The Great US Adderall Shortage is likely going to last at least for another year

In case you haven't heard, there's a national Adderall shortage. There has in fact been a national Adderall shortage for quite some time now. And there is no fucking end in sight.

Now, in the grand scheme, I suppose that extended-release amphetamine salts are small potatoes compared to cancer, or COVID, or police brutality, or what have you. But at the same time, the United States is a cutthroat country obsessed with productivity. And for those of us who rely on those little pills for getting shit done, let me tell you: it fucking sucks. Even worse is that the problem may very well stem from those scammy social media start-ups selling mail-order ADHD diagnoses for profit that began popping up in the early days of the pandemic. As The Guardian reports in a comprehensive piece about the issue:

Last October, the Food and Drug Administration (FDA) announced a shortage of Adderall, one of the most common stimulant medications for ADHD.


Meanwhile, the Drug Enforcement Administration (DEA), which controls the supply of the drugs, announced last month that it would not increase manufacturing quotas for 2023, despite the shortage – again, without providing a reason. 


As the coronavirus spread in 2020, the US Department of Health and Human Services authorized an emergency suspension of the 2008 Ryan Haight Act, which had banned the prescription of controlled substances by telehealth providers without an in-person examination. That rule change enabled a wave of telemedicine companies to reach ADHD patients through convenient, mobile-friendly apps.


The Federal Trade Commission opened a civil case into whether the company used deceptive marketing practices.

Two years after it began, the explosion of online, on-demand ADHD prescriptions was over.


The DEA declined to answer emailed questions, but the agency's thinking was evident in a letter it sent to drugmakers last summer, saying it was scrutinizing their production requests because of "the sheer volume of ADHD medications on the market coupled with aggressive marketing practices" from certain firms, according to a recent report from the Wall Street Journal. The letter said the DEA would ensure that "the manufacturing of controlled substances used to treat ADHD is driven by a legitimate need and not improperly driven purely by profit motive, pressure from marketing firms, or a desire to obtain more market share – all factors that led to an oversupply of opioids during the prescription opioid crisis."

To be clear: ADHD is real, regardless of how much the armchair pundits like to opine about "kids these days" or video games or shiny butterflies or whatever shitty joke they're making this week. It's not something "everyone has a little bit" of either; though I'll be the first to admit that "ADHD" is in fact a terrible and unhelpful name for what the condition actually describes.

The thing is, people with ADHD don't really struggle with attention; rather, we struggle with Executive Function. One might even say that we have too much attention, but lack the ability to regulate it, at least not in the way that comes naturally to neurotypical folks. As a result, we struggle with neurotypical expectations of things like time management, organizational skills, and working memory.

This is perhaps the most frustrating part of this whole shortage: how it requires people with ADHD to work overtime with our Executive Function skills to conform to the bureaucratic red tape around our medication, in order to obtain the medication that helps us perform Executive Functions. It was annoying enough that I had to contact my doctor once every 30 days but no sooner than 3 days before the end of the month in order to get my prescription refilled (and hope like hell there's no weekend/holiday/sick day/delay in communication/etc). That's a cadence of annoyance that I've sadly gotten used to. Now I have to contact my doctor every month but no sooner than 3 days before the end of the month, then hope I pick the right pharmacy for him to send the prescription to; then go in-person to that pharmacy to see if they actually have the medicine in stock right now (because they won't tell me over the phone out of regulatory fear that I'm a junkie trying to case the place). Then, if it's not in stock, or if there's a different brand of Adderall in stock, I have to go back to my doctor (and/or insurance company for approval, depending on the brand) to ask for a new prescription; and then once again hope like hell that the next pharmacy I pick actually has it in stock; or that no one else gets to the differently-branded stock in the first pharmacy before I'm able to get through all these approvals.

Executive function, baby!

Did I mention this sucks and that I have a human being that I care for as well as a job and other obligations that take time away from me going through that aforementioned process every month (except I also have to go through it, because I need the medicine to take care of the child and keep the job that enables me to take care of the child and get the medicine)? This all puts me on edge, which makes me anxious, which makes it harder to manage my executive functions, which makes me depressed, which makes me more anxious, which makes me irritable, which makes it harder to manage my executive function? Cool, good talk.

'The worst it's ever been': mysterious US Adderall shortage puts ADHD patients at risk [Wilfred Chan / The Guardian]