Author: abubakar
Kareem on LeBron Breaking His NBA Scoring Record
Kareem Abdul-Jabbar:
That is the magic of sports. To see something seemingly impossible, reminding us that if one person can do it, then we all somehow share in that achievement. It is what sends children onto playgrounds to duplicate a LeBron layup or a Steph Curry three-pointer. Or Mia Hamm inspiring a whole generation of girls to come off the bleachers and onto the field. Millions of children across the country pushing themselves toward excellence because they saw an athlete do something spectacular and they want to do it too. Or at least try. That same kind of drive is behind many of humankind’s greatest achievements.
And it’s all exceptionally glorious.
Perfectly said.
★
Kareem Abdul-Jabbar:
That is the magic of sports. To see something seemingly impossible, reminding us that if one person can do it, then we all somehow share in that achievement. It is what sends children onto playgrounds to duplicate a LeBron layup or a Steph Curry three-pointer. Or Mia Hamm inspiring a whole generation of girls to come off the bleachers and onto the field. Millions of children across the country pushing themselves toward excellence because they saw an athlete do something spectacular and they want to do it too. Or at least try. That same kind of drive is behind many of humankind’s greatest achievements.
And it’s all exceptionally glorious.
Perfectly said.
Donald Trump Asked Twitter To Take Down This Chrissy Teigen Tweet
The revelation came during a congressional hearing on Twitter’s handling of the Hunter Biden laptop story.
View Entire Post ›
The revelation came during a congressional hearing on Twitter’s handling of the Hunter Biden laptop story.
★ My 2022 Apple Report Card
My remarks on Apple’s year.
This week Jason Snell published his annual Six Colors Apple Report Card for 2022. As I’ve done for a few years now — 2021, 2020, 2019, 2018 — I’m publishing my full remarks and grades here. On Snell’s report card, voters give per-category scores ranging from 5 to 1; I’ve translated these to letter grades, A to E.
The Mac: A
How would you rate Apple’s performance in the Mac in 2022?
Consider new Mac models, the continued Apple Silicon transition,
new macOS versions, and anything else you deem relevant. 5 is
best, 1 is worst.
MacOS 13 Ventura is a solid upgrade.
The Apple silicon transition continued with another strong year. The MacBook Air is Apple’s most popular and most important Mac, and the M2 models that debuted at WWDC are the best laptops for most people ever made. Thin, light, fast, long-lasting battery life, and they even introduced the midnight colorway — the first truly “dark” laptops from Apple since the black MacBooks sold circa 2006–2008, and before that, the G3 PowerBooks from 2001. Apple silicon is absolutely pantsing its x86 competition, and no one else is making ARM chips for serious PCs.
The Mac Pro was the one Mac that skipped the M1 generation of chips, but while disappointing, that omission was more than made up for by the addition of the Mac Studio — a “small tower for pros” form factor that Mac users have been clamoring for ever since the discontinuation of the G4 Cube.
Apple also finally (no sarcasm intended) introduced the reasonably-priced standalone 5K Studio Display. The built-in webcam is meh at best, but the display itself is wonderful, including the $300 option for “nano-texture” anti-glare/anti-reflective glass. This is my ideal display.
There’s an ongoing clamor for an Apple Silicon version of the 27-inch iMac (or iMac Pro even), but I think that desire is misguided. It is much better to get a Studio Display — which should be a great display for years and years — and a Mac Mini or Mac Studio to connect to it. You’ll be able to replace the Mac Mini or Studio once, twice, maybe even three times before the Studio Display needs to be replaced. The 24-inch iMac is no more “all-in-one” than a Mac Mini connected to a Studio Display — the iMac has an external power brick that’s about the size of an Apple TV. Sure, that power brick is smaller than a Mac Mini, but it’s still a box you need to connect. I think it’s more likely that Apple will stop selling any iMacs at all than add a larger model.
The iPhone: A
How would you rate Apple’s performance on the iPhone in 2022?
Consider the new iPhone models, iOS updates, and anything else you
deem relevant. 5 is best, 1 is worst.
Not a groundbreaking year for iPhone, but it’s neither possible nor desirable to break new ground every year. iOS is 15 years old and it’s appropriate for Apple to treat it as a mature platform, because that’s what it is. iOS 16 is a solid upgrade, with much of Apple’s efforts seemingly directed at polish and reliability. Both technically and conceptually, iOS has a solid foundation.
It’s a shame that the Mini form factor was dropped from the iPhone 14 lineup. But big-ass phones are more popular than elegant small ones, so the addition of the iPhone 14 Plus — Apple’s first non-Pro 6.7-inch iPhone — is a net win. My biggest gripe about the iPhone 14 Pro models remains their use of polished stainless steel for the sides. It feels slippery at times, and steel is so much heavier than aluminum (or, cough, titanium). I bought a 14 Pro because of the camera system and other Pro-exclusive features, but I’d prefer those features in an iPhone that feels like and weighs as little as the non-pro iPhone 14.
The Dynamic Island is a wonderfully inventive design: useful, attractive, fun.
The iPad: B
I’d have scored this lower if not for the solid improvements to the consumer-level iPad hardware in 2022. It’s great that the 10th-gen no-adjective iPad starts at just $450 and brings that model into the modern “all-screen/no home-button” design era. I hope Apple eventually moves the non-pro models from Touch ID on their side buttons to Face ID, but that’s a reasonable tradeoff today for lower prices.
I generally don’t complain about mere “speed bump” hardware updates, but the iPad Pro models are unchanged, industrial-design-wise, since 2018. That’s a long time. I can’t help but believe that if not for COVID and two years of work-from-home and severe travel restrictions between the U.S. and China, that we’d have seen a design refresh for the iPads Pro in 2022. It feels like just another sign that among Apple’s three personal computing platforms — Mac, iPhone, and iPad — iPad comes last in terms of attention. Those are my personal priorities, too, so I don’t fault them. But I’m not here to grade Apple on a curve. That said, though — those 2018 designs are excellent. My daily driver iPad remains a 2018 11-inch iPad Pro.
Stage Manager was a major new feature for both MacOS and iPadOS this year, but I can’t help but think it was more important for the iPad. On the Mac, Stage Manager is an alternative new way to manage windows and multiple apps. On the iPad, it feels more like an attempt to enable a level of multi-app productivity that heretofore wasn’t possible. For me, at least, it isn’t appealing and feels half-baked conceptually. The iPad experience offered much more clarity — which I found satisfying, if at times frustrating — in the early 2010s, when it was just a big iPhone. Conceptually I find advanced usage of iPadOS to be muddled. I suppose it’s actually untrue but I’ll be damned if it doesn’t feel like I’m more productive on my small-screen iPhone than I am on my large-screen iPad. It’s the damnedest thing.
Apple Watch: A
Apple Watch Ultra is a splendid new interpretation of what an Apple Watch can be. It’s obviously more rugged, but the larger screen and significantly longer battery life offer serious advantages even for the un-athletic and unadventurous. Titanium is an excellent material, more durable than aluminum and far lighter than steel. (Would be cool if, next year, they offer it in a dark-tinted titanium too.)
Software-wise, WatchOS has seemingly achieved platform maturity. Apple knows what WatchOS is for, users agree, and they continue to polish and improve it.
Wearables: A
I loved my first-gen AirPods Pro and didn’t think I’d see a need to replace them with the new second-gen model, but holy hell are both the noise cancellation and transparency modes improved. Making the case Find My compatible is a nice addition too. When they were announced in September, I wrote, “The new AirPods Pro are the best single expression of Apple as a company today. Not the most important product, not the most complicated, not the most essential. But the one that exemplifies everything Apple is trying to do. They are simple, they are useful, and they offer features that most people use and want.” Having owned and used them daily for months now, I stand by that.
Apple TV (hardware/OS): B
The best new feature of the new Apple TV hardware is the price. It’s finally in the range where I felt it should have been for years. No, it’s nowhere near as cheap as the HDMI sticks or cheap boxes from competitors, but the real competition for Apple TV is the built-in “smart” software on modern TVs. The current pricing of Apple TV hardware is commensurate with its value.
Apple doesn’t get enough credit for making advanced features like Dolby Vision and Atmos audio “just work”. I can imagine numerous ways that the tvOS interface can be improved, but it’s by far the best such interface I’ve seen. I use it nightly and don’t know what I’d do without it.
Services: B
How would you rate Apple’s performance in services in 2022?
Consider Apple TV+, Apple News+, Apple Fitness+, Apple Music,
iCloud, Apple Card, Apple Pay, AppleCare, and anything else you
deem appropriate. 5 is best, 1 is worst.
At this point, I find “Services” to be overly broad as a single category for Apple. It’s almost like if there were just one category for “Hardware”. 2022 was a mixed bag. I’ve been a fan of TV+ original content from its inception and it continues to get better. “Severance” was my favorite season of a TV series since “Mad Men” ended in 2015. Apple Music has a great catalog but a lousy confusing software interface — quite possibly Apple’s worst app. iCloud is underrated — many people internalized the “Apple is bad at services and syncing” narrative from a decade ago and don’t realize how good the company has gotten at it. iCloud is secure, fast, and reliable today. iCloud backup for iPhones and iPads is a remarkably good and essential service — not just for disaster recovery, but also for seamless migrations from old to new devices.
It’s starting to feel downright miserly, though, that Apple is still offering only a mere 5 GB of storage at the free tier, and have left the paid-tier storage allotments unchanged since like forever.
HomeKit/Home: C
Progress continues, clearly. Anecdotally, the HomeKit stuff in my house seemingly works more reliably than ever. It’s great that Apple contributed HomeKit to serve as the foundation for the open Matter standard, and that Matter devices are now starting to come to market. But big picture, this whole thing still feels like it’s always poised to get good “next year”. 2022 wasn’t that year.
Hardware Reliability: A
Anecdotally, no hardware problems for me last year other than my old, much, much-used and still-used 2014 MacBook Pro suffering a swollen battery. A much-used 8-year-old device finally suffering a problem is a sign of how good Apple’s hardware reliability is.
Software Quality: B
How would you rate the overall quality of Apple’s software,
including operating systems, bundled apps, and sold apps, in 2022?
Consider anything you deem appropriate. 5 is best, 1 is worst.
I gave this one a 2 last year, on the grounds of questionable design. I get the impression this category is meant more as a gauge of bugginess, reliability, and performance. I still have the same concerns about the direction of Apple’s software design that I did last year, especially on the Mac. But I think their software reliability has been excellent. Consider the numerous features under the Continuity umbrella. Features like copying something on your iPhone and being able to just paste it on your Mac, and vice-versa. Or starting a new message in Mail on your iPhone and using Handoff to finish writing it on your Mac. Those features have been around for years, but it seems to me they work more reliably than ever. I appreciate that. So, fine here’s a 4 this year.
Developer Relations: C
Repeating myself from last year: Resentment over App Store policies continues to build. Frustrations with the App Store review process seem unimproved. Apple’s goal should be for developer relations to be so good that developers want to create software exclusively for Apple’s platforms. The opposite is happening.
Social and Societal Impact: A
Again I’ll repeat myself from last year, while upping my grade from 4 to 5:
I believe that climate/carbon is the societal area where a company like Apple can and should make the most difference, and I’m hard-pressed to think how they could be doing more than they are, practically.
We’re living in sensitive times on other social issues, and Apple seems to be managing that very astutely and honestly.
The forgotten victims of the Adderall shortage
Dion Lee/Vox
People with narcolepsy need stimulants, too. But many pharmacy shelves are empty. Nicole can’t do her job without her medication. The resident physician in Wisconsin, who is in her early 30s, takes the generic version of a stimulant called Concerta to treat her narcolepsy as well as her attention deficit and hyperactivity disorder (ADHD). Untreated, her ADHD makes it difficult to keep focus and do routine tasks, and the narcolepsy makes it impossible to stay awake.
“If I sit down for any length of time, like to read a book or emails, I’ll pretty much fall asleep within five minutes or so,” Nicole said. “Around noon, I get this heaviness, that feeling like you are absolutely going to fall asleep no matter what you do.”
But starting last fall, it became progressively harder for Nicole to get her medication. At first, her regular pharmacy needed a few extra days to get it in stock. By January, none of the nearby pharmacies in her insurance’s network had it. She had to wait two weeks for her insurance to agree to cover the more expensive brand-name version of the drug at an out-of-network pharmacy, which was the only place and the only version of the drug she could find. She had to go without her medication for most of that time.
Without it, Nicole can’t drive or do certain parts of her job. She was doing a research rotation last time she ran out of her meds, so she was able to keep working. But she has a surgery rotation coming up, and she has no idea if she’ll have her meds by the time it does.
“I can’t operate without medication. It’s not safe,” Nicole said. “I can’t be a functioning doctor.”
Many people like Nicole who rely on prescription stimulants are finding the pharmacy cupboards bare. Adderall, which uses amphetamine salts as its active ingredient, is the most well-known of these drugs, and ADHD is the most well-known condition they treat. But methylphenidate-based stimulants like Concerta and Ritalin are also increasingly hard to find. And they don’t just treat people with ADHD, though the effect of the shortages of them has gotten nearly all of the attention from media, lawmakers, and drug monitoring agencies.
People who have narcolepsy need these drugs, too. They’ve largely been invisible because there are so few of them. Recode spoke to several, nearly all of whom wished to remain anonymous or not use their full name because they didn’t want an often stigmatized medical condition to become public.
“Narcolepsy can be incredibly debilitating if left untreated,” Keith Harper, board president of the Narcolepsy Network, a patient support organization, said.
The major cause of the problem appears to be remote-only telehealth companies, which were the beneficiary of a pandemic-era rule change that allowed providers to prescribe controlled substances like stimulants without ever seeing their patients in person. These services advertised aggressively on social media platforms like TikTok, promoting their ease of access to diagnoses of — and drugs to treat — ADHD. Some have been accused of overprescribing drugs through rapid and possibly inaccurate diagnoses, which led to a spike in demand for prescription stimulants that rigid regulatory restrictions made it impossible to meet. Once Adderall went into a shortage, patients had to look for alternatives, including Concerta and Ritalin.
Now those drugs, too, are in short supply. That means many people with narcolepsy can’t get access to the medications they need. Some say it’s ruining their lives.
The telehealth boom was an ADHD boom, too
Narcolepsy is a rare neurological sleep disorder. The cause is unknown, although research has linked it to low levels of hypocretin, a chemical in the brain that controls wakefulness and REM sleep. It has several symptoms, but the best known is excessive daytime sleepiness, which can cause a sudden onset of sleep. There is no cure, but prescription stimulants are one way to treat narcolepsy as well as a similar disorder called idiopathic hypersomnia. For many people who otherwise can’t stay awake, these medications are life-changing.
While an estimated 200,000 people in the United States have narcolepsy, millions of people have ADHD, which is believed to affect about 10 percent of children and 4 percent of adults. ADHD can be treated with the same stimulants, though the effects are different. Prescription stimulants also have a high potential for abuse and addiction, so they’re regulated by the Drug Enforcement Administration as controlled substances. This classification means their production and distribution are tightly managed — everyone from the manufacturers to the patients are subject to various restrictions — and only a certain number of them can be made every year.
JB Reed/Bloomberg via Getty Images
The FDA declared a shortage of Adderall last October.
This can cause shortages even in normal times, and the pandemic was not a normal time. Telehealth boomed, and telehealth apps took advantage of the suspension of a rule that patients had to be seen in-person to prescribe controlled substances. A social media-fueled increase in awareness of ADHD and its symptoms caused some people to realize that they had the condition. Working from home brought new distractions that made it too difficult for people with untreated ADHD to function, so they sought out help. Some telehealth apps promised to provide it the next or even the same day.
Accordingly, the health information technology company IQVIA reported that prescriptions for Adderall and its generic versions increased from 35.5 million in 2019 to 41.2 million in 2021. Healthcare analytics firm Trilliant Health found that prescriptions for Adderall increased by nearly 25 percent between the beginning of 2020 and 2021 for the 22 to 44 age group, a rise it attributed to the growth of digital health platforms. Neither IQVIA nor Trilliant had data for methylphenidates available.
Some ADHD patients have credited the telehealth apps for providing treatment that was far more accessible than what they were limited to before, when they had to wait months and might spend hundreds of dollars to see a provider in person. But there have also been allegations that the apps’ providers were being pushed to prescribe potentially dangerous medications to patients for a disorder they may not even have. Some apps are reportedly being investigated by the federal government, as is at least one pharmacy that filled telehealth prescriptions. All have denied any wrongdoing.
Drug availability is not accessibility
Last October, the FDA declared that Adderall was in shortage. Teva, one of the largest manufacturers of both the brand and generic versions of Adderall, blamed labor and manufacturing issues along with increased demand for its shortage, which it says will last until at least March. Several other Adderall manufacturers said they were also experiencing issues, blaming it on a shortage of the active ingredient, supply constraints, and demand increase. Teva’s reason was simply “other.”
But the FDA does not consider methylphenidate to be in a shortage, and told Recode that it was “not aware of any nationwide availability concerns,” although there were perhaps some “temporary, localized supply issues.” But the American Society of Health-System Pharmacists (ASHP), which also tracks drug shortages, does consider certain methylphenidate drugs to be in shortage.
“Our definition of a shortage is definitely more patient-focused, and the FDA’s is definitely more overall market,” said Erin Fox, who leads the University of Utah’s Drug Information Service, which provides content for the ASHP’s drug shortage center. “They’re probably just looking at the overall numbers and not thinking about the access issues and logistics that patients have to go through to actually get the product.”
Notably, the ASHP listed Adderall as being in shortage months before the FDA did. It’s possible that the FDA will follow the ASHP on methylphenidate, too. And the methylphenidate shortage appears to have started months after Adderall’s did, possibly or partially in response to it. Some providers and patients have said that when Adderall ran out, they switched to other stimulants, creating an unexpected increase in demand.
There’s also a shortage of information about methylphenidate supply from major pharmacies and drug manufacturers. Rite Aid said that it is “aware of the nationwide shortage of these medications,” while Walgreens admitted that it has “seen some intermittent supply issues with the generic form of [Concerta].” CVS did not respond to request for comment. Recode also reached out to multiple methylphenidate manufacturers that the ASHP said were having trouble manufacturing enough of the drug to meet demand, including Amneal, Camber, Lannett, Sun, Teva, and XL Care, with questions about availability. None responded.
Mario Tama/Getty Images
Rite Aid says it is “aware of the nationwide shortage of these medications.”
Even if the drugs are technically available as far as the FDA is concerned, they may not be accessible. The active ingredient might be the same, but that doesn’t mean all methylphenidate drugs are created equal. Some people find certain generic versions of Concerta to be less effective than others, but those generic versions may be all they can now find. Some pharmacies have even started restricting their limited supply of stimulants to their existing customers, making them unavailable to anyone new whose regular pharmacy ran out. Or, as Nicole found, a version of the drug that their insurance doesn’t cover may be all that’s available, or it may be in a pharmacy that’s out of network, making the only source of the drug prohibitively expensive.
Meagan Turner, a 30-year-old psychotherapist in Atlanta who has narcolepsy, ended up calling around to several pharmacies to fill her Adderall prescription recently, only finding it at a small independent shop that her insurance didn’t accept. She spent about $300 out of pocket and hopes the shortage is over by the next time she needs a refill.
“Considering that even some days I can take Adderall and still need a nap, not having Adderall leaves me falling asleep left and right, or just being wildly not-present since all my energy is focused on keeping my eyes open,” Turner said.
Making or taking a controlled substance means everything is harder
The United States is subject to drug shortages even when there isn’t a pandemic wreaking havoc on supply chains. It isn’t helping matters that many health insurance plans refuse to cover certain pharmacies or drugs. But with controlled substances, the problem becomes even more difficult to solve as manufacturers can’t just make more drugs in response to more demand.
The DEA sets a quota for the maximum amounts of controlled substances that can be made in a year. There are also rules and restrictions on their manufacture and distribution. That quota can be changed, but the DEA refused to do so for 2023, despite acknowledging reports of shortages in methylphenidate drugs and the FDA-declared shortage of amphetamine salts.
“We are aware that the pharmaceutical industry is claiming that there is a quota shortage for the active ingredients in ADHD drugs,” the agency told Recode. “Based on DEA’s information — which is provided by ADHD drug manufacturers — this is not true.”
“DEA is committed to ensuring that all Americans can readily access needed medications,” it added.
The controlled substance rules make filling prescriptions more difficult for patients, too. These drugs are subject to federal laws, state laws, and even pharmacy-specific policies. Patients have to get a new prescription from their provider every time (no refills). They also run the real risk of getting flagged as a drug seeker. Healthcare providers run the risk of getting in trouble if they send too many prescriptions out for the same person.
On top of all that, controlled substance laws don’t allow patients to fill their prescriptions until a few days before their current one runs out, giving them a tight deadline to find an alternative source if their pharmacy is out of stock. For people with narcolepsy, once they run out of their medication, the process of getting more becomes infinitely more difficult. Not only are they then suffering from the symptoms of unmedicated narcolepsy, but they may also feel even worse due to the rebound effect of suddenly going off of their drugs.
“They literally expect someone whose body doesn’t know when it is day or night to have their shit together enough to make sure that during a two-day window they can spend hours driving all around the city to multiple pharmacies, stand in line, and find their medication?” said Lynne, a 30-year-old marketing freelancer in Florida who has narcolepsy.
Lynne has traveled as many as 300 miles to find a pharmacy with her stimulants, although it only had half of the amount she needed. She’s currently splitting the few pills she has left in half and quarters while she looks for another pharmacy that has them in stock.
“I’m barely getting by,” she said. “To me, these meds are my life.”
We know the shortage will end, but we don’t know when
It’s possible the stimulant shortage will get worse and last for months. Meanwhile, many manufacturers are unable to say when they’ll be able to supply more of these drugs, and government agencies seem to be doing little to help. One thing that may have an impact is when President Biden lifts the pandemic public emergency in May, as the suspension of the in-person visit rule may go with it. But some medical professionals and organizations are advocating for the Biden administration to revise that rule, and Done, one of the major ADHD telehealth apps, is paying lobbyists to push to end the in-person requirement.
Several telehealth apps have already stopped prescribing stimulants or shut down entirely when the scrutiny of their practices began last spring. If the DEA is cracking down on certain services for overprescribing, that may have a chilling effect on the ones that remain, including Done. But patients can always take their telehealth app-provided diagnoses to another provider and try to get prescriptions through them.
Tom Williams/CQ-Roll Call, Inc via Getty Images
Rep. Abigail Spanberger recently wrote to the FDA and the DEA expressing her concerns over the Adderall shortage.
At least one lawmaker is paying attention. Rep. Abigail Spanberger (D-VA) wrote to the FDA and the DEA regarding the Adderall shortage last December, demanding that the two agencies work together to fix the shortage and ensure that people with ADHD can get their Adderall again. (The letter doesn’t mention other stimulant shortages or people with narcolepsy.)
For people who take Concerta, however, there is a new hurdle. The authorized generic version of it was discontinued in January, which may cause another sudden spike in demand for alternatives when their manufacturers are already struggling.
Brian, a former nurse in his 50s who lives in San Diego, has severe narcolepsy and says he’s basically housebound without Concerta, which he takes the authorized generic version of. Even showering is risky without that medication, he says. Two weeks ago, his usual pharmacy finally ran out. The only place he could find more was a pharmacy in Palm Springs.
To be able to make the two-hour drive, Brian took his last pill, knowing that if the pharmacy was out when he got there, he wouldn’t be able to get back. He says he spent at least $250 between gas, food, and an Airbnb to spend the night because he couldn’t drive there and back on the same day. But he got his medication — for this month, anyway.
In a few weeks, he’ll have to do it all over again. But this time the authorized generic will have been discontinued. He has no idea what he’ll do then.
“It’s a nightmare,” he said. “It’s a nightmare disease.”
Clarification, February 10, 1:35 pm ET: A name has been changed in this story to further protect a source’s identity.
Dion Lee/Vox
People with narcolepsy need stimulants, too. But many pharmacy shelves are empty.
Nicole can’t do her job without her medication. The resident physician in Wisconsin, who is in her early 30s, takes the generic version of a stimulant called Concerta to treat her narcolepsy as well as her attention deficit and hyperactivity disorder (ADHD). Untreated, her ADHD makes it difficult to keep focus and do routine tasks, and the narcolepsy makes it impossible to stay awake.
“If I sit down for any length of time, like to read a book or emails, I’ll pretty much fall asleep within five minutes or so,” Nicole said. “Around noon, I get this heaviness, that feeling like you are absolutely going to fall asleep no matter what you do.”
But starting last fall, it became progressively harder for Nicole to get her medication. At first, her regular pharmacy needed a few extra days to get it in stock. By January, none of the nearby pharmacies in her insurance’s network had it. She had to wait two weeks for her insurance to agree to cover the more expensive brand-name version of the drug at an out-of-network pharmacy, which was the only place and the only version of the drug she could find. She had to go without her medication for most of that time.
Without it, Nicole can’t drive or do certain parts of her job. She was doing a research rotation last time she ran out of her meds, so she was able to keep working. But she has a surgery rotation coming up, and she has no idea if she’ll have her meds by the time it does.
“I can’t operate without medication. It’s not safe,” Nicole said. “I can’t be a functioning doctor.”
Many people like Nicole who rely on prescription stimulants are finding the pharmacy cupboards bare. Adderall, which uses amphetamine salts as its active ingredient, is the most well-known of these drugs, and ADHD is the most well-known condition they treat. But methylphenidate-based stimulants like Concerta and Ritalin are also increasingly hard to find. And they don’t just treat people with ADHD, though the effect of the shortages of them has gotten nearly all of the attention from media, lawmakers, and drug monitoring agencies.
People who have narcolepsy need these drugs, too. They’ve largely been invisible because there are so few of them. Recode spoke to several, nearly all of whom wished to remain anonymous or not use their full name because they didn’t want an often stigmatized medical condition to become public.
“Narcolepsy can be incredibly debilitating if left untreated,” Keith Harper, board president of the Narcolepsy Network, a patient support organization, said.
The major cause of the problem appears to be remote-only telehealth companies, which were the beneficiary of a pandemic-era rule change that allowed providers to prescribe controlled substances like stimulants without ever seeing their patients in person. These services advertised aggressively on social media platforms like TikTok, promoting their ease of access to diagnoses of — and drugs to treat — ADHD. Some have been accused of overprescribing drugs through rapid and possibly inaccurate diagnoses, which led to a spike in demand for prescription stimulants that rigid regulatory restrictions made it impossible to meet. Once Adderall went into a shortage, patients had to look for alternatives, including Concerta and Ritalin.
Now those drugs, too, are in short supply. That means many people with narcolepsy can’t get access to the medications they need. Some say it’s ruining their lives.
The telehealth boom was an ADHD boom, too
Narcolepsy is a rare neurological sleep disorder. The cause is unknown, although research has linked it to low levels of hypocretin, a chemical in the brain that controls wakefulness and REM sleep. It has several symptoms, but the best known is excessive daytime sleepiness, which can cause a sudden onset of sleep. There is no cure, but prescription stimulants are one way to treat narcolepsy as well as a similar disorder called idiopathic hypersomnia. For many people who otherwise can’t stay awake, these medications are life-changing.
While an estimated 200,000 people in the United States have narcolepsy, millions of people have ADHD, which is believed to affect about 10 percent of children and 4 percent of adults. ADHD can be treated with the same stimulants, though the effects are different. Prescription stimulants also have a high potential for abuse and addiction, so they’re regulated by the Drug Enforcement Administration as controlled substances. This classification means their production and distribution are tightly managed — everyone from the manufacturers to the patients are subject to various restrictions — and only a certain number of them can be made every year.
JB Reed/Bloomberg via Getty Images
The FDA declared a shortage of Adderall last October.
This can cause shortages even in normal times, and the pandemic was not a normal time. Telehealth boomed, and telehealth apps took advantage of the suspension of a rule that patients had to be seen in-person to prescribe controlled substances. A social media-fueled increase in awareness of ADHD and its symptoms caused some people to realize that they had the condition. Working from home brought new distractions that made it too difficult for people with untreated ADHD to function, so they sought out help. Some telehealth apps promised to provide it the next or even the same day.
Accordingly, the health information technology company IQVIA reported that prescriptions for Adderall and its generic versions increased from 35.5 million in 2019 to 41.2 million in 2021. Healthcare analytics firm Trilliant Health found that prescriptions for Adderall increased by nearly 25 percent between the beginning of 2020 and 2021 for the 22 to 44 age group, a rise it attributed to the growth of digital health platforms. Neither IQVIA nor Trilliant had data for methylphenidates available.
Some ADHD patients have credited the telehealth apps for providing treatment that was far more accessible than what they were limited to before, when they had to wait months and might spend hundreds of dollars to see a provider in person. But there have also been allegations that the apps’ providers were being pushed to prescribe potentially dangerous medications to patients for a disorder they may not even have. Some apps are reportedly being investigated by the federal government, as is at least one pharmacy that filled telehealth prescriptions. All have denied any wrongdoing.
Drug availability is not accessibility
Last October, the FDA declared that Adderall was in shortage. Teva, one of the largest manufacturers of both the brand and generic versions of Adderall, blamed labor and manufacturing issues along with increased demand for its shortage, which it says will last until at least March. Several other Adderall manufacturers said they were also experiencing issues, blaming it on a shortage of the active ingredient, supply constraints, and demand increase. Teva’s reason was simply “other.”
But the FDA does not consider methylphenidate to be in a shortage, and told Recode that it was “not aware of any nationwide availability concerns,” although there were perhaps some “temporary, localized supply issues.” But the American Society of Health-System Pharmacists (ASHP), which also tracks drug shortages, does consider certain methylphenidate drugs to be in shortage.
“Our definition of a shortage is definitely more patient-focused, and the FDA’s is definitely more overall market,” said Erin Fox, who leads the University of Utah’s Drug Information Service, which provides content for the ASHP’s drug shortage center. “They’re probably just looking at the overall numbers and not thinking about the access issues and logistics that patients have to go through to actually get the product.”
Notably, the ASHP listed Adderall as being in shortage months before the FDA did. It’s possible that the FDA will follow the ASHP on methylphenidate, too. And the methylphenidate shortage appears to have started months after Adderall’s did, possibly or partially in response to it. Some providers and patients have said that when Adderall ran out, they switched to other stimulants, creating an unexpected increase in demand.
There’s also a shortage of information about methylphenidate supply from major pharmacies and drug manufacturers. Rite Aid said that it is “aware of the nationwide shortage of these medications,” while Walgreens admitted that it has “seen some intermittent supply issues with the generic form of [Concerta].” CVS did not respond to request for comment. Recode also reached out to multiple methylphenidate manufacturers that the ASHP said were having trouble manufacturing enough of the drug to meet demand, including Amneal, Camber, Lannett, Sun, Teva, and XL Care, with questions about availability. None responded.
Mario Tama/Getty Images
Rite Aid says it is “aware of the nationwide shortage of these medications.”
Even if the drugs are technically available as far as the FDA is concerned, they may not be accessible. The active ingredient might be the same, but that doesn’t mean all methylphenidate drugs are created equal. Some people find certain generic versions of Concerta to be less effective than others, but those generic versions may be all they can now find. Some pharmacies have even started restricting their limited supply of stimulants to their existing customers, making them unavailable to anyone new whose regular pharmacy ran out. Or, as Nicole found, a version of the drug that their insurance doesn’t cover may be all that’s available, or it may be in a pharmacy that’s out of network, making the only source of the drug prohibitively expensive.
Meagan Turner, a 30-year-old psychotherapist in Atlanta who has narcolepsy, ended up calling around to several pharmacies to fill her Adderall prescription recently, only finding it at a small independent shop that her insurance didn’t accept. She spent about $300 out of pocket and hopes the shortage is over by the next time she needs a refill.
“Considering that even some days I can take Adderall and still need a nap, not having Adderall leaves me falling asleep left and right, or just being wildly not-present since all my energy is focused on keeping my eyes open,” Turner said.
Making or taking a controlled substance means everything is harder
The United States is subject to drug shortages even when there isn’t a pandemic wreaking havoc on supply chains. It isn’t helping matters that many health insurance plans refuse to cover certain pharmacies or drugs. But with controlled substances, the problem becomes even more difficult to solve as manufacturers can’t just make more drugs in response to more demand.
The DEA sets a quota for the maximum amounts of controlled substances that can be made in a year. There are also rules and restrictions on their manufacture and distribution. That quota can be changed, but the DEA refused to do so for 2023, despite acknowledging reports of shortages in methylphenidate drugs and the FDA-declared shortage of amphetamine salts.
“We are aware that the pharmaceutical industry is claiming that there is a quota shortage for the active ingredients in ADHD drugs,” the agency told Recode. “Based on DEA’s information — which is provided by ADHD drug manufacturers — this is not true.”
“DEA is committed to ensuring that all Americans can readily access needed medications,” it added.
The controlled substance rules make filling prescriptions more difficult for patients, too. These drugs are subject to federal laws, state laws, and even pharmacy-specific policies. Patients have to get a new prescription from their provider every time (no refills). They also run the real risk of getting flagged as a drug seeker. Healthcare providers run the risk of getting in trouble if they send too many prescriptions out for the same person.
On top of all that, controlled substance laws don’t allow patients to fill their prescriptions until a few days before their current one runs out, giving them a tight deadline to find an alternative source if their pharmacy is out of stock. For people with narcolepsy, once they run out of their medication, the process of getting more becomes infinitely more difficult. Not only are they then suffering from the symptoms of unmedicated narcolepsy, but they may also feel even worse due to the rebound effect of suddenly going off of their drugs.
“They literally expect someone whose body doesn’t know when it is day or night to have their shit together enough to make sure that during a two-day window they can spend hours driving all around the city to multiple pharmacies, stand in line, and find their medication?” said Lynne, a 30-year-old marketing freelancer in Florida who has narcolepsy.
Lynne has traveled as many as 300 miles to find a pharmacy with her stimulants, although it only had half of the amount she needed. She’s currently splitting the few pills she has left in half and quarters while she looks for another pharmacy that has them in stock.
“I’m barely getting by,” she said. “To me, these meds are my life.”
We know the shortage will end, but we don’t know when
It’s possible the stimulant shortage will get worse and last for months. Meanwhile, many manufacturers are unable to say when they’ll be able to supply more of these drugs, and government agencies seem to be doing little to help. One thing that may have an impact is when President Biden lifts the pandemic public emergency in May, as the suspension of the in-person visit rule may go with it. But some medical professionals and organizations are advocating for the Biden administration to revise that rule, and Done, one of the major ADHD telehealth apps, is paying lobbyists to push to end the in-person requirement.
Several telehealth apps have already stopped prescribing stimulants or shut down entirely when the scrutiny of their practices began last spring. If the DEA is cracking down on certain services for overprescribing, that may have a chilling effect on the ones that remain, including Done. But patients can always take their telehealth app-provided diagnoses to another provider and try to get prescriptions through them.
Tom Williams/CQ-Roll Call, Inc via Getty Images
Rep. Abigail Spanberger recently wrote to the FDA and the DEA expressing her concerns over the Adderall shortage.
At least one lawmaker is paying attention. Rep. Abigail Spanberger (D-VA) wrote to the FDA and the DEA regarding the Adderall shortage last December, demanding that the two agencies work together to fix the shortage and ensure that people with ADHD can get their Adderall again. (The letter doesn’t mention other stimulant shortages or people with narcolepsy.)
For people who take Concerta, however, there is a new hurdle. The authorized generic version of it was discontinued in January, which may cause another sudden spike in demand for alternatives when their manufacturers are already struggling.
Brian, a former nurse in his 50s who lives in San Diego, has severe narcolepsy and says he’s basically housebound without Concerta, which he takes the authorized generic version of. Even showering is risky without that medication, he says. Two weeks ago, his usual pharmacy finally ran out. The only place he could find more was a pharmacy in Palm Springs.
To be able to make the two-hour drive, Brian took his last pill, knowing that if the pharmacy was out when he got there, he wouldn’t be able to get back. He says he spent at least $250 between gas, food, and an Airbnb to spend the night because he couldn’t drive there and back on the same day. But he got his medication — for this month, anyway.
In a few weeks, he’ll have to do it all over again. But this time the authorized generic will have been discontinued. He has no idea what he’ll do then.
“It’s a nightmare,” he said. “It’s a nightmare disease.”
Clarification, February 10, 1:35 pm ET: A name has been changed in this story to further protect a source’s identity.
The case for better-seats-cost-more movie tickets
Magic Mike’s Last Dance. | Claudette Barius/Warner Bros.
AMC’s new plan is … good? Let’s say I want to take myself to see Magic Mike’s Last Dance on Friday at the AMC 34th Street theater in Manhattan. Could happen! And if it does, I have two options: I can buy a regular ticket for $26.88. Or I can pick a seat in the middle of the theater and pay … $1 more.
If this was a Knicks game or a Broadway show, this would be no big deal: Consumers are very familiar with the idea of paying more, or less, for seats based on desirability and demand: Front-row tickets for Taylor Swift cost thousands of dollars; nosebleeds to see Foreigner in Las Vegas are more affordable.
But for the beleaguered movie business, this is a new idea. AMC Theatres, the world’s largest movie theater chain, announced their “Sightline” plan earlier this week: Most tickets sell for the regular price, but a limited number of seats in the center of the theater will cost $1 or $2 more per ticket. It’s debuting the plan this weekend at some of its locations in New York, Chicago, and Kansas City.
It also rubs a lot of people the wrong way. Which is presumably why AMC CEO Adam Aron, whose company announced the program on February 6, took to Twitter two days later to defend it, chalking the move up to “inflationary times.”
(2/3) In inflationary times, costs rise, so prices rise. Under the old system, our only option was to raise prices on all seats. Sightline lets us raise prices only on our most popular seats, but we can also hold the line on Standard seats & actually cut prices on Value seats.— Adam Aron (@CEOAdam) February 8, 2023
Aron also noted that AMC will sell the least-desirable tickets at a discount (more on that in a minute) and — unlike his company’s earlier press release, which presented the move as an inevitable one that would roll out to all of AMC’s theaters by the end of the year — he couched it as a “test” the company would “carefully monitor.”
That’s uncharacteristic defensiveness from a CEO who has spent the last few years operating at Musk-level bluster (for background on Aron and his recent conversion to meme stock ringleader, see this excellent Businessweek profile). And it shows you just how ingrained the idea of one-size-fits-all ticketing is at American movie theaters. As well as the problems inherent with any announced price hike, particularly at a time when Americans have been seeing price hikes on everything from energy to eggs.
So maybe pay-by-seat movie tickets won’t be here to stay, but they probably should be. They make sense, and the theater business has deep, systemic problems — some created by its own missteps and the rest by big changes in the way we consume entertainment. If you still like seeing movies in a room with other people instead of on your couch or on your phone, you’re going to have to roll with some changes.
“They should have done this years ago,” says Wedbush Securities analyst Michael Pachter. “I’m amazed that no one has done it yet.”
Pachter, like Aron, points out that variable pricing exists in just about every other entertainment venue, along with plenty of other transactions that we all intuitively understand: When you’re on an airplane, you’re well aware that the person sitting next to you could have paid much more, or less, depending on when they bought their ticket.
We’re also used to paying different amounts for movies based on the time and place we view them: You can shell out the US average of $11 a ticket for a movie when it comes out, or wait months and pay less to rent it at home. Or wait even longer, and pay nothing (not really nothing, but it will feel that way) when it shows up as part of your Netflix or Disney+ or HBO Max subscription.
The movie business has also periodically floated attempts to do variable pricing based on the kind of movie theaters show. In the late 1990s, then-Universal Studios owner Edgar Bronfman Jr. suggested that movies that cost more to make should have more expensive tickets, and was roundly panned. But AMC played with the idea in 2019 without much fanfare, and got very little grief for it; by the time last year’s The Batman debuted, AMC hiked prices for that movie (as did other exhibitors) and bragged about it; it expects to do the same for other would-be blockbusters.
And as Aron has said, variable pricing can also mean viewers pay less to see a movie, though studios generally won’t allow theaters to lower prices beyond a certain level. Still, in theory, AMC’s new seating plan means I could see Magic Mike at a discount, since AMC is cutting the price of “value tickets” — in this case, the ones in the neck-creaking first row — by $2. But in order to get that discount I’d need to join AMC’s fan club, and there was nothing on the Fandango ticketing app telling me that option existed. So let’s be clear: This is an attempt to generate more money per ticket, not less.
It’s also an attempt to generate more revenue for a deeply troubled business. Even before the pandemic, movie-going had become something people do less and less each year, for a litany of reasons: They don’t like the experience, or the movies they used to watch are streaming instead. Or they’re just happy to scroll TikTok and YouTube.
In 2002, Americans went to the movies an average of 5.2 times per year; by 2019, per the Motion Picture Association, that number had declined to 3.5 times per year. The trend doesn’t seem like it’s going to improve post-pandemic: Last year, when the industry celebrated box office hits like Top Gun: Maverick, the per capita average was still an anemic 1.9, according to estimates from media investor Matthew Ball.
This leads to a vicious cycle: Smaller audiences in theaters have pushed more studios to move more movies to streaming — good luck finding a rom-com in a theater these days — which means audiences get trained not to go to the movies, which pushes more movies to streaming. All of which leads to empty theaters.
That’s why AMC is frequently mentioned as a bankruptcy candidate. And why the owners of Regal, the second-biggest theater chain in the US, filed for bankruptcy last month and will shutter 39 locations. The industry is still trying to figure out novel ideas to get people back into theaters: As analyst Rich Greenfield notes, this month Paramount and theater chains seemed to successfully lure older audiences to see 80 for Brady, a movie about … older people who like Tom Brady … by charging lower prices. But any clear-eyed industry observer will tell you that there are simply too many movie screens and that more of them will go away in the future.
In the meantime, theaters are figuring out how to reduce costs, via smaller staffs and online ticketing, and raise prices in less obvious ways, like pushing more expensive food. (Though that still didn’t save Alamo Drafthouse, a really excellent chain of boutique theaters, from filing Chapter 11 a couple of years ago, either).
Eventually, they’re going to want to raise prices on tickets, one way or another: “They’ve done a great job of jacking up concessions,” says Pachter. “The next thing is to charge us more.”
That’s probably not what you want to hear. But if you still like going to the movies, you’re going to have to get used to it.
Magic Mike’s Last Dance. | Claudette Barius/Warner Bros.
AMC’s new plan is … good?
Let’s say I want to take myself to see Magic Mike’s Last Dance on Friday at the AMC 34th Street theater in Manhattan. Could happen! And if it does, I have two options: I can buy a regular ticket for $26.88. Or I can pick a seat in the middle of the theater and pay … $1 more.
If this was a Knicks game or a Broadway show, this would be no big deal: Consumers are very familiar with the idea of paying more, or less, for seats based on desirability and demand: Front-row tickets for Taylor Swift cost thousands of dollars; nosebleeds to see Foreigner in Las Vegas are more affordable.
But for the beleaguered movie business, this is a new idea. AMC Theatres, the world’s largest movie theater chain, announced their “Sightline” plan earlier this week: Most tickets sell for the regular price, but a limited number of seats in the center of the theater will cost $1 or $2 more per ticket. It’s debuting the plan this weekend at some of its locations in New York, Chicago, and Kansas City.
It also rubs a lot of people the wrong way. Which is presumably why AMC CEO Adam Aron, whose company announced the program on February 6, took to Twitter two days later to defend it, chalking the move up to “inflationary times.”
(2/3) In inflationary times, costs rise, so prices rise. Under the old system, our only option was to raise prices on all seats. Sightline lets us raise prices only on our most popular seats, but we can also hold the line on Standard seats & actually cut prices on Value seats.
— Adam Aron (@CEOAdam) February 8, 2023
Aron also noted that AMC will sell the least-desirable tickets at a discount (more on that in a minute) and — unlike his company’s earlier press release, which presented the move as an inevitable one that would roll out to all of AMC’s theaters by the end of the year — he couched it as a “test” the company would “carefully monitor.”
That’s uncharacteristic defensiveness from a CEO who has spent the last few years operating at Musk-level bluster (for background on Aron and his recent conversion to meme stock ringleader, see this excellent Businessweek profile). And it shows you just how ingrained the idea of one-size-fits-all ticketing is at American movie theaters. As well as the problems inherent with any announced price hike, particularly at a time when Americans have been seeing price hikes on everything from energy to eggs.
So maybe pay-by-seat movie tickets won’t be here to stay, but they probably should be. They make sense, and the theater business has deep, systemic problems — some created by its own missteps and the rest by big changes in the way we consume entertainment. If you still like seeing movies in a room with other people instead of on your couch or on your phone, you’re going to have to roll with some changes.
“They should have done this years ago,” says Wedbush Securities analyst Michael Pachter. “I’m amazed that no one has done it yet.”
Pachter, like Aron, points out that variable pricing exists in just about every other entertainment venue, along with plenty of other transactions that we all intuitively understand: When you’re on an airplane, you’re well aware that the person sitting next to you could have paid much more, or less, depending on when they bought their ticket.
We’re also used to paying different amounts for movies based on the time and place we view them: You can shell out the US average of $11 a ticket for a movie when it comes out, or wait months and pay less to rent it at home. Or wait even longer, and pay nothing (not really nothing, but it will feel that way) when it shows up as part of your Netflix or Disney+ or HBO Max subscription.
The movie business has also periodically floated attempts to do variable pricing based on the kind of movie theaters show. In the late 1990s, then-Universal Studios owner Edgar Bronfman Jr. suggested that movies that cost more to make should have more expensive tickets, and was roundly panned. But AMC played with the idea in 2019 without much fanfare, and got very little grief for it; by the time last year’s The Batman debuted, AMC hiked prices for that movie (as did other exhibitors) and bragged about it; it expects to do the same for other would-be blockbusters.
And as Aron has said, variable pricing can also mean viewers pay less to see a movie, though studios generally won’t allow theaters to lower prices beyond a certain level. Still, in theory, AMC’s new seating plan means I could see Magic Mike at a discount, since AMC is cutting the price of “value tickets” — in this case, the ones in the neck-creaking first row — by $2. But in order to get that discount I’d need to join AMC’s fan club, and there was nothing on the Fandango ticketing app telling me that option existed. So let’s be clear: This is an attempt to generate more money per ticket, not less.
It’s also an attempt to generate more revenue for a deeply troubled business. Even before the pandemic, movie-going had become something people do less and less each year, for a litany of reasons: They don’t like the experience, or the movies they used to watch are streaming instead. Or they’re just happy to scroll TikTok and YouTube.
In 2002, Americans went to the movies an average of 5.2 times per year; by 2019, per the Motion Picture Association, that number had declined to 3.5 times per year. The trend doesn’t seem like it’s going to improve post-pandemic: Last year, when the industry celebrated box office hits like Top Gun: Maverick, the per capita average was still an anemic 1.9, according to estimates from media investor Matthew Ball.
This leads to a vicious cycle: Smaller audiences in theaters have pushed more studios to move more movies to streaming — good luck finding a rom-com in a theater these days — which means audiences get trained not to go to the movies, which pushes more movies to streaming. All of which leads to empty theaters.
That’s why AMC is frequently mentioned as a bankruptcy candidate. And why the owners of Regal, the second-biggest theater chain in the US, filed for bankruptcy last month and will shutter 39 locations. The industry is still trying to figure out novel ideas to get people back into theaters: As analyst Rich Greenfield notes, this month Paramount and theater chains seemed to successfully lure older audiences to see 80 for Brady, a movie about … older people who like Tom Brady … by charging lower prices. But any clear-eyed industry observer will tell you that there are simply too many movie screens and that more of them will go away in the future.
In the meantime, theaters are figuring out how to reduce costs, via smaller staffs and online ticketing, and raise prices in less obvious ways, like pushing more expensive food. (Though that still didn’t save Alamo Drafthouse, a really excellent chain of boutique theaters, from filing Chapter 11 a couple of years ago, either).
Eventually, they’re going to want to raise prices on tickets, one way or another: “They’ve done a great job of jacking up concessions,” says Pachter. “The next thing is to charge us more.”
That’s probably not what you want to hear. But if you still like going to the movies, you’re going to have to get used to it.
Layoffs are making LinkedIn the new hot social network
People are sharing more about being laid off on LinkedIn than before. | Dion Lee/Vox, Getty Images, Shutterstock
Vulnerability is having a moment on the platform as mass layoffs hit the tech industry. When Rob Fishman, a former account executive at a tech startup, was laid off in January, he wasn’t sure how to talk about it.
Even though tens of thousands of tech employees at startups like his — and at major tech companies like Google, Meta, and Microsoft (which owns LinkedIn) — were being laid off, there was still, he said, a stigma attached to talking about it.
But he wanted people to know he was in the market for a new job, so he decided to post on LinkedIn.
Fishman wrote a lighthearted, self-deprecating post listing out everything he did on the day he was let go (For instance, read the email that he was laid off, call his fiancé, wallow in self-pity for a while, drink a large margarita, drink another large margarita, edit his résumé).
The post ended up getting more than 40,000 views, nearly 500 likes, and, most surprisingly, a bunch of offers of support from people he’d never met.
“It was complete and total LinkedIn strangers. Just completely altruistic people. Not hiring managers,” said Fishman, who said he had six job interviews in the two weeks after being laid off — and all of those opportunities came from LinkedIn.
“It was an unwritten assumption before that job-seeking has to be as private as possible”
In the past several months, as changing economic conditions, overhiring, and stock market drops have led to mass layoffs in tech, media, and other industries, vulnerability is having a moment on LinkedIn. It’s true that, early in the pandemic, many people turned to LinkedIn to share stories about how lockdown was negatively impacting their jobs. For the most part, though, the professional social networking site has long had a reputation for being a place where people go to boast about their career accomplishments, posting “hustle porn” and inspirational platitudes. Now, the tone has shifted. People are sharing their personal layoff stories more prominently on LinkedIn, especially if they’re tech workers.
Recode spoke with over half a dozen tech professionals who never regularly used the platform but are suddenly finding it more relevant for their professional and even personal lives. They’re using LinkedIn to announce they’ve been laid off, find out who among their former colleagues was also let go, and connect with industry peers who are sharing job leads. Importantly, they’re applying to jobs directly on the site.
Suddenly, LinkedIn has become a very popular social media platform for tech workers during this economic slump, and that’s reflected in the numbers. Web analytics firm SimilarWeb found that monthly traffic to LinkedIn grew more than 60 percent from January 2020 to January 2023, and from December 2022 to January it went up 17 percent. LinkedIn saw record user engagement last quarter, and a 10 percent increase in revenue year over year. As of early February, 18.6 million people have added an “open to work” green photo frame to their LinkedIn profile photos, up from 6 million in February last year (users first got the option in 2020), according to LinkedIn.
“It was an unwritten assumption before that job-seeking has to be as private as possible,” said Rohan Rajiv, director of product management for careers at LinkedIn, reflecting on the mood at the beginning of the pandemic in 2020 when a wave of Covid-related layoffs hit a number of industries. “I think what has changed is that this has become more the norm now. There is a complete destigmatization.”
“I feel like it’s easier to go and publicly announce that, ‘hey, I was laid off too’”
The recent growth in layoff talk is also part of a seismic shift for a whole generation of tech employees who have only known abundance, perks, and seemingly unlimited growth in their sector. Suddenly, many of them are out of a job and realizing they need to pivot — maybe even away from tech. And for many, LinkedIn is a starting point to make that change.
Why people want to talk about being laid off on LinkedIn
For many tech professionals who once rarely used LinkedIn, the platform has become a helpful place to share about their situation, especially after they’ve been cut off from internal work communication channels like Slack or workplace listservs. They’re also turning to the platform at a time when some industry people who used to build a professional presence on Twitter seem to be using that network less.
Before the current tech slump, if you worked at a Big Tech company or hot startup where job security was high and cash was free-flowing, you probably didn’t feel the need to post regularly on LinkedIn to boost your career. Everything changed after this recent wave of layoffs.
Neha Krishna worked for eight years at Google, hiring graduating PhD students for the company. She said she was always a top performer on her team who felt well-rewarded for her work. She loved working at Google.
“I was absolutely living a dream,” Krishna told Recode.
Then, in late January, she was laid off along with 12,000 of her colleagues — via email. She was quickly cut off from Google’s many internal communication tools, like email groups and meme-sharing sites where she could talk to her coworkers.
Without access to those channels, Krishna didn’t have a good sense of who was let go and which teams were most affected. So she went on LinkedIn, where she saw post after post of former colleagues sharing that they too had been laid off. She was surprised by the breadth of the cuts and the fact that even well-respected company leaders had also lost their jobs.
“It’s comforting to know that you’re not alone, and it has nothing to do with you. It’s more the company,” said Krishna. “When you get into that mentality, I feel like it’s easier to go and publicly announce that, ‘hey, I was laid off too.’”
While other social media platforms like Twitter, Instagram, and TikTok are also popular with tech workers, Krishna and several other industry professionals who recently lost their jobs said that LinkedIn seemed to be the place they could actually network.
Many said that Twitter — which famously leans snarky — didn’t feel supportive or like a place where many people would earnestly help each other find jobs. On TikTok, some tech workers have been posting videos documenting their life before versus after being laid off — but those videos aren’t leading to traditional networking opportunities the way LinkedIn posts often do. Krishna said she uses TikTok and Instagram a lot but sees them more as places for socializing with friends and entertainment rather than seeking professional support.
Now, Krishna regularly posts or comments on other people’s updates on LinkedIn. She hasn’t found a new job yet but, like many others, Krishna said it’s comforting to be on LinkedIn so she can swap notes with peers, get job referrals, and even give advice to other tech workers who have also recently been laid off. She said she was pleasantly surprised that people still working at Google found her on LinkedIn and offered to refer her to other positions.
“I truly believe that human beings naturally want to help others,” said Krishna. “People no longer think, like, ‘oh, you know, I have my job and I should just stay quiet or stay put.’” LinkedIn is a space where people feel it’s socially acceptable — and even encouraged — to lend a hand to former colleagues.
Not everyone wants to be professionally vulnerable on LinkedIn
Even though LinkedIn has become a place where people are more comfortable sharing, there are limits to the vulnerability people show and what kinds of posts are successful. Not every layoff post gets attention, and some lead nowhere. And for some, the pressure to post on LinkedIn can itself become a major source of stress.
After Rob Fishman posted his LinkedIn note about drinking margaritas and wallowing in self-pity after losing a job, he wrote a follow-up post about the upsides of sharing his layoff situation on LinkedIn and encouraged others to do the same. That post went viral, too.
A recently laid-off tech industry peer, software architect Robb Miller, wasn’t having the same experience.
Miller’s posts about being laid off — which were also vulnerable but more straightforward and less humorous — didn’t attract much attention. They hadn’t connected him to any job leads. So he decided to comment on Fishman’s latest post, saying as much.
“I was being a smartass. I was like, ‘Yeah, that’s sweet that you [Fishman] are yelling from an ivory tower, but the rest of us weren’t getting this kind of traction,’” he told Recode.
Ironically, Miller’s comment on Fishman’s viral post ended up catching the attention of LinkedIn strangers who did connect Miller with some job leads — so in a way, it turned into another LinkedIn layoff success story (although Miller ended up accepting a job offer shortly after from a different lead).
But it also shows how successful networking on Linkedin after a layoff isn’t a given. It can depend on the whims of the algorithm and how well your post is primed for engagement, just like many other social media platforms.
Kayla Lazenby started using LinkedIn a lot several years ago when she wanted to transition from being a teacher to working in education technology. She successfully used the platform to find a job at a startup. When she was laid off from that job around Thanksgiving last year, she said her layoff post landed on the LinkedIn feed of an executive at another tech company. Even though she didn’t know that executive, they were impressed by her resumé and ended up hiring her.
Lazenby said it helped that she already had a strong presence on LinkedIn. She was more than just a “casual consumer” but instead an “active user” who shared her story and personality on the site. Her experience shows how, for many, sharing about being laid off on LinkedIn isn’t just about being authentic: There’s a strategy to it.
“None of the people who are doing this are foolish about the fact that they’re doing this on a public forum that will be seen by future employers,” said Emily Rose McRae, a director of research at Gartner who leads the firm’s future of work research center. McRae said she noticed that most laid-off tech employees are careful not to publicly slam their former employer, even though tensions were high around the mass layoffs. “It’s still LinkedIn; it’s still primarily a professional network.”
“The goal is to help people grow, learn, and find their next job”
Gabi Weinberg, who works part time at tech venture firm Atento Capital, said that even though there’s less stigma attached to being open for work than before, he prefers to use LinkedIn in a more private capacity by sending direct messages to companies he’s interested in working with.
Weinberg said that if you’re not working for a big-name company like Google or Facebook, your layoff could be seen as less publicly “marketable.” He also said he personally didn’t feel comfortable sharing as much publicly on the platform as some others.
“It seems more culturally appropriate to share if you were laid off at a big tech company, whereas, if you’re at a mom-and-pop or smaller company, it’s not the same,” he said.
Other people Recode spoke to acknowledged that the feeling of having to post on LinkedIn can be a burden during an already stressful time.
“I think there’s a pressure built around LinkedIn, that you say you’re open to a job and if you’re not scrolling 24/7, you might miss that one post, and you miss an opportunity to apply,” said Lazenby, who said she gave herself a day to be sad and ignore social media after being laid off before she posted about it.
A big question, though, is what happens when people get tired of talking about layoffs and stop offering help — what Gartner’s McRae called “compassion fatigue.” Already, some LinkedIn users Recode talked to complained about the constant stream of sad news about layoffs appearing on their feed all the time. Or what happens when there’s no longer an economic downturn and people find new jobs and have less of an incentive to use LinkedIn?
While LinkedIn is finding more ways to keep people on its site — showing them more news and investing in career influencers — it is still a social network framed squarely around careers.
“Our vision has been for economic opportunity. We’re not here for the extra clicks,” said LinkedIn’s Rajiv. “The easiest mode of expansion would be cat videos, right? That’s not the goal. The goal is to help people grow, learn, and find their next job.”
So far, that goal seems to be working out well for LinkedIn — at least during this period of great economic uncertainty in tech.
People are sharing more about being laid off on LinkedIn than before. | Dion Lee/Vox, Getty Images, Shutterstock
Vulnerability is having a moment on the platform as mass layoffs hit the tech industry.
When Rob Fishman, a former account executive at a tech startup, was laid off in January, he wasn’t sure how to talk about it.
Even though tens of thousands of tech employees at startups like his — and at major tech companies like Google, Meta, and Microsoft (which owns LinkedIn) — were being laid off, there was still, he said, a stigma attached to talking about it.
But he wanted people to know he was in the market for a new job, so he decided to post on LinkedIn.
Fishman wrote a lighthearted, self-deprecating post listing out everything he did on the day he was let go (For instance, read the email that he was laid off, call his fiancé, wallow in self-pity for a while, drink a large margarita, drink another large margarita, edit his résumé).
The post ended up getting more than 40,000 views, nearly 500 likes, and, most surprisingly, a bunch of offers of support from people he’d never met.
“It was complete and total LinkedIn strangers. Just completely altruistic people. Not hiring managers,” said Fishman, who said he had six job interviews in the two weeks after being laid off — and all of those opportunities came from LinkedIn.
In the past several months, as changing economic conditions, overhiring, and stock market drops have led to mass layoffs in tech, media, and other industries, vulnerability is having a moment on LinkedIn. It’s true that, early in the pandemic, many people turned to LinkedIn to share stories about how lockdown was negatively impacting their jobs. For the most part, though, the professional social networking site has long had a reputation for being a place where people go to boast about their career accomplishments, posting “hustle porn” and inspirational platitudes. Now, the tone has shifted. People are sharing their personal layoff stories more prominently on LinkedIn, especially if they’re tech workers.
Recode spoke with over half a dozen tech professionals who never regularly used the platform but are suddenly finding it more relevant for their professional and even personal lives. They’re using LinkedIn to announce they’ve been laid off, find out who among their former colleagues was also let go, and connect with industry peers who are sharing job leads. Importantly, they’re applying to jobs directly on the site.
Suddenly, LinkedIn has become a very popular social media platform for tech workers during this economic slump, and that’s reflected in the numbers. Web analytics firm SimilarWeb found that monthly traffic to LinkedIn grew more than 60 percent from January 2020 to January 2023, and from December 2022 to January it went up 17 percent. LinkedIn saw record user engagement last quarter, and a 10 percent increase in revenue year over year. As of early February, 18.6 million people have added an “open to work” green photo frame to their LinkedIn profile photos, up from 6 million in February last year (users first got the option in 2020), according to LinkedIn.
“It was an unwritten assumption before that job-seeking has to be as private as possible,” said Rohan Rajiv, director of product management for careers at LinkedIn, reflecting on the mood at the beginning of the pandemic in 2020 when a wave of Covid-related layoffs hit a number of industries. “I think what has changed is that this has become more the norm now. There is a complete destigmatization.”
The recent growth in layoff talk is also part of a seismic shift for a whole generation of tech employees who have only known abundance, perks, and seemingly unlimited growth in their sector. Suddenly, many of them are out of a job and realizing they need to pivot — maybe even away from tech. And for many, LinkedIn is a starting point to make that change.
Why people want to talk about being laid off on LinkedIn
For many tech professionals who once rarely used LinkedIn, the platform has become a helpful place to share about their situation, especially after they’ve been cut off from internal work communication channels like Slack or workplace listservs. They’re also turning to the platform at a time when some industry people who used to build a professional presence on Twitter seem to be using that network less.
Before the current tech slump, if you worked at a Big Tech company or hot startup where job security was high and cash was free-flowing, you probably didn’t feel the need to post regularly on LinkedIn to boost your career. Everything changed after this recent wave of layoffs.
Neha Krishna worked for eight years at Google, hiring graduating PhD students for the company. She said she was always a top performer on her team who felt well-rewarded for her work. She loved working at Google.
“I was absolutely living a dream,” Krishna told Recode.
Then, in late January, she was laid off along with 12,000 of her colleagues — via email. She was quickly cut off from Google’s many internal communication tools, like email groups and meme-sharing sites where she could talk to her coworkers.
Without access to those channels, Krishna didn’t have a good sense of who was let go and which teams were most affected. So she went on LinkedIn, where she saw post after post of former colleagues sharing that they too had been laid off. She was surprised by the breadth of the cuts and the fact that even well-respected company leaders had also lost their jobs.
“It’s comforting to know that you’re not alone, and it has nothing to do with you. It’s more the company,” said Krishna. “When you get into that mentality, I feel like it’s easier to go and publicly announce that, ‘hey, I was laid off too.’”
While other social media platforms like Twitter, Instagram, and TikTok are also popular with tech workers, Krishna and several other industry professionals who recently lost their jobs said that LinkedIn seemed to be the place they could actually network.
Many said that Twitter — which famously leans snarky — didn’t feel supportive or like a place where many people would earnestly help each other find jobs. On TikTok, some tech workers have been posting videos documenting their life before versus after being laid off — but those videos aren’t leading to traditional networking opportunities the way LinkedIn posts often do. Krishna said she uses TikTok and Instagram a lot but sees them more as places for socializing with friends and entertainment rather than seeking professional support.
Now, Krishna regularly posts or comments on other people’s updates on LinkedIn. She hasn’t found a new job yet but, like many others, Krishna said it’s comforting to be on LinkedIn so she can swap notes with peers, get job referrals, and even give advice to other tech workers who have also recently been laid off. She said she was pleasantly surprised that people still working at Google found her on LinkedIn and offered to refer her to other positions.
“I truly believe that human beings naturally want to help others,” said Krishna. “People no longer think, like, ‘oh, you know, I have my job and I should just stay quiet or stay put.’” LinkedIn is a space where people feel it’s socially acceptable — and even encouraged — to lend a hand to former colleagues.
Not everyone wants to be professionally vulnerable on LinkedIn
Even though LinkedIn has become a place where people are more comfortable sharing, there are limits to the vulnerability people show and what kinds of posts are successful. Not every layoff post gets attention, and some lead nowhere. And for some, the pressure to post on LinkedIn can itself become a major source of stress.
After Rob Fishman posted his LinkedIn note about drinking margaritas and wallowing in self-pity after losing a job, he wrote a follow-up post about the upsides of sharing his layoff situation on LinkedIn and encouraged others to do the same. That post went viral, too.
A recently laid-off tech industry peer, software architect Robb Miller, wasn’t having the same experience.
Miller’s posts about being laid off — which were also vulnerable but more straightforward and less humorous — didn’t attract much attention. They hadn’t connected him to any job leads. So he decided to comment on Fishman’s latest post, saying as much.
“I was being a smartass. I was like, ‘Yeah, that’s sweet that you [Fishman] are yelling from an ivory tower, but the rest of us weren’t getting this kind of traction,’” he told Recode.
Ironically, Miller’s comment on Fishman’s viral post ended up catching the attention of LinkedIn strangers who did connect Miller with some job leads — so in a way, it turned into another LinkedIn layoff success story (although Miller ended up accepting a job offer shortly after from a different lead).
But it also shows how successful networking on Linkedin after a layoff isn’t a given. It can depend on the whims of the algorithm and how well your post is primed for engagement, just like many other social media platforms.
Kayla Lazenby started using LinkedIn a lot several years ago when she wanted to transition from being a teacher to working in education technology. She successfully used the platform to find a job at a startup. When she was laid off from that job around Thanksgiving last year, she said her layoff post landed on the LinkedIn feed of an executive at another tech company. Even though she didn’t know that executive, they were impressed by her resumé and ended up hiring her.
Lazenby said it helped that she already had a strong presence on LinkedIn. She was more than just a “casual consumer” but instead an “active user” who shared her story and personality on the site. Her experience shows how, for many, sharing about being laid off on LinkedIn isn’t just about being authentic: There’s a strategy to it.
“None of the people who are doing this are foolish about the fact that they’re doing this on a public forum that will be seen by future employers,” said Emily Rose McRae, a director of research at Gartner who leads the firm’s future of work research center. McRae said she noticed that most laid-off tech employees are careful not to publicly slam their former employer, even though tensions were high around the mass layoffs. “It’s still LinkedIn; it’s still primarily a professional network.”
Gabi Weinberg, who works part time at tech venture firm Atento Capital, said that even though there’s less stigma attached to being open for work than before, he prefers to use LinkedIn in a more private capacity by sending direct messages to companies he’s interested in working with.
Weinberg said that if you’re not working for a big-name company like Google or Facebook, your layoff could be seen as less publicly “marketable.” He also said he personally didn’t feel comfortable sharing as much publicly on the platform as some others.
“It seems more culturally appropriate to share if you were laid off at a big tech company, whereas, if you’re at a mom-and-pop or smaller company, it’s not the same,” he said.
Other people Recode spoke to acknowledged that the feeling of having to post on LinkedIn can be a burden during an already stressful time.
“I think there’s a pressure built around LinkedIn, that you say you’re open to a job and if you’re not scrolling 24/7, you might miss that one post, and you miss an opportunity to apply,” said Lazenby, who said she gave herself a day to be sad and ignore social media after being laid off before she posted about it.
A big question, though, is what happens when people get tired of talking about layoffs and stop offering help — what Gartner’s McRae called “compassion fatigue.” Already, some LinkedIn users Recode talked to complained about the constant stream of sad news about layoffs appearing on their feed all the time. Or what happens when there’s no longer an economic downturn and people find new jobs and have less of an incentive to use LinkedIn?
While LinkedIn is finding more ways to keep people on its site — showing them more news and investing in career influencers — it is still a social network framed squarely around careers.
“Our vision has been for economic opportunity. We’re not here for the extra clicks,” said LinkedIn’s Rajiv. “The easiest mode of expansion would be cat videos, right? That’s not the goal. The goal is to help people grow, learn, and find their next job.”
So far, that goal seems to be working out well for LinkedIn — at least during this period of great economic uncertainty in tech.
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