How to get adderall?

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Pooja Parikh Traveled Across The World For The HS Diagnosis That Changed Her Life Forever

Tell your doctor that it was your parents or significant other’s idea for you to reach out for help regarding your concentration issues. If it wasn’t even your idea in the first place, how could you be there just to get medication?

1. Bring up that you’ve been talked to at work about your lack of productivity and that although it was never stated, you feel like you’ve been dismissed from other jobs in the past due to similar issues.

Source: Giphy

2. Say that you’re really against medication and you only want to use it as a last resort. This will make it feel like it was your doctor’s idea in the first place.

3. Say that you’re really embarrassed about having to go through this and it’s why you haven’t reached out for help sooner.

4. Never mention any past drug use, eating disorders, depression, or sleeping issues. These are all deal breakers.

5. And last but not least, make sure you keep looking all around the room, ask your doctor to repeat himself at least 5 times, and pick-up something in his office and play with it. Just trust me.

Side Note: If you aren’t good at playing the innocent victim, you could also take the “I was on it in the past but I tried life without it and I can’t accomplish anything” approach. It’s a little bit more risky but it requires less of a performance.

Adderall is a prescription stimulant meant to treat attention deficit hyperactivity disorder (ADHD). It contains a combination of amphetamine and dextroamphetamine, central nervous system stimulants that affect the chemicals in the brain that contribute to hyperactivity and inattention. Adderall and other medications in the stimulant class (Vyvanse, Ritalin, Concerta) can have a very positive impact on the professional and educational performance and experience of those with ADHD by increasing one’s ability to focus. It also supports elements of patients’ personal lives that may be impacted by attention disorders.

But has our country’s use of Adderall pushed past normal limits, and have pockets of our population not actually afflicted with ADHD gotten hooked? In a word: Yes.

In this article, we’ll explore the history of Adderall and amphetamines, spotlight some troubling trends that have emerged in recent years, and offer possible solutions to taking steps towards addressing the over-prescribing of and over-reliance on prescription stimulants.

The rise of amphetamines

In 1996, Shire Pharmaceuticals introduced Adderall, the patented blend of amphetamine salts, to compete in the market of ADD/ADHD medications like Ritalin, which had emerged onto the prescription drug scene in the 1980s and ‘90s. But the use of amphetamines far predates the late 20th century. Amphetamine was first synthesized in 1887 by Romanian chemist Lazar Edeleanu, who reported on it but never discovered its physiological effects. In 1929, Los Angeles chemist Gordon Alles discovered it as well. Alles was trying to develop a drug to improve upon ephedrine, which was used to treat asthma, colds, and allergies. Alles’ compound, called beta-phenyl-isopropylamine, was ultimately injected into his body to test its efficacy (self-testing was routine in the early days of scientific discovery), according to the Chemical Heritage Foundation. Several minutes later, his sinuses were clearer, but he noticed something more noteworthy: An unmistakable feeling of well-being.

Ultimately, as an asthma treatment, the compound failed; as a euphoria-producing stimulant, it soared. Alles approached pharmaceutical company Smith, Kline, and French (SKF) about a partnership—and in exchange for his scientific capabilities, SKF agreed to market amphetamine as a “wonder drug.” Benzedrine Sulfate, as Alles’ drug became known, was one of the first psychoactive prescription drugs, and was marketed as the first antidepressant.

By the late 1930s, college students used what they referred to as “pep pills” to increase productivity; American soldiers in World War II took amphetamine to counter fatigue and boost morale; amphetamine-based drugs even became popular among mothers and housewives in the 1950s to lift spirits and combat ennui. College students of the ‘90s and 2000s were certainly not the first group to get hooked on prescription stimulants—it just went by a different name, and was distributed for different reasons. The Chemical Heritage Foundation sums it up well: “Once Alles and SKF brought amphetamines into public consciousness, they never truly went away.”

Despite Benzedrine Sulfate/amphetamines being marketed as a healer of mental malaise, studies at the time showed that it actually had little impact on severe depression or anxiety. Instead, scientists found that it could potentially exacerbate psychiatric symptoms, even causing psychosis in some cases.

Another major red flag attached to prescription amphetamines, even in its early days? the Chemical Heritage Foundation writes,“

“Almost from its beginning…amphetamine was ripe for nonmedicinal use.”

Indeed, this legacy is still very much alive today.

Stimulants in the 21st century: Trends & observations

Within the last decade alone, we have seen a huge increase in the prescribing of Adderall and similar prescription stimulants. This is a direct result of ADD/ADHD being diagnosed with much more frequency, which begs the question: Are we better able to diagnose ADHD today because of better screening practices and more access to care, or, are people, in this age of technological distraction, social networking, and school/career competition, seeking out Adderall just to keep up? It is certainly hard, in today’s climate, not to be seduced by all our available distractions. “It didn’t escape me that just as Adderall was surging onto the market in the 1990s, so, too, was the internet, that the two have ascended within American life in perfect lock-step,” observed writer Casey Schwartz in the New York Times Magazine last fall.

In many ways, I wear two hats when it comes to ADHD medications because I do have patients that are genuinely afflicted with this condition and need prescription medication to manage it. But I wonder if simple distraction is being conflated with ADHD, and if instead of examining and working on the underlying issues at-hand—be it boredom or distraction or depression—we are too often handing out Adderall as an easy cure-all.

Prescription popularity

ADHD was first included in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1987. According to the Centers for Disease Control and Prevention (CDC), in the 1990s, around 3-5% of American children were believed to have ADHD. By 2013, that figure rose to 11%. The CDC writes:

“The first national survey that asked parents about ADHD was completed in 1997. Since that time, there has been a clear upward trend in national estimates of parent-reported ADHD diagnoses. It is not possible to tell whether this increase represents a change in the number of children who have ADHD, or a change in the number of children who were diagnosed.”

The report adds that the number of FDA-approved ADHD medications also increased “noticeably” since the 1990s.

And somewhere along the line, ADHD diagnoses and stimulants made their way into the world of adolescents and adults. Schwartz, in her examination of what she calls “Generation Adderal”, notes that in 2012, roughly 16 million Adderall prescriptions were written for adults ages 20 to 39. She also points out that Adderall is all over college campuses, taken with and without prescriptions. Indeed, Schwartz notes that the off-label use of prescription stimulants was the second-most common form of illicit drug use by 2004 (after marijuana). In a college environment, which is very often filled with high-pressure situations, tough deadlines, and unrelenting stress, our young people have discovered that taking a pill can help them complete their tasks faster and with less distractions. The unmanageable suddenly seems very manageable.

From college to career

But what about when young adults transition their Adderall use from the classroom to the conference room? Over the last few years, there seems to have been a steady uptick of people in their 20s and 30s using Adderall to bolster their professional lives. Indeed, a recent study of 11 million U.S. workers found that workplace drug tests are coming back positive at the highest rates in a decade, and they’re continuing to increase. The study notably revealed that amphetamine positivity increased 44% between 2011 and 2015. Alan Schwarz, a foremost expert on the topic of ADHD and prescription stimulants, states,

“It stands to reason that if you feel as if you succeeded in college partly because of these drugs, you’re more likely to feel as if you need them to succeed in the workplace.”

It seems, however, there is a common “so what” attitude surrounding Adderall use since it’s a drug that is known for engendering positive behaviors. Indeed, a recent survey from Partnership for Drug-Free Kids revealed that one in five teens believe it’s ok to abuse prescription drugs as long as they weren’t doing it to get high. In some cases, young people don’t even see non-prescribed Adderall as an illicit substance so much as a study or work aid. But let us not forget: Adderall and similar prescription stimulants are classified by the Drug Enforcement Administration (DEA) as Schedule II drugs, in the same category as cocaine, because of their highly addictive properties.

The incredible pressure to succeed professionally, combined with an overprescribing and “quick-fix” culture, has caused something of an Age of Adderall. And despite Adderall lacking the same negative associations that drugs like opioids invariably have, there are major and worrisome impacts that we must pay attention to and address if we want to help our young people lead healthy lives.

Side-effects

Adderall’s most glaring side effects include weight loss (due to appetite suppression), anxiety, irritability, insomnia, and, of course, dependence. Adderall “crashes”—caused by stopping Adderall suddenly—can cause depression and sluggishness. Some regular Adderall users, when not taking it, experience anhedonia—the inability to experience a normal sense of pleasure or joy. It can be exceedingly difficult to transition from the constant “up” state of Adderall to no stimulant assistance, and the fatigue and lack of motivation can be crushing. In its most extreme states, prolonged Adderall use, especially when combined with a lack of sleep, can cause panic attacks, paranoia, and psychosis. Indeed, in Schwartz’s “Generation Adderall” she recounts her own harrowing experience with a panic attack after days of continuous Adderall use. A few years back, Alan Schwarz wrote an article detailing one man’s addiction to Adderall, ultimately leading to a psychotic episode and, weeks later, suicide. Of course, situations like this are more rare than commonplace, but it doesn’t diminish the underlying reality: This is a highly addictive class of drugs, and our young people, in growing more reliant on them, are at risk.

Something I’ve seen in my work at Mountainside Treatment Center is co-addictions, with Adderall being used in conjunction with other substances to balance its effects. It’s rare to find a patient who isn’t also abusing Central Nervous System depressants such as alcohol and benzodiazepines (like Xanax) to lessen the effects of Adderall, which has likely caused them sleep deprivation and anxiety. What this means for psychiatrists is that we’re treating a more complex patient when it comes to Adderall addiction.

Something else to consider is that because Adderall can create a false sense of interest and motivation, it can halt some users from identifying what truly gives them passion, especially for those kids who start taking it in high school or college, and then enter their careers still abusing stimulants. If and when the day comes that they stop, they may be left wondering what, professionally or personally, truly lends them joy or a sense of purpose.

Solutions

So, what can we, as medical professionals, do to help our patients from falling into patterns of addiction with prescription stimulants?

  • Be more vigilant about screening: Some patients really are struggling with ADHD, and those patients can be helped with prescription stimulants, but we must ensure that we’re not handing out prescriptions to kids who don’t really need it. It’s quite easy for someone to come in listing ADHD symptoms they read about online and inquire about an Adderall prescription. It is our professional obligation to be more attentive in our decision-making. One simple way to achieve this? Schedule multiple meetings with a patient before writing a prescription. Getting to know them better, and really understanding their needs, could help carve a clearer sense of what might help them.
  • Implement better prescribing practices: Research has indicated that the time-release Adderall, which releases smaller doses of the drug into your bloodstream over a period of time, are less prone to abuse than the fast-acting variety. If you do decide to prescribe Adderall to your patient, try the time release version first and see how it goes. Further, there are prescribing practices that we should all follow in terms of limiting the amount of prescriptions during certain amounts of time, not upping the milligram dosage at the patient’s request, and so forth. Some prescribers write-out four prescriptions at one visit and say, “Call me next semester when you’re back in town.” We have to be better than that.
  • Educate patients and families on potential dangers of stimulant use: Many young people want a quick-fix solution to their ailments, which can lead them to ask for an Adderall prescription without investigating the potential side effects. It’s important that psychiatrists inform patients (and parents when you’re dealing with teenagers) on the side effects mentioned earlier, as well as Adderall’s addictive nature. When meeting with your patients, investigate attitudes, situations, and behavior patterns that may indicate over-reliance, misuse, or “self-medication”, which may be ominous warning signs of their vulnerability to addiction. Additionally, before ever prescribing stimulants, consider non-pharmaceutical interventions, or non-stimulant medications, that might help improve their focus—especially if you’re not certain the patient has ADHD. Also, if or when you are meeting with your patients who are prescribed Adderall, it’s a good idea to do random urine toxicology screening to see if there are other substances in their system that shouldn’t be there. Your patients should test positive for amphetamines and negative for other illicit substances. This can be an opportunity to identify patients at risk for co-occurring addictions, or it will serve as an assurance that they are appropriately taking the medication you prescribed.
  • Uncover any co-morbidities or issues at play: As psychiatrists, it’s our responsibility to not just prescribe medications, but to get to the bottom of what is afflicting our patients. Perhaps a patient comes to you feeling distracted and listless at work. Instead of turning to the little white pad right away, it’s important to probe what else is happening in this patient’s life. Maybe a romantic relationship recently ended; perhaps, they are feeling insecure in their career path. Building a relationship and a mutual trust with our patients, and opening up conversations about what is really going on with them, could help us better diagnose conditions, and ultimately help our patients work on their issues in the long-term.
  • Changing attitudes: This is a much taller order and a very long-term pursuit. But I do believe that as caregivers and as a society, we must shift away from putting so much weight on quick-fix solutions. Our collective “there’s a medication for that” attitude needs to change. Our work in the psychiatric community must go beyond writing prescriptions: We should be guiding our young people to find their paths, helping them realize their strengths, passions, and yes, even weaknesses in this ever-complex world.

Adult ADHD Test

Adult Attention Deficit Hyperactivity Disorder (ADHD) is a relatively common, often unrecognized condition. It affects 4.4% of U.S. adults, but most adults with ADHD live with the symptoms and suffer the often-devastating effects of ADHD in their lives without identifying the source of their struggles. Instead, their difficulties are attributed to their own shortcomings. Once diagnosed, many adults are happy to learn that they do not have a character flaw as aptly described in the title of one popular book on ADHD, “You Mean I’m Not Lazy, Stupid or Crazy?!” (a classic book for adults with ADHD).

Adult ADHD Exists

Many adults who suffer from untreated ADHD avoid diagnosis or treatment due to the negative stigma associated with ADHD. Many people dismiss ADHD as little more than laziness targeted as a marketing opportunity by pharmaceutical companies. However, many years of scientific research confirms adult ADHD does indeed exist, and that ADHD diminishes adults’ quality of life.

Regardless of the stigma surrounding ADHD, knowing about your adult ADHD is preferable to struggling unawares. With an accurate diagnosis, many treatment options and coping strategies become available. ADHD is not a “one size fits all” disorder and many factors must be considered before a definitive diagnosis is made and an appropriate treatment is found.

It’s Better to Know

An ADHD diagnosis is not a death sentence, nor does it guarantee a lifetime of taking pills. Medication is not always effective, and there are many adults with ADHD who do not want medication as part of their treatment plan. However, without knowing you have adult ADHD, there’s certainly nothing anyone can do to help. If you do have ADHD, you can rely on ADDA, the world’s only organization dedicated exclusively to helping adults with ADHD.

ADDA provides accurate and science-based education on treatment alternatives such as CBT, ADHD coaching, and medication, and as scientific research has proven the benefits of additional treatments, ADDA has also expanded its education efforts to include strategies such as mindfulness practice, exercise, diet and therapy.

The World Health Organization Adult Self-Report Scale (ASRS) Screener

The World Health Organization has prepared a self-screening questionnaire you can use to determine if you might have adult ADHD. The Adult Self-Report Scale (ASRS) Screener will help you recognize the signs and symptoms of adult ADHD. The ASRS is comprised of 6 questions that are ranked on a scale of 0 to 4. If you have at least 4 of these 6 symptoms significantly, you may have ADHD and should seek out a formal diagnosis.

When you complete this Adult ADHD questionnaire, if the results seem to indicate you might have ADHD (that is, four or more of your answers in Part A are located in the grey boxes), then bring a copy of the questionnaire with you when you seek diagnosis to help with the diagnostic process.

A Good Starting Point

This screening test is a symptoms checklist for adult ADHD and not a diagnostic test. A full assessment and potential diagnosis of ADHD is not accomplished using an online test or during a quick doctor’s appointment. A thorough evaluation usually takes more than one visit, and must be done by a professional who is trained in ADHD*. Other conditions can sometimes resemble ADHD, so it is important to work with a professional who is able to rule out these other conditions and make the appropriate diagnosis. Many psychologists, psychiatrists, therapists and some general practice physicians are trained to diagnose adult ADHD.

A thorough assessment requires a complete physical and psychiatric medical history as well as screening to rule out any possible physical disorders. All assessments should include an extensive interview with you and often with your significant other (other people are often more aware of your behaviors and struggles than you are), and the application of various symptom-rating scales. For accuracy, it is common to use more than one scale to confirm results.

*Note: The professionals qualified to diagnose ADHD, especially ADHD in adults, are defined differently by the governing bodies of mental and/or medical health professionals on a state-by-state and country-by-country level. The list of approved professionals to perform ADHD diagnoses therefore varies with each jurisdiction. The process of diagnosing ADHD, particularly in adults, requires extensive knowledge, skills and training, not only to identify ADHD properly, but to separate comorbid conditions and correctly distinguish and diagnose other conditions which may mimic ADHD. Check with your local health care governing body for a definitive list of care providers deemed qualified to diagnose ADHD.

Take the Test

To take the test, please download the Adult ADHD Questionnaire. This link will download a PDF containing the adult ASRS questionnaire, which you can print and complete by following the instructions.

Please note this test is a starting point, not as a diagnostic tool. This score is not intended as a mental disorder diagnosis, or as any type of healthcare recommendation.

You’ll Need Adobe Reader

You will need Adobe Reader in order to open and read PDF files including the ASRS. You can get Adobe Reader here (a new window will open so you can download and install it without leaving this page). To open the file in your browser window, simply click on the link. However, if you want to download the file to view later, then right click on the link and choose “Save Target As” or “Save File As.” Then select where you want to save the file on your hard drive.

Once you have saved the file, locate where you saved it, and double click to open it. To print the ASRS, select the “Print” option from the menu.

How to Bring Up ADHD With Your Doctor

In addition to signs of inattention and hyperactivity, here are other symptoms that might lead you to wonder if you have ADHD:

  • You have trouble being patient with your kids.
  • You feel like you can’t stay on top of everything.
  • You can’t seem to get to anything on time.
  • You lack the motivation to get things done.
  • You procrastinate on important tasks, such as only starting to gather your tax receipts a few days before (or on) April 15.
  • You frequently lose things.
  • You have a child with ADHD, and you see some of your own personality traits in the child.
  • You remember having trouble concentrating and studying in high school or college.

“Any one of these symptoms in isolation is not enough to make a diagnosis of ADHD, but if you notice multiple ADHD signs in your work, academic life, relationships, and parenting, you should talk to your doctor about ADHD,” Ramsay says.

Although ADHD cannot be cured, it can be treated. “In most cases, people wait too long to bring their ADHD symptoms up to their physicians,” he adds. His suggestion: “Trust yourself enough and err on the side of bringing it up.”

RELATED: Anxious? Distractible? Impulsive? 5 Signs You Might Have Adult ADHD

People with ADHD symptoms may hesitate to mention their worries about the condition to their doctor because they fear they’ll be labeled a hypochondriac. Ramsay points out that although ADHD is under-recognized in the medical community, he doesn’t deny that the popular claim that ADHD is over-diagnosed has some merit. “The real problem is actually misdiagnosis, not over-diagnosis,” he says. “There’s an over-diagnosis of ADHD in people who want to take medication to enhance their academic performance, but an under-diagnosis of ADHD in people who truly have it.”

How to Talk to Your Doctor About ADHD

Once you’ve made the decision to discuss your ADHD symptoms with your doctor, it’s good to have a plan for how you will address the issue.

Larry Drum, MD, an internal medicine physician in Los Alamitos, California, who has dealt with many cases of ADHD, offered some suggestions on how to talk to your doctor about ADHD:

Step 1: Put away your fears about being labeled a hypochondriac. “People with symptoms of ADHD seem to be more accurate about their diagnosis than people I see with a lot of other conditions, such as migraine headaches,” Dr. Drum says. “In most cases, people with ADHD have had suspicions they have the condition for a very long time.”

Step 2: State ADHD as your reason for seeing the doctor when you make your appointment. “Too many times, patients will bring up their ADHD symptoms at the end of an appointment they made for a cold or high blood pressure,” Drum says. “Instead, make an appointment specifically to discuss ADHD. It warrants a whole visit.”

Step 3: Briefly explain your symptoms and then let the physician take control. “I usually let patients talk for about five minutes about ADHD symptoms that have been bothering them and pick up on keywords and factors I then need to explore,” Drum says. These days, primary care physicians are under a lot of pressure to see patients in a short period of time, so the more time the doctor can spend asking the right questions, the better. “If someone is too talkative, I may not get a chance to ask important questions,” he says, adding that the best way to communicate your ADHD symptoms is usually with examples of how they interfere with daily life.

Step 4: If you have self-diagnosed ADHD and tried medication, tell your doctor. “I see some adults in their thirties or forties who are witnessing their children suffer with something that parallels how they struggled as children or teens,” he says. Some people in this second group have tried their children’s ADHD medication and found it really helps. Although it is never a good idea to take medication that hasn’t been prescribed to you by your doctor, it’s important to be honest and it may even be useful for a proper prescription. “As your physician, it is helpful to know that,” he says.

What Your Doctor Needs to Know About Diagnosing ADHD in Adults

Medically reviewed by ADDitude’s ADHD Medical Review Panel

How Do They Test for ADHD in Adults?

Not long ago, most doctors believed that children outgrew symptoms of attention hyperactivity deficit disorder (ADHD or ADD) with time. It was considered a pediatric condition. ADHD was traditionally linked to hyperactivity, which fades in early adolescence. We now know that ADHD is a lifelong condition that manifests differently for different patients. Some never display outwardly hyperactive behavior. Because our understanding of diagnosing ADHD in adults has improved so much in the last few decades, many adults are recognizing their symptoms for the first time, and seeking an evaluation late in life.

Recognizing ADHD Symptoms in Adults

Most adults seeking an evaluation have spent a lifetime learning to compensate for ADHD symptoms such as inattention, disorganization, and impulsivity. Because they are bright, creative, and good problem solvers, these undiagnosed individuals find ways to make life work for them — often until mounting family and career responsibilities push them to seek a diagnosis and symptom relief. Dr. William Dodson, a board-certified adult psychiatrist who has specialized in adults with ADHD for the last 23 years, says the average age of diagnosis in his practice is 39.

“ been able to find compensations and ways around their ADHD their entire lives,” says Dodson, until their challenges “just overwhelm their ability to cope with their ADHD.” They typically go to the doctor for other conditions they think they may have, like anxiety or a mood disorder.

Common symptoms of ADHD among adults include:

  • Distractibility and inconsistent focus
  • Forgetfulness
  • Disorganization
  • Inability to finish projects
  • Tension or restlessness
  • Inconsistent performance often perceived as being unreliable
  • Motivation not based on importance, but interest and urgency
  • Unable to get enough restful sleep
  • Poor sense of time
  • Intense emotions and sensitivity to criticism
  • Unexplained underachievement (not failing, but not achieving what you feel you should be or could be)
  • Substance abuse and/or dependence

Diagnosing ADHD in Adults

The standard checklist to determine if a child has ADHD is the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth edition (DSM-V). This symptom guide is invalid for adults. The only way to diagnose ADHD in adulthood is through a careful clinical interview to gather a detailed medical history. It’s important to see a clinician who specializes in ADHD, and will take the time required to identify symptoms in adulthood.

Surveys tell us that most general physicians, even most psychiatrists, undergo no training on ADHD. “Ninety-three percent of adult psychiatrists, when asked, report that they’ve never had any ADHD training, either in their residency or in their continuing medical education, whether in children, adolescents, or adults,” says Dodson. It’s no wonder so many struggle to get an accurate ADHD diagnosis in adulthood.

The clinical interview may be supplemented with neuropsychological testing, which offers greater insight into strengths and weaknesses, and helps identify co-existing, or comorbid, conditions.

“The part that most family physicians miss out on would be the differential diagnosis,” explains Dr. Michele Novotni, former president and CEO of the national Attention Deficit Disorder Association (ADDA), speaker, best-selling author, psychologist, and coach. “ADHD symptoms can be the result of different mental health issues, such as anxiety or a mood disorder. Any of these conditions can be occurring with ADHD.”

It’s important to see a clinician who also has a thorough understanding of its comorbid conditions. The emotional sensitivity component of ADHD can look like a mood disorder and/or anxiety, particularly in adults who have lived with ADHD all their lives. If your clinician doesn’t understand the nuances of each related condition, and how they can mimic one another, you may endure a frustrating waste of time and money. A clinician trained in just one of these conditions will see only the condition they’re trained to see, and that often leads to a misdiagnosis of a mood disorder and/or anxiety. Of course, an inaccurate diagnosis leads to ineffective (and in some cases, counterproductive) treatment, which often worsens the problem.

“The best way to find a competent clinician,” Dr. Dodson says, “is to start either with the ADDitude’s ADHD Directory, or go to a CHADD or NADDA meeting. These are people who are just a couple of years ahead of you and they can tell you who’s good and who’s not.”

Physicians unfamiliar with making a mental health diagnosis should refer patients to either a psychiatrist or psychologist who is trained to diagnose and treat ADHD and its comorbid conditions.

“You want to see someone who realizes that there’s a lot of talent embedded in the problems,” suggests Dr. Edward Hallowell, a practicing psychiatrist and founder of the Hallowell Center for Cognitive and Emotional Health. “You don’t want to get a diagnosis and walk out feeling like things are all bad, and will be forever.”

Treating ADHD in Adults

Dr. Russell Barkley is a clinical professor of psychiatry and pediatrics at the Medical University of South Carolina. When adult patients ask him questions about why they should try medication to manage their ADHD, he begins his reply with two important words: “Medication works,” he says. “When you find the right medicine, you can experience substantial improvements in your ADHD symptoms.”

The same medications used to treat children who have ADHD are also used to treat adults. Stimulants like Ritalin, Concerta, Vyvanse, or Adderall, comprise the first line of treatment, not the last resort, Dodson says.

“About 80 percent of adults with ADHD have some kind of co-occurring condition that complicates the treatment of their ADHD,” says Novotni. She warns that not treating all of the problems leaves the patient struggling and frustrated.

Debra Brooks was a treatment holdout — at first. Upset about her diagnosis, she says, “for about six weeks, I flailed. I resisted starting medication. But then I remembered what the neurologist who diagnosed me had said: ‘Why did you pay me $1,400 if you didn’t want my advice?’”

After starting a medication regimen, every patient should consider working with an experienced psychologist, psychiatrist, or life coach, says CHADD director Meyer. These professionals can help people with ADHD learn behavioral, time-management, and organizational strategies to enhance their quality of life.

“A coach can give you ways to manage your ADHD symptoms,” Novotni says. “If you’re hyperactive, a coach can suggest ways of channeling your energy — for instance, taking a walk during your coffee break. If you’re impulsive, a coach can teach you ways to delay your responses, so you can think about them.”

“Education of the entire family about what ADHD is — its strengths, its weaknesses, and its treatments — is essential,” concludes Dodson. Understanding of how the ADHD brain works is essential to success.

In addition, Meyer offers these tips for the newly diagnosed:

  • Know your legal rights. Having ADHD means you’re protected under two federal laws that apply to individuals with disabilities.
  • Seek support by attending meetings of your local chapter of CHADD, a non-profit advocacy and education organization (click “Find local chapters” on CHADD’s home page).
  • Don’t feel compelled to tell your boss. “There’s more understanding about ADHD now, but that doesn’t mean that supervisors are happy to learn that one of their employees has the condition,” says Meyer. If, however, you think accommodations — closing your office door, taking more breaks — will help you improve your job performance, you may want to discuss these with your employer.

The bottom line: Adults with ADHD should learn as much as possible about how to make the most of their unique brain wiring. This may include individual or couple’s therapy, support groups, and learning new ways to do things.

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Updated on November 4, 2019

Whats the best way to get an Adderall prescription?

If you’re intelligent, I recommend being straight up with your primary care doctor. I have never been diagnosed with ADD but I have experienced symptoms of it ( just like every other human being ) and I never liked school. It was always a struggle to sit down and do the damn homework. Long story short, I’ve never taken adderall, but I heard about it and was curious. I went to my doctor, talked about ADD, told him my symptoms and that I dont think i need to be classified as having a disorder like ADD I was just curious if Adderall would help with motivation and studying habits. He agreed and basically told me that he doesnt have ADD either, but he has a prescription of adderall as well, that he uses it as needed, i.e. sleepless nights, extremely busy days, etc.

So he prescribed me a copious amount of 5mg IR tabs and had me experiment with dosage to see what would work for me. Came back about a month later and got prescribed 20mg IR twice a day. I dont use them everyday but I asked him to prescribe me a month supply of twice a day anyway. It only takes a 10mg to get me going, so i will be set for a few months and will always have access to the doc if i need more.

Basically my advice is be smart. If you start taking it EVERY day and notice that you are having to up the dosage, stop using it for a week and restart the process. If you think you are developing an addiction or dependency on it, just finish out your prescription and stop taking it completely. You are an adult, you can decide what is right for your body and adjust your nutritional needs to benefit yourself. If you happen to be one of those people who cant handle recreational drug use or performance enhancing drugs JUST DONT TAKE THEM. But then again, I dont care, if you’re an idiot be and idiot just do the world a favor and dont reproduce.

In 2010, when Raphael was a first-semester college freshman struggling to get through finals, he did what it seemed like all his friends were doing: he got an Adderall from a fellow student and holed up in the library. It was the first time he’d tried the stimulant—a mixture of amphetamine salts often prescribed for attention deficit hyperactivity disorder (ADHD)—which is often used off-label as a “study drug” by those not diagnosed with the disorder.

“I was a little surprised by how much I loved it,” Raphael, now 25, tells Quartz. “It made me feel like a philosopher king.” Soon, he became part of the estimated 20% of college students who abuse prescription stimulants. But he didn’t anticipate that, six years later, he’d be using Adderall daily while working as a web developer at an e-commerce shop in Los Angeles.

The story of how he procured his first stimulant prescription proves how prevalent an ADHD diagnosis has become. “I don’t really have ADHD. But after freshman year, I found a drug dealer with a PhD,” Raphael says, referring to his psychiatrist. “I said that people thought I had ADHD in high school, and the psychiatrist just said, ‘Okay,’ and took out her little pad. I’ve had a prescription ever since.”

As a millennial, Raphael is part of the first generation of Americans to be routinely prescribed stimulants during childhood and adolescence and who gone on to abuse those stimulants in high school and college. Now, as Alan Schwarz points out in his new book ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic, millennials are graduating into the workplace, and many of them are continuing to use prescription stimulants as job-performance enhancers.

If you used Adderall throughout college, quitting when you start working can be difficult. This isn’t just because ADHD medications like Adderall are highly addictive Schedule II-controlled substances—putting them in the same category as cocaine—but also because many users come to see them as a driving factor in their success. “It stands to reason that if you feel as if you succeeded in college partly because of these drugs, you’re more likely to feel as if you need them to succeed in the workplace,” Schwarz says.

“If you feel as if you succeeded in college partly because of these drugs, you’re more likely to feel as if you need them to succeed in the workplace.”

While there is a lot of research about the abuse of stimulants on college campuses, there’s still no reliable data quantifying stimulant use among American adults in the workplace. The National Institute on Drug Abuse is looking into this relatively new trend, however: A recent study of 11 million US workers found that workplace drug tests are coming back positive at the highest rates in a decade, and they’re continuing to increase. Amphetamines, including Ritalin and Adderall, were the second most common drugs detected after marijuana. (Drug test results sometimes include methamphetamine, or crystal meth, in the amphetamine category, so it’s unclear how much of this increase is due to prescription amphetamines.) Meanwhile, the number of adults with prescriptions for ADHD medication is moving past 5 million, and prescriptions among 26- to 34-year-olds are the driving force.

“You’ll likely see more in professions that are dominated by people in their 20s,” Schwarz says. As an example, he cites a millennial-run tech company in New York City where an employee “keeps Adderall in an Altoids case in her open purse for anyone to grab as necessary.” The company’s founder, a woman in her 20s, takes Adderall in order to sleep just three and a half hours a night and says it’s “necessary for survival.”

Assessing the issue of amphetamine use in the workplace is tricky for many reasons, one being that adults with legitimate ADHD diagnoses can greatly benefit from medication. For those plagued with chronic disorganization and an inability to focus, an Adderall prescription can be a career saver. But as Schwarz points out in his book, “There’s no way to know how many of were legitimate—the reasonable result of greater awareness of adults truly having ADHD—and which materialized from dishonest patients or lazy doctors.”

Raphael credits his own tech knowledge to Adderall. In college, he often used his amphetamine-induced laser focus to teach himself to code. He eventually started a successful freelance web-design business, and now makes $75,000 a year as a full-time web developer. Raphael says he feels “totally dependent” on Adderall to succeed: “Without it, I don’t really see the art within the coding.”

The impulse to chemically enhance one’s work performance, of course, isn’t limited to particular fields. While doing research for ADHD Nation, Schwarz talked to a glassblower, a yoga teacher, a beer-warehouse stacker, newspaper reporters, bartenders, professors, dentists, doctors, and truck drivers who all acknowledged taking Adderall to power through their work.

“The number of people entering drug rehab specifically for abuse of Adderall and other ADHD medications has risen substantially.”

As there’s no long-term research on Adderall’s effects, even the safety of controlled use is still up for debate. Known risks include side effects such as insomnia, increased blood pressure, irregular heart beat, appetite suppression, headaches, dry mouth, and anxiety. In some cases, according to a wealth of research, amphetamines can trigger hallucinations, delusions, and psychosis. “The number of people entering drug rehab specifically for abuse of Adderall and other ADHD medications has risen substantially,” Schwarz writes.

News stories about prescription stimulants often concern the estimated one in ten people who become dangerously dependent. In “Generation Adderall,” a recent piece for the New York Times Magazine, journalist Casey Schwartz detailed her decade-long Adderall addiction, during which she wound up in the ER after an amphetamine-induced panic attack. “My life was no longer my own…. The Adderall made my life unpredictable, blowing black storm systems over my horizon with no warning at all,” Schwartz writes. “Still, I couldn’t give it up.” In 2011, Richard Fee, once a popular college class president and aspiring medical student, committed suicide after struggling for years with an Adderall addiction enabled by careless doctors. “Recent years have seen several other such stimulant-related suicides,” Schwarz writes. These cautionary tales illustrate the dire consequences of rampant misdiagnosis and cavalier overprescription.

Partly because of such alarming news stories, Raphael, for one, is concerned that his older colleagues will judge him negatively for being part of “Generation Adderall.” He feels that Baby Boomers wring their hands over prescription-drug use among millennials—despite the fact that Baby Boomers created “Generation Adderall” in the first place.

“I think the blame is a little backwards there,” Raphael says. “You can’t prescribe a whole generations of kids drugs, tell them to ‘be the best you can be,’ and then when they go take the drugs, turn around and accuse them of cheating and call them ‘Generation Adderall.’” Judgment is often misdirected at young adult users themselves instead of at the doctors and pharmaceutical companies who perpetuate the trend. Fearing repercussions, Raphael hasn’t told his colleagues about his usage.

Not that they’d ever likely suspect it, anyway: Raphael looks more like a workaholic than a drug addict. He’s the type of Adderall user who doesn’t usually make news. “I’ve never had panic attacks or wound up in the ER,” he says. “I get enough sleep.” He calls himself a “chronic but high-functioning user” with “just enough self-control to keep below the level at which it would start to negatively impact my work performance.”

It has negatively impacted his relationships, though. “Since it makes you focus on work, it can be a lonely drug,” he says. His mother is concerned about his use, and his one significant attempt to quit happened a year ago, at his girlfriend’s request. She’d accused him of “being more interested in aligning things on websites than going to dinner and a movie,” so he agreed to stop. Aside from a couple of days spent binge-watching Frasier, he had no withdrawal symptoms. Soon, his relationship improved, but his career suffered. “I had obligations to all these clients,” he says. “When I stopped taking Adderall, I just stopped emailing them, because I didn’t want to build a website—I wanted to hang out with my friends.” Three months later, Raphael started taking the drug again.

Employers, so far, haven’t done much to address ADHD medication misuse in the workplace.

Employers, so far, haven’t done much to address ADHD medication misuse in the workplace. One rare attempt to regulate prescription stimulants in a professional setting took place in the millennial-dominated world of esports, also known as competitive video gaming. In 2015, the Electronic Sports League, or ESL Gaming, added Adderall to its list of substances prohibited from ESL tournaments, and started drug-testing players. The ban came after a prominent 26-year-old professional Counter-Strike: Global Offensive player admitted in an interview that his whole team had used Adderall during an ESL tournament.

“Adderall is just part of the esports culture,” says Ryan Morrison, who’s known as the “Video Game Attorney” at the law firm Morrison/Lee. “Some people joke that 95% of players take it.” Top professional esports players make “literally millions of dollars” and usually live in team houses where they’ll practice games like League of Legends and Dota 2 for nine hours straight. “One player told me, ‘I want to win, and I’m not gonna win if everyone else is taking Adderall and I’m not,’” Morrison recalls. “Another said, ‘It’s just like drinking a monster energy drink.’ It’s not—they’re taking a Class 2 controlled substance. They don’t realize it.”

The ESL’s amphetamine ban proved hard to enforce, especially as players with “legitimate prescriptions” were still allowed to use it during tournaments. “This just meant the players went and got prescriptions,” Morrison says. “Not every esports player needs Adderall, but all of them can get prescriptions if they decide it’s necessary.”

It’s hard to imagine a tech company or a law firm enacting a similar ban. A few years ago, the National Business Group on Health published a short report called “ADHD Diagnosis and Stimulant Medication Misuse: Five Things Employers Can Do.” “This sounded encouraging, until it focused almost entirely on reducing employers’ insurance costs for the growing number of unnecessary prescriptions,” Schwarz says. “Frankly, because the report didn’t discuss the ‘misuse’ mentioned in its title in any meaningful way, it indicated how blind employers are to this trend.”

Even if employers were aware of the trend, would they be inclined to try to stop it? Unlike many other drugs—especially “downers” such as marijuana, Valium, and even heroin—stimulants like Adderall often help job performance instead of hurting it. Perhaps because of this, employers haven’t been quick to complain. “What could my boss possibly say about it?” Raphael says.

If you’re like Raphael and don’t experience significant physiological downsides to taking ADHD medication, it’s not hard to see why you’d be reluctant to stop taking it, despite the health risks. But aside from the potential for addiction, Schwarz is concerned that, even if one person’s stimulant use at work doesn’t directly hurt them or their colleagues, widespread use among workers could have insidious societal ramifications, especially for productivity.

“If several of your competitors in the workplace are using Adderall, and if you feel as if your competition is getting an advantage—that they’re staying up three extra hours working, or billing more hours, or developing more ad campaigns, or whatever it may be—you might feel compelled to take the drug, too, even if you’d prefer not to,” Schwarz says. “These are serious drugs with great addictive possibilities. You start to play with fire.”

The career trajectories of “Generation Adderall” are just beginning. It remains to be seen how many millennials will find themselves struggling with stimulant addictions enabled by doctors as teenagers, and how many will continue the Adderall habits they started in college for the rest of their working lives.

Raphael, for one, can’t predict what his relationship with Adderall will look like in the future—but as his job isn’t getting easier, he’s not planning to quit again anytime soon: “We might end up being one the smartest, saddest, loneliest groups of people ever.”

In our fast-paced world where there never seems to be enough hours in the day, it seems that almost everyone is looking for ways to develop focus or get ahead. Some people, whether they have been diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) or not, have turned to prescription medications to help them gain a competitive edge. Drugs like Ritalin, Concerta, Vyvanse, and Adderall are being used more and more by both children and adults and the abuse rates continue to rise.

For those with severe forms of ADHD, prescription drugs can be a lifesaver and allow them to regain the focus and concentration they lacked while not on medication. However, the illegal abuse of prescription stimulants is skyrocketing and it is something that our society as a whole needs to address.

Have you considered taking Adderall to treat your ADHD or just to gain more focus and concentration in your everyday work or personal life? If so, you should first be aware of the following facts:

You Must Speak with Your Doctor to Get a Prescription for Adderall in SF

Adderall and similar drugs are not over-the-counter. They are Schedule II drugs that have a high potential for abuse and can only be taken when prescribed by a doctor.

Adderall is generally only prescribed in San Francisco to those who have ADHD and those who do not have the disorder may have an altered reaction to the drug. Your doctor or mental health professional can determine if you have ADHD by checking for symptoms listed in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5). There are 18 total symptoms and adults who display six or more symptoms and children under 16 who display five or more symptoms are generally diagnosed as having the disorder. In some cases, the doctor will prescribe a stimulant such as Adderall to see if it helps the patient manage their symptoms.

San Francisco ADHD Patients Are More Likely to Abuse Adderall

Some people take Adderall and other stimulants because they enjoy the euphoric feeling that comes with using the drug. This feeling is what leads many to abuse and become dependent on the drug. A recent study also found that those who experience these euphoric feelings when taking stimulants are less genetically predisposed to actually having ADHD. Those who use Adderall as a recreational drug are also more predisposed to abuse other drugs such as alcohol, marijuana, and tobacco.

The Use of Adderall in the Adult Population is Increasing

In the year 2007, there were approximately 5.6 million prescriptions issued on a monthly basis to adults aged 20 to 39. In 2012, that number had tripled, approaching the 16 million mark. Adult prescriptions are increasing at a much faster level than those for children. Some believe it is due to the increased awareness that these drugs increase concentration and can even provide cognitive enhancements to users. This is causing adults to turn to the drugs as a way to cope with stress and work demands.

Stimulants Do Not Always Offer Positive Benefits

Adderall and similar stimulants may help children sit still longer and improve their focus if they have ADHD. However, there is no proof that they actually improve their academic performance. In fact, stimulants can actually impair some creative abilities. In addition, stimulant drugs can be extremely addictive due to the rush of neurotransmitters such as dopamine that affect some users, giving them a sense of euphoria that can be easy to become dependent on.

Stimulants can also elevate blood pressure and speed up the heart. This can lead to issues such as constricted blood vessels and can also lead up to a heart attack or stroke. If you drink while taking Adderall, the effects can be even more dangerous. Drinking while taking Adderall increases the risks of heart problems and can cause heart attacks in otherwise healthy individuals.

Adderall can also increase anxiety due to the way it enhances the effects of dopamine. This can cause dry mouth, paranoia, shortness of breath, and nervousness—especially in those who are already prone to worry or anxiety.

Those who take stimulants may also have trouble sleeping. This leads to exhaustion the next day and causes many to take more stimulants to simply stay awake. Tolerance levels also build quickly with stimulants and users must take more and more to achieve the same effects. This makes stimulants very habit-forming and it can be easy to develop a dependence on them that is difficult to break. Read our articel : Understanding Adderall

Advertising for ADHD Drugs is Misleading

The FDA has cited every major ADHD drug—including Adderall, Concerta, Vyvanse, Focalin, and even non-stimulants such as Strattera and Intuniv—for misleading advertising and false claims. Some of the drugs have been cited multiple times. These false advertising campaigns by major pharmaceutical companies may be what has led to the increased use—and abuse—of stimulant drugs in the past fifteen years.

Stimulants Such as Adderall Can Have Frightening Side Effects

Along with increased blood pressure, heart rate, and anxiety, Adderall can also cause mental health issues that are especially troubling in children. The medication guide that accompanies Adderall warns users to notify a healthcare professional if they experience any mental problems including believing things that are not real or seeing or hearing things that do not exist. There is even evidence of stimulants drugs triggering depression in children and causing terrifying hallucinations in teens. Though rare, there have also been reports of stimulant abuse leading to suicide.

Diagnosis of ADHD Continues to Rise

The number of children between the ages of 4 and 17 who have received an ADHD diagnosis has risen over 41 percent in the last ten years. Almost two-thirds of those who have received a diagnosis have been prescribed a stimulant such as Ritalin or Adderall. Boys are twice as likely to receive a diagnoses than girls and are also more likely to be prescribed a stimulant medication. Today, almost 20 percent of high school boys have received an ADHD diagnosis. While some believe this is due to recognition of the condition, others argue that it is due to pharmaceutical advertising and a misunderstanding of the natural temperament of boys of this age.

Many of Those Who Use Adderall Do Not Consider It a Drug

Most people who take Adderall without a prescription do not consider it to be a dangerous drug. Instead, they thought of it as a study tool and considered it safe because it improved their concentration and because they knew that doctors prescribed it to children.

College students are among the most likely to use and abuse stimulants—especially those that are not prescribed to them. According to a recent study, more than 20 percent of Ivy League college students used an unprescribed stimulant at least once while in college to help them study. Estimates of those college students who use illegal stimulants range from 6.9percent to over 35 percent and most of those students who were interviewed did not feel like they were cheating or doing anything illegal. In fact, college students were likely to brag about their usage on social media, especially on apps like Twitter and Snapchat.

Many Doctors Tend to Ignore FDA Warnings About Stimulants

There have been numerous FDA warnings regarding Adderall, Ritalin, and similar stimulants. Though the administration warns that these drugs can be highly addictive and have dangerous side effects, doctors continue to prescribe them. Even a 2004 FDA advisory warning about the possibility of cardiac arrest hasn’t changed the amount of stimulants doctors prescribe. FDA warnings that Adderall, Ritalin, and other prescription stimulants are addictive and can have potentially dangerous side effects also haven’t deterred doctors from prescribing them.

Major League Baseball Players Are Among the Most Frequent Users of ADHD Drugs

Though there is a ban on stimulant use in the Major League Baseball Association, players continue to use performance-enhancing drugs. When the ban was announced, players began requesting therapeutic exemptions so they could continue to take the banned substances. The rates of MLB players who take stimulants is more than double of the normal population. Though some argue that professional athletes are more likely to suffer from ADHD than others, many don’t agree and believe that players are only using the stimulants to enhance their playing abilities and gain a competitive edge.

The Cognitive-Enhancing Effects of Stimulants Are Unclear

Though many believe that stimulants will give them an edge in school, sports, or careers, experts caution that the cognitive effects of the drugs have not been widely studied and their effects are still unclear. There have been conflicting reports generated from the studies that have been performed and experts argue that most studies are conducted to find impairment in study subjects, not an improvement. There is also a lack of evidence on the long-term effects of stimulant usage, especially in healthy individuals who do not display signs of ADHD. This should serve as a warning to those use the drugs for recreational use and make them think twice about using stimulants such as Adderall for everyday performance improvement.

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Choosing a Professional to Diagnose and Treat Your ADHD

Search the ADDitude Directory for ADHD Professionals Near You

Perhaps one of your friends was evaluated for adult ADHD recently, or you had an a-ha moment, after taking a look at your desk at the office. You thought back to your childhood and realized that you’ve always been disorganized and impulsive. Or perhaps you brought your child to a professional for an evaluation, and as the doctor ticked off the symptoms, you wanted to say, “Me, too!” So you think you may call a professional to talk with her about it.

Who Can Diagnose ADHD in Adults?

Before you search for someone to help you, keep these facts in mind:

  • A psychologist, a psychiatrist, or a neurologist is best equipped to diagnose ADHD in adults. A master level therapist is recommended only for the initial screening.
  • Only a psychiatrist, neurologist, or family physician can prescribe medication for adults with ADHD.
  • If you need counseling, choose a psychologist or master level therapist. A psychiatrist is a good choice, depending on his or her ability to provide counseling that helps solve problems.
  • Remember that your problems don’t go away once your ADHD is discovered and medically treated. There are usually a number of problems remaining for which counseling is required.

Since adult ADHD is a relatively new specialty, many professionals have not received formal training as part of their schooling. It is up to each professional to keep abreast of ADHD by attending seminars or workshops and by reading professional journals and books in the field. Some professionals are more interested in this area and more experienced than others. Some fail to recognize ADHD as a legitimate condition.

If you were to hire someone to clean your house, watch your kids, or fix your car, it would be reasonable to ask for references, so you could check out the qualifications of the person you’re hiring. When you’re hiring someone to help you with mental health challenges, you should do the same thing.

Many of us are in such awe of doctors that we find it hard to ask questions, especially if we are questioning the doctor’s abilities. Isn’t that rude? Won’t the doctor be offended? It’s your right to know the qualifications of the professional you may be working with, and most doctors realize this. See the sidebar for five questions every adult should ask his or her doctor.

An effective method of finding a doctor familiar with diagnosing and treating adult ADHD is to contact your local organization for adults with ADHD. If you don’t know of a local group, get in touch with the Attention Deficit Disorder Association (ADDA)or Children and Adults with Attention- Deficit/Hyperactivity Disorder (CHADD). Ask about professionals in your area who might be able to help you, or check out ADDitude’s directory to find a support group or psychologist.

Check Up on the Doc: Five Questions

You don’t have to insist on asking the doctor or counselor herself the following questions. Usually the office staff can give you the information you need to make an informed decision. Feel free to print these questions for your personal use.

  1. How many clients with adult ADHD have you treated?
  2. How long have you been working with adults with ADHD?
  3. What is involved in your assessment and treatment process? Written tests/Interviews? Family history? Behavior modification? Medication?
  4. What are the costs involved?
  5. Have you received any special training in the diagnosis or treatment of adult ADHD?

Excerpted from Adult ADD, by MICHELE NOVOTNI, Ph.D.

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Updated on January 22, 2020

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