Lacking Answers and Alternatives in the Adderall ShortageBunk Police
The popularity of Adderall is only growing, while availability has screeched to a sudden halt. Adderall, the prescription ADHD medication that so many Americans rely on, has been declared “in shortage” since August of last year. The shortage was reported by the FDA and a number of pharmaceutical manufacturers, with reasons remaining unclear, and solutions—far and few between.
Though Adderall has been prevalent for years, the consumption of this amphetamine-based stimulant has increased dramatically since the pandemic. According to CNN, the demand for Adderall has risen 27% since 2019, with prescriptions jumping from 35.5 million to 45 million last year (Musa, et al., 2023). Though Adderall is a helpful aid for those with ADHD, depression, and narcolepsy, this sudden spike has raised concern in the medical space.
Why is demand for Adderall so high? Is Adderall addictive?
The high demand for Adderall could be due to a number of factors. Firstly, the lax regulations surrounding prescribing controlled substances via telehealth medicine (something that became both possible and popular during the pandemic). Many medical professionals are skeptical of healthcare startups prescribing medication after brief, 30 minute telehealth sessions. Physicians are raising questions about the level of evaluation possible in such a limited timeframe.
Dr. Sai Iyer, a developmental and behavioral pediatrician at UCLA Health, stated that her evaluation for children who may have ADHD “includes the use of clinical surveys and potentially a cognitive evaluation, in addition to feedback from parents, teachers, and coaches” (2022). Iyer also expressed that ADHD can be easily misdiagnosed, making it extremely important to understand the full situation.
A healthcare startup named Cerebral is currently in question for this very reason. They are under investigation for potential violations against the Controlled Substances Act.
Fortune magazine stated, “[Cerebral] has been accused […] of setting a goal of prescribing stimulants to all of its ADHD patients, in an effort to increase customer retention” (Prater, 2022). Needless to say, a company prescribing a drug with a high abuse potential—simply to compel customers to return—is a dangerous and disturbing notion.
Adderall can cause withdrawal symptoms, such as depression, irritability, fatigue, headaches, and anxiety—even after one use. This is why it is often considered an addictive substance. An article from Addiction Center clarifies, stating that “over time, those habitually using Adderall develop a tolerance to the drug and are unable to function normally without it” (Jeurgens, 2023). Though dependence doesn’t necessarily equate addiction, many affirm that Adderall should not be prescribed frivolously, especially without thorough evaluation.
Another possible cause for the rise in demand is the surfacing of mental health issues during (or caused by) the pandemic. It is fully possible that COVID-related stressors brought out what was already occurring. Similarly, the shift in classroom format from in-person to fully virtual learning may have exposed underlying attention issues among students.
Why is there an Adderall shortage?
The Adderall Shortage is especially frustrating for many, simply because the reasons for the shortage itself are largely unknown. Some pharmaceutical companies have listed “demand increase” or “shortage of active ingredients” as their reasoning. Others simply list “other,” or do not provide any reason at all.
Dr. Yoram Unguru, a pediatric physician who specializes in drug shortages, expressed his concern for the lack of transparency from manufacturers. Unguru said, “Pharmaceutical manufacturers are not required to disclose the reason for disrupted supply. Knowing the exact reason for a given shortage is always challenging. It’s really difficult to be able to anticipate and let alone come up with meaningful solutions if you don’t know what the problem is” (Musa, et al., 2023).
While some believe these are pandemic-related factors, others are wondering if the provided reasons are too general or too reductive. Is there more to the story that researchers, let alone the general public, do not have access to?
What are the Adderall alternatives?
Medical professionals are scrambling to find adequate Adderall alternatives. Some are prescribing similar stimulants, or methylphenidate (such as Ritalin, which is also in shortage, as of January). Others are changing patients to longer or shorter-acting versions, to stretch the supply as much as possible (Lupkin, 2023). Though this provides a solution for some, many fear what will happen if the new “solutions” aren’t working.
Stopping Adderall consumption “cold turkey” is typically not recommended, due to the potential for Adderall withdrawal symptoms to occur. With no clear end in sight, there is growing concern for patients turning to other sources for their supply—namely, illicit markets.
The very present threat of fentanyl in black market Adderall makes it increasingly difficult to ensure public safety. Similarly, underground Adderall could contain other dangerous cutting agents, such as methamphetamine. Harm reduction organizations urge those acquiring Adderall from unregulated sources to test pills before consumption. It is important to never assume black market pills (even look-alikes) are the same as the prescribed alternative.
While the shortage persists, and demand steadily climbs, physicians are doing their best to provide solutions for those relying on Adderall. This shortage sheds light on both the covert nature of the pharmaceutical industry, and the potential problem of medicating as the go-to mental health solution. With alternatives at bay, and the shortage stretching on, this begs the question—will Adderall consumption decrease over time? Or will demand only continue to rise?
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