The Adderall shortage is a mental health crisis, experts say

By Lisa Marie Basile | Fact-checked by Davi Sherman
Published May 9, 2023

Key Takeaways

  • The United States Food and Drug Administration announced a shortage of the generic version of Adderall in October 2022. There is no clear end date to the shortage.

  • The shortage might have been caused by an uptick in prescriptions and misuse of the drug.

  • Experts believe patients who need the drug but cannot access it are at risk. There are some alternatives to the medication. 

This past October, the United States Food and Drug Administration (FDA) announced a shortage of Adderall (also referred to as Adderall IR). The ongoing shortage is putting pressure on the medical community and patients alike.

Adderall, used to treat attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD) and narcolepsy, is made from a blend of amphetamine salts, including D-amphetamine saccharate, D-amphetamine sulfate, D,L-amphetamine sulfate, and D,L-amphetamine aspartate.[] 

Recent data reveal that about 3.5% of the US population has ADHD, while it’s thought that the prevalence of narcolepsy falls between 25 and 50 per 100,000 people.[][]

The FDA says that they are in “frequent communication with all manufacturers of amphetamine mixed salts.” There’s no clear information on when the shortage will come to an end. []

A search on the FDA’s Drug Shortages database shows that Teva Pharmaceuticals, the nation's top supplier of branded and generic Adderall, is still experiencing “unprecedented increase in demand” and “supplying at or above demand currently at low inventory.” It’s worth noting that Teva also laid off 305 ​​workers last year, which may have also slowed production.[]  []

Other manufacturers produce the mixed salts, but they also cite an increase in demand or a shortage of active ingredients. The company USharma Windlas, which produces amphetamine mixed salts, says its stock is unavailable, with an estimated recovery anticipated for the end of June 2023. Aurobindo Pharma says that it expects availability by April 2023 but does not cite a reason for the shortage.[] 

News articles about the shortage continue, with patients saying they’ve had trouble refilling much-needed prescriptions or are facing withdrawal symptoms.[] 

Why is there an Adderall shortage?

There seem to be a few reasons. Increased demand is certainly at play. According to Axios, data from IQVIA, a health research firm, shows that 41.4 million Adderall prescriptions were fulfilled in the US in 2021—a 10% increase from the year before. 

Additionally, Vox reports that the shortage is tightly tangled up with the US Drug Enforcement Agency, which, in reaction to the growing misuse of prescription drugs, has played a hand in limiting drug production.[] In fact, one cross-sectional study of 231,141 students in 3,284 secondary schools found that “past-year prescription stimulant nonmedical use ranged from 0% to more than 25% across US schools.”[] In 2016, the journal Experimental and Clinical Psychopharmacology called stimulant medication misuse, including misuse of Adderall, “a serious problem” in the US.[] 

Another variable? Axios notes that scores of new telemedicine startups began making it easier for people to receive a diagnosis—sometimes an inaccurate one—of ADD or ADHD and to attain Adderall prescriptions, especially during the pandemic.[] Some physicians also believe that the pandemic’s stresses may have led more people to seek the drug.[]

But for patients with valid prescriptions who are turned away altogether, the consequences can be dire, Turner says. “This [can be] outright dangerous. It's well known…that people with untreated ADHD are at higher risk of traffic accidents, substance abuse, and other consequences.”

Turner thinks that the shortage is a mental health crisis. “For individuals suffering from a lack of treatment, they probably would describe this situation as a crisis. The uncertainty of when this issue will be resolved is one of the most frustrating parts.”

She adds, “Certainly there are people who abuse stimulant medications….[but] people with legitimate ADHD should not be penalized for the actions of some.”

What else should physicians know? 

“Until supply is restored, there are alternative therapies, including the extended-release version of amphetamine mixed salts, available to health care professionals and their patients for amphetamine mixed salts’ approved indications. Patients should work with their health care professionals to determine their best treatment option,” the FDA says.[] 

In response to the shortage, The Medical Letter says that Adderall alternatives include the short-acting stimulants “dexmethylphenidate (Focalin, and generics), methylphenidate (Ritalin, Methylin, and generics), and dextroamphetamine (Zenzedi, ProCentra, and generics).”[] 

Long-acting stimulants include “Adderall XR (and generics), which contains both immediate- and delayed-release beads….and Mydayis, which is formulated as capsules containing immediate-release beads and 2 variations of delayed-release beads.” 

Harold Hong, MD, a psychiatrist for New Waters Recovery, says that you should also talk to your patients about other remedies, including “psychotherapy, lifestyle modifications, or alternative remedies such as changing diet or exercise habits.” 

Additionally, it’s important that you keep a channel of dialogue open with patients who can't access their medication. This is because some patients have been known to “turn to the street for their medication, potentially increasing their exposure to dangerous drugs or counterfeits,” Hong says.

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