On October 12, 2022, the U.S. Food and Drug Administration (FDA) announced a shortage of a drug formulation of amphetamine mixed salts, commonly referred to by the brand name Adderall. Adderall is an FDA approved drug for the treatment of narcolepsy and attention deficit hyperactivity disorder (ADHD), including anger, anxiety, forgetfulness and trouble focusing.1
Adderall is categorized as a controlled substance because it contains highly addictive stimulants known as amphetamine and dextroamphetamine.2
Demand for Adderall Has Significantly Increased in the United States
According to the U.S. National Institutes of Health (NIH), approximately 16 million Americans used prescription stimulants including Adderall in 2017.3 This figure increased even more during the COVID-19 pandemic. The number of patients between the ages of 22 to 44 that were prescribed Adderall grew by 7.4 percent between the second quarter of 2019 and the second quarter of 2020. This number increased even further in 2021 by 15.1 percent.4
It is believed that the number of people taking Adderall has increased due, in part, to the emergence of new online mental health care entities during the pandemic, which were given authority by the U.S. Drug Enforcement Agency (DEA) to prescribe controlled substances like Adderall and Ritalin via tele-health.5
During the COVID pandemic, tele-health prescription drug prescribers were offered assessments with a physician that took as little as 30 minutes, even though the diagnosis of ADHD should involve a thorough evaluation because it can be confused with other conditions. This has prompted concerns about the over-prescription of Adderall.
Sai Iyer, MD, developmental and behavioral pediatrician at UCLA Health said:
You don’t just diagnose ADHD without looking at the full picture and understanding what’s going on. Is this just ADHD? Is it ADHD with a co-existing condition? Or is it not ADHD at all?6
Why is There a Shortage of Adderall?
Some physicians have acknowledged that Adderall shortages do occur from time to time. In the past, during October-December, companies that make stimulant medication have run short of the raw material they need for production.7 8 Teva Pharmaceuticals, the largest manufacturer of Adderall in the U.S. was struggling to hire employees for its packaging line this past summer. The company is also experiencing supply chain problems.9
The national shortage of Adderall is creating a challenging situation for the parents of children who are prescribed this drug as a result of an ADHD diagnosis. Kandi and Lion Fludd of Las Vegas, Nevada said their son had to go seven days without his medication before a pharmacist could fill his prescription. Lion Fludd stated:
I was calling the pharmacy every day. After four days, his teacher walked out to my vehicle when I was picking him up from school and said, ‘I can’t deal with it anymore—you have to do something. She said he was rolling on the ground, wasn’t focused and getting in other kids’ faces. When he’s not on medication … there are no boundaries10
Gabrielle Shapiro, MD, a psychiatrist and a professor at the Icahn School of Medicine at Mount Sinai in New York said:
Parents are panicked. Their children are being sent home from school or told they cannot come back if they are not on their meds. I have high school students that are trying to take their SATs and do their applications for college, and they can’t focus. They can’t get them done.11
Bloomberg health reporter Ike Swetlitz said:
So some people are just going without. You know, they’re not doing as well at their jobs. They’re not really able to keep up as much in professional and personal relationships. Some people I’ve talked to are trying to compensate with other sort of stimulants, drinking a lot of coffee, energy drinks—people I’ve talked to who have thought about going to the black market.12
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