When Things Don’t “Add” Up: The Adderall Shortage

If you take Adderall or know anybody who takes Adderall on a regular basis, you may have heard about the infamous Adderall shortage. On October 12, 2022, the FDA announced a shortage of the immediate release formulation of Adderall. It’s been five months and the shortage isn’t getting better – it’s growing. 

According to the United States Food and Drug Administration (FDA), amphetamine mixed salts, often referred to by the brand name Adderall, are approved for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. Many people rely on these drugs to function in their daily life.

We unpacked the lore behind the shortage and spoke to a few Elon students about how the shortage is affecting them. 

Why is this happening? 

While pretty much unprecedented, there are a few reasons why Adderall has become so difficult to get. The shortages began due to a labor shortage at Teva Pharmaceuticals, which sells the most Adderall in the country, causing delays in production. Then the snowball effect took over. 

To make things more frustrating, central nervous system stimulants are considered controlled substances. Due to the fact these medications have long-standing histories of abuse and addiction, they have to be kept under lock and key. This means that the Drug Enforcement Administration (DEA) puts a limit on how many stimulants a pharmacy can dispense at one time, as well as a limit on how frequently patients can refill their prescriptions. The DEA also puts limits on the active ingredients pharmaceutical companies need to use to make these medications every year. Manufacturers can’t scale up the production because then the DEA will get involved. 

There shouldn’t be a shortage, but the DEA has set calculations on how much of the ingredients are needed to meet the demands and then distribute that amount. But the DEA uses prescription numbers from previous years to calculate this amount. This is where one issue lies, as ADHD diagnoses have continued to rise in recent years and the DEA has not made proper accommodations for those diagnoses.

When people began working from home or helping their children with virtual schooling at the beginning of the pandemic, some started to recognize ADHD symptoms in themselves or their children. The growth in ADHD diagnoses during/since 2020 was unmatched. This has driven up the demand for Adderall prescriptions. According to NBC News, Adderall prescriptions for adults rose 15.1% during 2020. That’s double the rise seen the year before. Manufacturers can’t keep up. 

“I’ve just had to suck it up.”

Adderall is most often prescribed to people who have an ADHD diagnosis. ADHD is a chronic neurodevelopmental disorder that has a range of symptoms. It’s different for everyone, but it commonly affects one’s attention span, impulse control, executive functioning, and ability to stay still. This can lead to struggles in relationships and daily life– school and work included. 

ADHD brains produce much lower levels of dopamine and norepinephrine than neurotypical brains do. Stimulant medications work by increasing those chemicals and therefore helping to manage ADHD symptoms. This medication is life-changing for some people.  

For many college students, treatment for ADHD isn’t just something they can put on hold. Elon sophomore Caroline M. didn’t hear about the shortage until a few months ago when she was given only half of her 30-day prescription of Adderall at the pharmacy. When she asked where the rest of the pills were, she was told that she “was lucky to get what they had.” It was just an inconvenience at first, but after a while, Caroline began to ration her pills. “On the days I didn’t take them, I’d get so frustrated with myself for not being able to perform like normal,” Caroline told us. 

Similarly, Elon senior Abigail W. says that the shortage has affected her mental health.“Without taking my medication, I feel like I can’t finish a task without starting a new one. It messes up my whole day and I get really frustrated with myself that I am not able to pay attention like my peers, even though it’s not fully in my control,” she said. Abigail was told to give the pharmacy one to two weeks to fill her prescription but those weeks have turned into months. Now her prescription is expired, which causes more hassle for her if she wants to get another refill.

She told The Edge that she found it hard to accept the shortage after taking medication for years. “It’s frustrating that routines we’ve had for years are being disrupted,” Abigail said. For many people with ADHD, a daily routine is the pillar that decides whether their day will be successful or not. We asked Abigail how she dealt with the shortage and she answered, “I’ve just had to suck it up.” 

When will it all end?  

It’s a mystery, really. Expected recovery times for the shortages vary. A few manufacturers have already recovered and have the medication in supply. Others have continued to push their expected recovery times back. Some don’t expect recovery until mid-April. 

As people scramble to find new options to treat their symptoms, the scarcity of Adderall has broadened to other stimulant medications as well. This has made finding alternatives difficult for some. Elon junior Mollie L. says that she hasn’t been able to get her Vyvanse prescription in months because doctors are now prescribing it as an alternative to those who usually take Adderall. Takeda Pharmaceuticals, the company that makes Vyvanse, claims that there is no shortage of the drug. But according to NBC News, dozens of pharmacies have reported that Vyvanse has been on and off of backorder for months. This has been frustrating for people who have had to switch their medications, as extra med checks with the doctors and negotiating with insurance companies can be a lot of work for the pharmacy to just be out of the new medication. 

Hopefully the shortage will end soon. Many people don’t understand the extent of the needs that are not being met. ADHD is a frequently misunderstood and stigmatized disorder. It doesn’t help that Adderall is often just known for its abuse as a “study buddy” for sleep-deprived college students. This is more than that. This is a medication that people rely on to function and if it were anything else, we might have seen more urgency from the DEA and FDA.

In a final comment, Caroline M. told The Edge, “in our neurotypical-favored society, it can be hard to keep up without proper treatment. Shortages like these cause millions of people to get left in the dust with little to no support from the rest of the country, who tell us to just suck it up.”