Adderall Shortage Continues, But Details Remain a Mystery

Adderall Shortage Continues, But Details Remain a Mystery

I have narcolepsy. I literally cannot function without Adderall. I cannot work or drive. Narcolepsy is awful. (Do not tell me to try natural remedies or essential oils!)

Luckily I haven’t had a problem getting Adderall…yet.

The Adderall shortage has been plaguing the U.S. for a while. The news only came out in July when a Reddit user mentioned the headaches to get the medicine refilled.

I admit that before July, I changed my pharmacy to Walgreens from CVS because CVS never seemed to have Adderall.

Oklahoma laws, federal laws, and insurance restrictions cause enough problems obtaining Adderall. I can only refill my prescription when I have two pills left. I’m only allowed 30 days at one time. So a pharmacy not having my medicine, especially on weekends or holidays when I cannot contact my doctor, can cause a panic attack.

The Shortage

The shortage is still dragging, and we have no answers. From Bloomberg:

More than half a year later, there’s been little resolution. Adderall, which treats attention-deficit/hyperactivity disorder and the sleep disorder narcolepsy, remains in short supply, with five companies reporting availability issues, according to the FDA. A recent survey of local pharmacies showed that some 97% didn’t have adequate stock of the medicine.

And for a drug regularly used by millions of Americans to stay focused, the reasons behind the shortage are largely a mystery.

The haphazard way the news of the Adderall issues trickled out is emblematic of the secrecy and confusion that has long existed around the manufacturing and distribution of the pills, classified by regulators in the same category as highly addictive drugs such as oxycodone and fentanyl. As the shortage stretches on, it shows the difficulties of tracking a tightly controlled medicine where any hiccup in the supply chain can lead to chaos. That’s all the more frustrating at a time technological advances and regulatory changes are meant to make it easier for people to fill prescriptions.

I hate that it’s a controlled substance. That alone makes the medicine so hard to get. You have to jump through hoops to get it.

You cannot fill it across state lines. You cannot mail it. Your doctor usually has to prove you need the medicine. You can only get 30 days at a time (that might be more on the insurance company and state). You can only fill it right at the end of your bottle (again, that might be an insurance state rule). I also know pharmacies can only keep a certain amount of narcotics.

The industry only recently allowed doctors to send the Adderall prescription electronically to the pharmacy. In only the last few years, the prescriptions no longer expire after seven days. It’s insane trying to retrieve the needed medicine.

The harsh rules and regulations on these controlled substances only affect people like me who don’t abuse the medicine. Addicts and wayward doctors will find a way to abuse the pills no matter the laws. Weird…almost as if criminals don’t care about laws and rules.

HINT FOR OTHER ADDERALL USERS: I put those last two Adderall pills in a container. I stockpile them if I run into a snag and cannot refill my medicine on time. It’s helped with vacations and holidays. ALSO! Call the day before you need your prescription and check on the supply. That way, you’ll know if they’ll get an order the next day.

Causes? Who Knows!

But then we are kept in the dark about the availability of medicine we need to function. I could fall asleep brushing my teeth. It’s not like the woman from Deuce Bigalow, Male Gigolo. That’s an extreme case of narcolepsy and rare!

Okay, I know this is turning into a rant, but I’m irritated.

The Adderall shortage isn’t really because of higher demand:

Some companies have said quotas on a key ingredient contributed to the problem, which the agency that sets those quotas denies. And shortages have been a recurring problem over the past dozen years, indicating deep-rooted issues.

The key ingredient is the amphetamine. The government limits how much amphetamine a company can have. No one knows the “quota” number, either. Gee, what a shock. The government is so secretive:

These quotas, established by the DEA, are intended to limit the amount of controlled substances produced to ensure that there’s enough to meet medical needs, but not so much that it can leak onto the black market.

But the DEA doesn’t disclose which companies are allotted what amount of Adderall’s raw ingredient, amphetamine, making it hard to figure out the role of quotas in shortages. Companies can request more amphetamine throughout the year.

Teva, a manufacturer “of four branded and generic Adderall pills” for U.S. pharmacies, blames the lack of workers, demand, and government production limits:

The labor problem was caused by “Covid workforce-related” issues, Kare Schultz, Teva’s then-chief executive officer, said in November. That was resolved by August, said Kelley Dougherty, a Teva spokesperson, who declined to comment further on the cause of the labor shortage.

Teva, the sole manufacturer of branded, immediate-release Adderall, said last year that it anticipated that the branded pills would come back in full supply more quickly than the cheaper, more common generic version. By the end of January, all of Teva’s branded Adderall pills were fully available, while all of the generics had constrained supply, according to the FDA. About 87% of prescriptions filled in the US last year were for the generic immediate-release or extended-release versions, data from Symphony Health show.

But that quota! The quota seems to be the biggest reason for a shortage at Teva and other companies:

Teva’s Dougherty said in October that DEA quotas contributed to the shortage. Robert Jaffe, a spokesperson for Lannett Co., which makes generic Adderall and is the drug’s third-largest producer, said in December that the DEA’s quotas prevented the company from meaningfully ramping up production in response to the shortage. Neither company answered questions about whether they requested a quota increase. Novartis AG’s generic-drug unit Sandoz, the second-largest maker, has had some of its requested increases granted and some denied, said spokesperson Leslie Pott. She said the federal agency has been working with the industry.

Everyone is Frustrated

Psychiatrists and sleep doctors are just as frustrated as patients:

Sreenivas Katragadda, a psychiatrist of 17 years in Manchester, New Hampshire, said he’s seen multiple shortages of ADHD medications and the situation is particularly bad.

“It is a logistical nightmare,” Katragadda said. “I will send the prescription to one pharmacy, which is the usual pharmacy for the patient. They’ll say they don’t have it, and they’ll say, ‘Maybe it is there in Nashua,’” a town that’s about 20 miles away.

“I’ll send it to Nashua, only to realize that before my prescription is filled, somebody else has sent another prescription that got filled first,” he said.

The doctors are also ticked that the DEA compared Adderall to the opioid crisis. Adderall and opioids are not the same. Even without a medical degree, I know this:

The Wall Street Journal reported in December that a DEA official wrote to Adderall manufacturers last year expressing concern that some of the factors that may be leading to increased demand for ADHD drugs are similar to those that led to “an oversupply of opioids during the prescription opioid crisis.”

This kind of comparison concerns clinicians who say that opioids and ADHD medicines have significant differences. Stimulants like Adderall give people with ADHD improved executive function, the set of cognitive skills involved in focusing, planning, and completing tasks. When used appropriately, they aren’t addictive in the way that high doses of painkillers can be. In fact, stimulants like Adderall reduce substance abuse in people with ADHD, according to published research.

“Many of us are concerned when people simplistically lump the stimulant medication with the opioids,” said Max Wiznitzer, division chief of pediatric neurology at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland, who treats children and young adults with ADHD.

I get sympathetic looks from pharmacists whenever a problem arises with my Adderall. They want to fill your prescription but cannot due to laws and restrictions. I know they hate not having Adderall on hand.

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