Threat in Your Medicine Cabinet: The FDA's Gamble on America's Drugs
53 comments
·June 17, 2025idopmstuff
ls612
My mom was a hospital pharmacist when she was still working and was beating the drum on this all my life as far as I can remember. All it accomplished was getting her called racist and xenophobic and losing friends :(
soangry
I'm so angry right now. I did a deep dive into this at one point after being prescribed some generic Vyvanse through Sun via Dillons/Kroger. The pills smell like fish and seem like they didn't work at all. I checked some records from the FDA and Sun wasn't listed. I brought it up to my doctor and they just brushed it off.
I really hope another class action lawsuit is brought against Sun.
timr
The "fishy odor" is a classic hallmark of amine-containing compounds [1], of which Vyvanse has three [2], including a terminal amine, which is so infamous (at least in the di-amine form) for being smelly that they have delightful names like "Cadaverine" [3].
I don't know if the completely purified drug officially has an odor, but usually you get some free amines that come along for the ride. More likely, some got outside of the gelatin capsule during shipping.
[1] https://www.science.org/content/blog-post/amines-and-landsca...
[2] https://en.wikipedia.org/wiki/Lisdexamfetamine#/media/File:L...
VeninVidiaVicii
I had the same exact issues on generic Vyvanse, which also causes me intense palpitations compared to the brand-name, I legit thought I was going to have a heart attack several times a day. So much so, that I quit it altogether—I couldn’t stand the side effects or the constant unavailability of the brand-name.
jnsie
I have nothing but respect for physicians but my experience is that each acts as a more narrow filter than the last and, beyond their direct expertise they have very little expertise in billing, pharmacy or anything outside of their direct domain, nor do they have the bandwidth for it. Add to that the advertising phenomenon of 'ask your doctor about X' and I suspect that anything beyond the immediate care you're receiving has very little chance of receiving thought/cogent answers.
xpe
I respect doctors (and people in general), but I don’t give the medical profession a passing grade. To speak in generalities (there are exceptions), their training is somewhat insane: long hours, sleep deprivation, knowledge cramming, and more. Their daily practice leaves little time or incentive for keeping up with studies. Most were not adequately taught statistics in the first place. To vent a bit more, I don’t think it is unfair to say the system is crap. If we could redesign it from scratch, understanding human nature, how people learn, and the need for ongoing learning, and evidence-based medicine, it would not be this. None of this is meant to assign blame to individuals.
thfuran
>Their daily practice leaves little time or incentive for keeping up with studies.
Their certification requires it, at least to some extent.
derbOac
I have plenty of criticisms for the physicians lobby in the US, but kind of agree this is one area where I'm not sure the problems lie in physicians (outside of some very general sense that they tend to be in key positions of influence in healthcare systems in government and elsewhere).
I do think it's a good example of why pharmacists should maybe have more power in the drug prescription process, and also wonder why insurance companies or pharmacies don't ban drugs from certain places and/or sue them themselves more often.
null
LoganDark
Oh boy. I've had quite the experience with my own ADHD medication (dextroamphetamine in my case, which is essentially the stuff Vyvanse metabolizes into), and when they substituted for a different brand, that brand was completely different and so totally not compatible with this body. So now I have a Brand Medically Necessary because when they tried to switch it on me I went into hypertensive crisis :)
pyuser583
The drug you mentioned had a reputation for these sorts of problems.
leereeves
How did you find out what factory the Vyvanse was made at?
sct202
You can figure out the generic manufacturer by matching the active ingredient with the pill shape, color, and imprints on a pill identification website. Finding the exact factory of that manufacturer is much harder though.
wl
If you're going to a pill identification website to find out the manufacturer of a prescription drug, you're working too hard. The manufacturer printed is on the prescription label.
actionfromafar
Isn't the new direction of capitalism in America Freedom from Regulation?
derbOac
The US is long past the point where we need to stop talking about medical regulation generically. Some regulation and enforcement needs to be increased, and others need to be decreased or eliminated, at least in my opinion.
To me this sort of thing is fraud, and I feel like the FDA needs more resources and oversight to fight it. But with other things I think the FDA needs to back off completely, where it's overstepped its useful mission. I personally would like to see the FDA stop telling people what they can purchase or receive from whom, but spend more time guaranteeing that whatever is on the label is what it says it is and nothing else.
billylb42
How did you arrive at that conclusion? All of the evidence provided in the article is prior to the “freedom of regulation” as you call it.
To me, it’s indicative of a rotting regulatory institution that lost its way. FDA is about safety, not low cost drugs. I don’t know how that mandate became mission critical for them but it happened before the current administration.
cogman10
Almost certainly happened because of Clinton and the FDAMA. It's a law that "cut red tape" IE removed safety protocols and standards.
These agencies are rotting primarily because they've been reworked to be business friendly over the last 40 years
cogman10
Yes. This is a clear example of why that's bad and why these agencies need funding and competent staffing.
throwawaymaths
these agencies had funding and competent staffing. they correctly identified that the factories were producing dangerous products.
kgujdtjof
Manufacturing drugs in India is like manufacturing them in Haiti. Why would anyone think that would be a good idea?
barbazoo
Care to explain?
Arkhadia
[dead]
null
cowpig
I have a pet theory about the medical industry in the USA.
The US is the most pure-capitalist nation on the planet, and medical services are as bad a fit as it gets for a market economy:
* interactions with the market are ideally as few as possible
* there is massive information asymmetry
* people can't "shop around" during medical emergencies
* the externalities are orders of magnitude more potent than the forces directly acting on a transaction
* most importantly, individuals in many cases *literally cannot exit the marketplace* (unless you consider death a viable consumer choice).
That second property creates a market incentive to squeeze every consumer dry. What can they do about it, really?
But it's insanely unethical, and extremely against the common good (externalities abound).
Those forces push the middlemen, the insurance providers, to do horrible shit. And since they are the middlemen with all of the power, and interact with literally every market actor, the culture of pure evil seeps into everything. Clinicians either becomes numb to the fact that insurance companies will literally just not pay things they agreed to pay, or live a life of endless frustration.
This is just "how it is", and so everyone, including regulators, shift their overton window to be able to function in a decrepit, toxic system.
dantheman
The majority of medical care and expenses are not emergency.
fn-mote
The report is horrifying, but in the current US political climate it is very hard to see how a government agency could undergo any positive cultural change.
A quick search finds recent firings [1] and [2]... who would lead a change?
[1]: https://floridianpress.com/2025/06/rep-wasserman-schultz-sla... [2]: https://fortune.com/2025/02/16/trump-cuts-fda-layoffs-food-s...
soangry
The issue I described existed before the administration change.
Neither's parties people wants to be poisoned.
wat10000
I’m pretty sure one party’s people does want to be poisoned, given the consistent advocacy for reduced pollution controls and such.
komali2
> Neither's parties people wants to be poisoned.
Voters for one party keep taking horse medicine and we can't seem to stop them when they experience negative side effects, and we couldn't get them to get vaccines even as their friends and loved ones were dying begging for it at the last minute. There's definitely a party divide here.
derbOac
I share your skepticism about false equivalence in general, but have to admit this particular issue to me gets at the heart of serious problems in US healthcare, and I don't see either party really addressing it. The way in which these problems get ignored by each party, and the rationale for doing so, is very different but so far I see both parties as either turning a blind eye to these problems, or lacking vision.
hnuser123456
On the other hand, my liberal parent gave me stimulants for 8 years that made me anxious when I previously wasn't, and killed my appetite so hard I couldn't take more than 1-2 bites of anything at dinner, and now I'm 32 looking like a 16 year old but with the fatigue of a 64 year old.
Loughla
I have no opinion on ivermectin. I don't think it's a miracle cure, but I also have no idea about the actual research in that space.
But.
My assistant at my last job was all in on it during COVID. It cures everything, according to her. The moment when her cognitive dissonance hit its peak was when she gave her husband ivermectin for a cold, and was absolutely astounded that he ended up in the emergency room with diarrhea and dehydration. She was convinced it was "vaccine injury" and that he did a sneaky and got the COVID shot without her knowing. Spoiler; he did not get vaccinated.
It really was pretty funny at the time, but also sad. She was sort of my bellwether for nuts behaviors. When she started spitting Q-anon talking points, as a middle aged woman completely disconnected from anywhere that should exist, I knew we had problems.
null
Arkhadia
[dead]
aaron695
[dead]
jmyeet
[flagged]
null
dantheman
Medicine is one of the most regulated and least capitalist markets.
null
jmyeet
Capitalism cannot exist without regulation. There is no such thing as a "free market". Capitalism relies upon regulation to enforce the enclosures it builds. Regulations are a direct product to protect profits.
For example, Medicare is prohibited from negotiating prices with drug companies for most medications. A few exceptions were carved out with the IRA passed under Biden. The VA can it pays a lot less. Why is Medicare forbidden from negotiating? Because the pharma industry lobbied for it.
Also, cheaper generics are banned from being imported even though you can buy the exact same thing for a 95%+ discount in Canada.
To see this regulation in action, you can pretty accurately predict what courts and the government will do by simply asking "what do the capital owners want?".
Just this weekend, we had an actual domestic terrorist in Minnesota kill a state lawmaker (and her husband) and attempt to kill at least one other. So far he's been charged with second-degree murder and some federal charges [1].
Now compare this to Luigi, the alleged shooter of UHC CEO Brian Thompson where the AG and US attorney immediately came out calling for the death penalty and laying first-degree murder and terrorism charges on him.
Now maybe the federal or state charges will be upgraded to first-degree but there's none of the same rhetoric about an actual terrorist. Ask yourself why.
[1]: https://www.cbsnews.com/minnesota/news/vance-boelter-fbi-det...
vanillax
"Capitalism cannot exist without regulation. There is no such thing as a "free market". Capitalism relies upon regulation to enforce the enclosures it builds. Regulations are a direct product to protect profits." - Source?
For more on this, I highly recommend Bottle of Lies by Katherine Eban. Fantastically written book that goes deep on this topic and will absolutely horrify you about everything related to the manufacture of generic drugs.