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The national ADHD drug shortage has entered its fifth month, leaving people who rely on medications like Adderall with few alternatives. The shortage has also affected other drugs, including Concerta, Ritalin, and Vyvanse.
Factors contributing to the ADHD drug shortage
ADHD diagnoses have surged during the pandemic. The DEA limits the production of ADHD, which are Schedule II drugs with high abuse potential. Additionally, manufacturing and supply chain issues have also exacerbated the ADHD drug shortage. Generics giant Teva, for one, has acknowledged facing “intermittent manufacturing delays.”
There are also unclear guidelines for doctors pondering how long to prescribe ADHD drugs, according to Dr. Heidi Moawad, a neurologist on Sermo’s medical advisory board.
“Maybe the pharmaceutical companies will increase their production of [ADHD drugs], but I don’t know if that really is the only solution,” she said. “There’s also a need to have good guidelines for duration of treatment.”
Online telehealth companies like Cerebral and Done have faced criticism for prescribing ADHD drugs too liberally. In May 2022, Cerebral acknowledged it was under investigation by the Department of Justice (DOJ) for “possible violations” of the Controlled Substances Act. The DEA is also investigating Done for similar reasons.
The pandemic has also played a role
Moawad also noted that the pandemic played a role in ramping up demand for ADHD drugs.
The pandemic ramped up the use of telehealth, which can be used for assessing if patients have certain patient-reported symptoms. The pandemic-based decision to waive enforcement of the 2008 Ryan Haight Act made it possible to prescribe controlled substances via telehealth providers without requiring a physical exam.
The stress of the pandemic is another factor. “Experts seem to agree that ADHD symptoms can change depending on the environment,” Moawad said. And it is likely that the early days of the pandemic, when many people were stuck indoors, amplified ADHD symptoms and inspired some people to get a diagnosis.
Demand for stimulants also saw considerable growth before the pandemic. An article in PLOS One noted that prescription amphetamine use jumped 2.5 fold from 2006 to 2016. The article also noted that the U.S. consumes the bulk of ADHD drugs. In March 2020, the U.S. was consuming 83.1% of global Adderall supply. The U.S. has less than 5% of the world’s population.
There was also a shortage of amphetamine salt products in 2011, which includes products such as Adderall XR, Adderall and generics.
Some pharma companies now project that the current ADHD drug shortage will continue into spring.
In December 2022, U.S. Representative Abigail Spanberger called for the DEA to address the nationwide shortage of Adderall prescriptions. However, DEA decided against increasing manufacturing quotas for ADHD drugs in 2023, arguing that the drugs were overprescribed.