Hi All, I've just been prescribed the generic version of Vyvanse and had a bit of sticker shock when I was rung up at my local pharmacy. Even with insurance it was nearly $300 for a months worth pills. I realize this is a problem likely unique to the United States, but I'm wondering how other folks are navigating the costs. While I can afford the medication, the idea of taking on a car sized monthly payment for the pills is really unpalatable. Do folks have any tricks or tips for getting the medication at a lower rate, switching to different medications (i.e. adderall or ritalin), or finding a secondary to cover prescriptions? I've read about Goodrx or SingleCare may be more affordable. Does anyone have experience with those providers?

As a side note, I oversee selection of our company health plan/insurance. While I'd rather not change for the sake of co-workers who have established their primary care physicians with our current offering, I have the ability to change it for 2026. If there folks have providers who cover more of the costs I'm open to hearing it.

Beyond the costs, does anyone have any advice or guidance for things to watch out for as I start taking the medication? Tomorrow is my first day and I'm a combination of excited and anxious.

Thanks!

In three days, I will have 7 years clean from opiates including heroin. I've actually been talking about it quite a bit on Tildes recently due to a lot of mental health threads popping up, but outside of this forum, I don't really think or talk about my previous life very often. For me, putting that life in the rearview and disengaging from the recovery community was the best way to stay clean.

However, around anniversaries, I usually take a bit of time to reflect. I consider where I was, where I am now, how I got there, and how I got here. I think about how different my life is now that I have an amazing career, a house, a wife, and a beautiful infant son.

This anniversary, I've been thinking about the Siren's song, the Faustian bargain, the devil in a dress. In other words, I've been thinking about how enticing false promises can be.

I think back to when I had my hydrocodone prescription for a knee injury right around the time I started partying pretty hard - toward the end of high school and early college. The people I started hanging out with were incredible to me. They were early in their addictions, so they were on top of the world. They had jobs, cars, unlimited drugs, and were surrounded by attractive women. They had zero side effects from their drug use and were living a crazy lifestyle that looked more fun than anything I'd ever imagined. They worked all day to pay the bills and sold small amounts of drugs to fund their own habits - use half, sell half at a party. Easy. This was when I started incorporating hydrocodone into my partying routine. I knew I liked opiates, but I didn't know you could be high all the time with zero consequences. (Spoiler alert, you can't. You all know where this is going).

Soon after, I became the guy I thought I wanted to be. I was the one who was carrying around a pharmacy in my backpack and was able to get my hands on any drug you can think of. I had a hundred friends and a million buddies. I was dating and having sex with women who I felt were "out of my league." I was getting my degree, and I was having a ton of fun pretty much every single day and night. When I look back at photos from this time in my life, I still have a hard time believing it was real. I have stories for days. Insane, amazing, hilarious stories. These were some of the best times of my life in many ways. At the time, I wanted it to last forever and thought maybe it could. This was the Siren's song working its magic. I was trapped by this point.

This lasted longer than you'd think. But eventually, I started experiencing withdrawal when I wasn't high. Then I had to start going on more and more "side quests" to get money for drugs since I could no longer satiate the craving by selling half and keeping half. I noticed that the people I once looked up to weren't doing so hot. A few of them overdosed, a few of them got arrested, and a few packed their bags to get away and get clean. My friends either got into drugs with me or distanced themselves.

Things started getting really dark after college. Now I was getting high alone most of the time and the parties were fewer and farther between. Things got really really dark when I was doing crazy shit like driving from NY to Texas without sleeping and buying black tar heroin. I often found myself in the open-air drug market in my city buying drugs at 4 in the morning from people with guns, found myself stealing pills from loved ones, started selling my belongings, crashed two cars, lost three jobs, etc. You get the picture.

If anyone has ever wondered why addicts go to such great lengths to get high, it's mostly because withdrawal is the most unpleasant thing you could ever imagine. Movies and TV don't even begin to show how unbearable it really is. Imagine a full body flu, kicking, shaking, puking and wishing you were dead. But that's not the worst part. The worst part is that your brain literally can't produce happy chemicals, so you can't feel a sliver of happiness or optimism. You can't even remain logical about the situation. Your brain is telling you that life is meaningless and without joy for now and for always unless you get high. Between that and the physical symptoms (both of which last weeks/months) it's way too easy to use the panic button and take a hit, which instantly makes everything beautiful and wonderful again.

I look at my life now and I cannot believe how fortunate I was/am. I managed to escape that hell with no felonies, no diseases, and few long-term consequences. This good luck allowed me to move on and build a better life with fewer obstacles than most. I feel immense sadness for the many others who weren't so fortunate. I can name 10 people I knew personally from those years that ended up losing their lives to fentanyl. I can name many more who have criminal records that make them hard to employ. I know that, of those of us who got clean, there are at least a handful that will continue to struggle, relapse, and possibly die. It's hard to imagine how something that makes you feel so unbelievably good can leave a pile of bodies in its wake.

I tell this story because I have been thinking about three interesting memories/concepts lately:

1. The Siren's Song - something that seemed pure and beautiful was the worst thing to ever happen to me.

2. The incubation period of addiction - this early phase where you found something you love and you want everyone to experience it. This is when addicts are the most dangerous I think. This is when they hook their friends and loved ones by demonstrating to others that they too can manage this amazing life just fine with no consequences. Like a virus, I was already infected and contagious, but since I wasn't showing symptoms, people didn't know to stay away from me.

3. A conversation I had with my drug counselor when I first got clean. I was beating myself up, telling her I blamed myself because I knew better than to get hooked on drugs. She got very serious and said to me, "Stop. Don't ever say that again. You didn't know. You might have heard, but you didn't know. I've seen hundreds of addicts, and none of you knew what you were getting into. If you had known, you wouldn't have done it. Simple as that."

I don't have any deep insights or points to make - just reflecting and wanted to open the floor for discussion. Have any of you ever had any experiences with a Siren's song?