Why the US is facing a shortage of Adderall, used to treat ADHD

Patients have been dealing with the scarcity since August, with pharmacies in the US finding it increasingly difficult to stock the drug.

The current shortage comes at a time when there has been a growing demand for Adderall, particularly since the beginning of the Covid-19 pandemic.

Adderall and its treatment for ADHD

Adderall is the brand name for the formulation that consists of a combination of dextroamphetamine and amphetamine. It is an FDA-approved drug for the treatment of ADHD and narcolepsy, a sleep condition that causes daytime sleepiness.

ADHD is one the most common neurodevelopmental disorders of childhood, usually diagnosed at an early age and lasting into adulthood. According to the US Centres for Disease Control and Prevention (CDC), children with ADHD might have trouble paying attention or controlling impulsive behaviours, and can be overly active.

Many adults remain undiagnosed, and symptoms can cause difficulty at work, home or relationships. The CDC states that symptoms can appear different at older ages, for example, hyperactivity can appear as extreme restlessness.

Adderall belongs to the class of drugs known as stimulants and increases the levels of dopamine and norepinephrine in the brain. For people diagnosed with ADHD, Adderall can help improve focus, concentration, impulse control and hyperactivity, because of its effects on the central nervous system.

It can also have the same effects on those who do not have ADHD.

Adderall is classified as a Schedule II drug in the US, which means that while it has positive medicinal effects, there is a large potential for abuse.

Over the past decade, there have been many reports about the growing use and misuses of stimulants like Adderall among students and athletes, who might find enhanced cognition or sports performance.

The FDA notes that “amphetamines have been extensively abused. Tolerance, extreme psychological dependence, and severe social disability have occurred.”

Since when have shortages been reported?

According to a survey between July 25 and August 5 by the US National Community Pharmacists Association, among 358 independent pharmacies, 64 per cent reported difficulties ordering Adderall.

Bloomberg had spoken to patients in several US states last month, and found that many were unable to purchase Adderall from major pharmacies. The medicine is supposed to be taken everyday and some patients were told they would have to wait more than a week before they could purchase it.

The FDA had also previously reported a shortage of Adderall, which lasted from September 2019 to May 2022.

Why is there a shortage?

The FDA notes that Teva Pharmaceutical Industries Ltd, the country’s largest supplier of Adderall, was “experiencing ongoing intermittent manufacturing delays.” While other companies continue to produce amphetamine mixed salts, “but there is not sufficient supply to continue to meet US market demand through those producers,” it added.

In August, Teva had said that labour shortages on its packaging line had caused disruptions to the supply of Adderall to pharmacies, but said they expected a “full recovery for all inventory and orders in the coming weeks.”

There has also been a surge in demand for Adderall in recent years, and in 2020, the US government loosened rules so that people could obtain Schedule II drug prescriptions through telehealth appointments rather than in-person visits, The Wall Street Journal reported.

Some of the companies have been criticised for prescribing drugs like Adderall that have high rates of abuse too frequently. San Francisco-based Cerebral Inc faced a wrongful termination suit by its former vice president, who has claimed the company aimed to prescribe the powerful stimulant to 100 per cent of its patients, something that he did not consider “safe or legal,” The New York Times reported.

Along with higher demand, the US Drug Enforcement Administration had set strict production quotas, making it even more difficult for patients to access Adderall. Furthermore, it doesn’t plan to increase production quotas until next year, and it is concerned that young people are abusing ADHD medications, The Wall Street Journal reported.