Earlier this month, The U.S. Food and Drug Administration has declared a nationwide shortage of immediate-release amphetamine mixed salts. For many people taking the drug, the announcement simply stated what they had known for months. Currently, getting the drug (often denoted by its brand name Adderall) can be tricky, very inconvenient, and sometimes completely impossible. Pharmacies nationwide are out of stock. People metered pills, drove for hours, and begged their doctors for alternative treatments. Drug shortages are not uncommon. There are currently more than 200 incidents in the United States alone. But this requires special attention. Adderall shortages could exacerbate the overdose crisis in the U.S. People may die.
“It really matters if I can’t access it,” a freelance writer named Kitty told me. (For privacy reasons, she asked to be given only her name.) Kitty was diagnosed with attention deficit hyperactivity disorder (ADHD) as an adult and found that slow-release Adderall was the most helpful drug for her, helping to She concentrates with no side effects. She ran out two weeks ago and was unable to refill her prescription. Without her regular supply, she looked for alternatives. “I was taking my friend’s medication and it was complicated,” she said. “It’s not my exact prescription.” It’s a higher dose, probably too high. She was grinding her teeth more and more.
How did this happen? The largest U.S. maker of these drugs, Teva Pharmaceuticals, was unable to hire enough workers for its packaging lines this summer. Teva fixed the problem, but a recent Bloomberg report said its shortage could continue into March. (A company spokesperson told WIRED that this will be resolved “in the next few months.”) In addition to Teva, several other manufacturers are now facing supply issues. As a Schedule II controlled substance, Adderall is closely monitored by the U.S. Drug Enforcement Administration, which sets strict caps on how much each company can produce. One can’t just speed things up and make up for another’s backorder. Even if all manufacturers suddenly added thousands of workers and the most efficient supply chain in the world, they would still be subject to DEA quotas.
Then there is demand. America loves Adderall. The use of prescription stimulants more than doubled in the United States between 2006 and 2016. Since then, the proportion of adults has risen again, with healthcare analytics firm Trilliant Health reporting a 22% increase in prescriptions for 22- to 44-year-olds from 2019 to 2021. The surge was driven by an increase in ADHD diagnoses, although Adderall also applies to other conditions, such as narcolepsy. New off-label uses are also emerging. For example, some doctors are treating fatigue after Covid-19 with prescription stimulants.
When telehealth regulations eased to help people get health care at home during the pandemic, a slew of mental health startups flooded social media with ads encouraging those who felt easily distracted to seek ADHD treatment without the need for in-person meetings. Those The ad worked. Diagnosis has surged again. The rapid rise of these companies has raised concerns about over-prescribing. Are they providing vital services to people who would otherwise go untreated for mental health issues, or are they just pill factories in the age of TikTok? Major pharmacies such as CVS and Walgreens have stopped prescribing controlled substances for popular startups Cerebral and Done, which is under federal investigation for its prescribing practices.
Is Adderall overused in the US? This is a tough question and one worth asking. It’s also completely irrelevant. The question at hand is what will happen — what has happened — when Americans suddenly stop taking the stimulants they have been prescribed or regularly take.
