June 13, 2023
Whoever says the Adderall shortage is over is living on a different planet. I have dozens of patients who rely on Adderall and who panic every month. Whenever it’s time to refill their prescriptions, the drama begins: Where can I find the medication I need?
This uncertainty is causing extreme hardship for many of my patients. While stimulant medication is not exactly like insulin (you won’t likely die without it), it is like eyeglasses. Without your glasses, your execution of everything suffers. You go about your day making mistakes, bumping into things, risking getting fired because suddenly you’re incompetent. I wish the Adderall shortage were over, but up here in the Boston area at least, it is as bad as it’s ever been.
I can’t figure out why. It’s not as if Adderall is like truffles; we don’t need special pigs to root it out from the ground. Production is not limited by the availability of its components. It’s easily synthesized. So why is there a limit on how much stimulant medication can be produced and marketed? Why are my patients suffering unnecessarily?
If limiting the production of Adderall is part of an effort to reduce or prevent the reselling or other misuse of the drug, that simply makes no sense. It’s just plain stupid. It’s like trying to reduce car theft by limiting the manufacture of cars.
It’s difficult for me not to believe this is a misguided attempt to avoid another oxycontin debacle. But limiting the manufacture of Adderall to prevent Adderall abuse only succeeds in punishing the patients who really need the drug.
To blame the Adderall shortage, as the FDA commissioner recently did, on improper or aggressive diagnosis of ADHD and improper or aggressive prescription of stimulant medication is to penalize the many for the mistakes of a few. Unless a doctor is intentionally over-diagnosing to make a profit — which does happen, unfortunately, but not nearly often enough to create a shortage of Adderall — then we ought to have enough of a supply to meet the needs of all people diagnosed with ADHD.
There is a shortage of Adderall because, for some reason, the manufacturing quotas set by the Drug Enforcement Administration (DEA) are not keeping up with demand. It’s good news that the demand is high because that means more people are getting diagnosed. Not too long ago, it was hard to find a doctor who knew enough to diagnose and treat ADHD.
Now that we’re diagnosing and treating more people with ADHD, especially adults, we ought to be able to prescribe for them the medications they need to live more productive, fulfilled lives.
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