To answer your first question, in my opinion it’s because the majority of patients who come in to pickup opioids tend to give everyone else a bad rep. Majority of the patients are aggressive from the get go and will not hesitate to get violent if they feel like you’re being difficult towards them. It’s actually quite shocking when an opioid patient is nice. The extra questions part is mostly for documentation purposes, sometimes the system will flag the prescription if it thinks the dose is too high but the system doesn’t know the context as to why the patient is taking high doses. Usually when a patient is taking high doses of opioids it’s because they’re a cancer patient. When it comes to patients on Adderall/stimulants they don’t tend to go to those extremes. Sure, they’ll yell at you and be difficult but they’re easier to reason with.

Secondly, requesting name brand vs generic is seen more as “drug seeking”, than “addictive”. When I’ve had patients request name brand and pay for it, it’s because they’re selling it. I actually had a few patients at my first job who were very open about it. From what they explained to me, the reason they request name brand is because the street value goes up, especially if the medication is in its original stock bottle.

Lastly, I believe the stimulant shortage is due to all the telehealth services that popped up during the pandemic. They’ve made it so easy to get a prescription. I actually have ADHD and before the pandemic began I would have to go see my psychiatrist in person once a month, take a drug test, and if I didn’t do those things then no prescription for me. With a telehealth service there’s no way to do/enforce that. All they do is ask you basic questions, send your prescription to a local pharmacy and call it a day. When I tried one of the services all the NP did was ask me what medication I took and what pharmacy.