received of 5.2 percent. but who is the support of those as well? i know who will they? so the weight behind now i'm could this end up being crucial,

but that was 60 man to the citizens eligible to vote, turned out who's 9090 percent. so just in just how important people see this election as the directors from the country goes moving forward. and with that tension generally becomes controversially off of the 1st problem is that close that will accused his arrivals of interfering with the count and reporting a results reg. zip type. edwin subsequently claimed that this has made opponent is working with us present, joe biden, to try and winning the election with outside how, but in a week from now, it all comes down to a straight shoots out as to who will lead the nation. but most of those have been sharing their thoughts on the future. one of us this and now these are suitable them. i believe it was a fair election. however, due to the rejection of some valid boxes, there was a delay in the counting. i'm sure everything will go smoothly and the run

a fully more concrete results. can you to know, you know, i believe i do, i move in in the run of i also think when it's expected, the election is where a huge surprise for me. i was expecting compile carrots star, a loop to win. i think it will be a hard race, but i want him to win. resorted to the travel since he didn't study that took his for an mfc who sold of the western countries excitedly hoping mr. ad on news, the rice had nato countries on monday to late thing. collections they want to topple out on it starts to look at the german, french, american, english, the magazines and newspapers, the economist, etc. that all right, i guess add on add up, but as of monday to ration that this information that that what they are doing the