Adderall has been in short supply in the U.S. since September, causing chaos and confusion for millions of people who need the medication to treat Attention-Deficit/Hyperactivity Disorder. The Adderall shortage has united doctors and patients in a search for the medication and the reason why there’s an Adderall shortage.
After months of patients scrambling to find temporary solutions like rationing pills, trying alternative meds and even resorting to dangerous practices like seeking dubious Aderrall dupes on the black market, doctors, pharmacies, patients and lawmakers are coming together to express shared feelings of frustration and a demand for answers.
Dr. Jen Hartsein of Hartstein Psychological Services in New York City “The Adderall shortage has impacted my clients and my friends. They do not have access to a medication that is really helpful to their day-to-day functioning, which then creates other issues. It’s an incredibly challenging situation.”
Dr. Todd Meckles, CEO and Board Chairman of NYC Psychiatric Associates says the Adderall shortage has “definitely affected my patients” and warns “It’s vital they get their ADHD medication. These people suffer and lose jobs if it’s not under control.”
Despite medical professionals emphasizing the importance of patients getting their meds, the wait to fill prescriptions is still reportedly longer than ever in New York City.
Capsule, a New York City-based pharmacy that touts same-day delivery for most medications has entirely stopped accepting prescriptions for Adderall and the generic version, Dextroamphetamin. If a doctor sends a prescription request for Adderall or Dextroamphetamine to Capsule the patient automatically receives a text message recommending that they try another pharmacy with an apology from Capsule that “we we able to fill this for you.”
At Drug Mart, a pharmacy on the Upper East Side of Manhattan, Pharmacist Rebecca Aminov says “People are calling here for it every day. We tell them it’s on back order and just not available.” According to Aminov “the brand name Adderall is available for Drug Mart to order but many insurance companies don’t cover it.”
According to Drug Mart, the consumer cost for a 30-day supply of Adderall starts at $450.
The Adderall shortage is affecting women
“Julie R.”, a mother from Manhattan who was recently diagnosed with ADHD at age 37 expressed her frustration with finding her meds, saying all pharmacies near her are sold out of both the generic and brand name.
“Capsule is always on backorder. CVS by me is out. Adderall availability is legit changing all the time, with the pharmacies. I can’t find any anywhere right now.”
Julie R, ADHD patient, New York City
Other ADHD’ers say they found pharmacies that still stock the brand name version of Adderall, but because insurance denies covering Adderall they’ve been forced to pay out of pocket.
“I’m lucky I was able to buy the brand name this month, but for how long?” says Blaire Postman, an advertising sales rep and comedian who currently tours the country performing a one-woman stage show called “Lady ADHD.”
Postman was diagnosed with ADHD as an adult and says she started to take ADHD more seriously during the pandemic. Despite the hefty $255 price per month for the brand name at her pharmacy, she says she dished out the dough because “Life without ADHD medication feels like walking through a sea of molasses.”
Postman does her show “Lady ADHD” to increase awareness about ADHD and talk about her journey with mental health.
Julie R and Blaire Postman are part of a rapidly growing number of women being diagnosed with ADHD as adults.
Why are so many women being diagnosed with ADHD as adults?
Dr. Hartsein explains “I think we are more aware of what to look for in women than we were before. Such a huge part of diagnosis was behavior. As we as a society are more aware, we are now better able to notice when there is an issue.”
ADHD diagnoses have steadily been on the rise for adults since the start of the pandemic. According to a July 2022 article in ADDitude Magazine, “ADHD diagnoses among adults are growing four times faster than ADHD diagnoses among children in the United States with a 26 percent increase among children and up to a whopping 123 percent increase among adults.”
Along with the sharp increase in diagnoses, there’s also been an increase in the amount of prescriptions written to treat ADHD. Health data company Trilliant Health says Adderall prescriptions for 22- to 44-year-olds rose 15.1% from 2020 to 2021, double the 7.4% rise from 2019 to 2020.
An increase in Telehealth use been connected to an increase in Adderall prescriptions
The increase in Telehealth since the pandemic is another factor some say also contributed to the explosion in ADHD diagnoses and Adderall prescriptions.
Done, a digital health company that says they focus on ADHD treatment and making high-quality psychiatric chronic care management more accessible and affordable for patients says they’ve seen an increase in patients that’s on par with the increase most telehealth companies saw since the start of the pandemic.
Many doctors view the rise of Telehealth as a positive tool for mental health, rather than something to blame for more prescriptions.
Dr. Hartstein and Dr. Meckles both see patients through Telehealth in addition to in-person office visits in their practices. Both doctors told The Liminal that Telehealth has been helpful with patient communication. Neither said they think Telehealth poses a problem for licensed physicians who use technology responsibly to prescribe medication.
What role does the DEA play in the Adderall shortage?
To find the root cause of the Adderall shortage many are now looking to the federal Drug Enforcement Agency (DEA) for answers.
The DEA sets limits for how much of a stimulant ingredient pharmaceutical companies are allowed to use each year. Despite the major increase in prescriptions being written for ADHD medications in 2022 and concrete data that shows those numbers going up, they declined to increase the amount of stimulant medication allowed in 2023.
The DEA’s decision not to help pharmaceutical companies meet the increased demand for medication has made lawmakers issue statements.
In December and February 2023, Rep. Abigail Spanberger (D-VA) wrote letters to the FDA and DEA pressing them for a plan. The ASHP is also publicly asking the government and the manufacturers for more transparency and action.
In an email response to The Liminal about the Adderall shortage, a rep for the DEA cited previous comments about the matter and replied
“The DEA is aware of patient reports that pharmacies are unable to fill prescriptions for their prescribed Adderall or one of its generic versions. Should the proposed established amphetamine APQ become inadequate to meet legitimate medical and scientific needs…DEA has the authority and ability to adjust the APQ during the course of the year. DEA remains in communication with FDA regarding these shortage reports.”
Dr. Meckles says he’s personally reached out to the DEA offering his services to help find a solution to the Adderall shortage.
“Psychiatrists and the DEA need to work together to make sure the appropriate people are on their medications. If we do this together we could put a major dent in this problem.“
For now, Meckles says while he does worry for his patients who are without meds, he’s optimistic there is a solution. “Working together (with patients, pharmacies and the DEA) is the key.”
