For many people diagnosed with ADHD (Attention-Deficit/Hyperactivity Disorder), a medication like Adderall is essential to their treatment plan and helps them manage symptoms and improve daily functioning.
However, in recent times, an alarming shortage of Adderall has left many individuals struggling to access this vital medication. The Adderall shortage has left many wondering what’s behind it.
In the CareTalk episode, “What’s Behind the Adderall Shortage”, hosts, John Driscoll and David Williams explore the current Adderall shortage and the root causes behind it.
What is ADHD and How is it Diagnosed?
ADHD, which stands for Attention-Deficit/Hyperactivity Disorder, is a neurodevelopmental disorder that primarily affects children but can persist into adulthood. It is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can significantly impact an individual's functioning and quality of life. People with ADHD often struggle with maintaining attention, staying organized, following through on tasks, and controlling impulsive behaviors.
Diagnosing ADHD involves a comprehensive evaluation conducted by a qualified healthcare professional, such as a psychiatrist, psychologist, or pediatrician, who specializes in mental health. The diagnostic process typically begins with a thorough medical and psychiatric history, including gathering information about the individual's symptoms and their impact on daily life. To meet the criteria for an ADHD diagnosis, the symptoms must be present in multiple settings, such as home, school, or work, and have been present since childhood. The healthcare professional will also rule out other potential causes for the symptoms, such as medical conditions or other psychiatric disorders.
ADHD is diagnosed using specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a widely accepted guide for mental health professionals. The DSM-5 identifies three main subtypes of ADHD: predominantly inattentive type, predominantly hyperactive-impulsive type, and combined type (which includes both inattentive and hyperactive-impulsive symptoms). The specific symptoms and their severity will determine the subtype diagnosed.
"There's been a big increase in the diagnosis of ADHD, especially during the pandemic. It's also now women and girls who have the diagnosis not just male as it has been in the past. In fact, there's been a 58% increase in patients age 22 to 44 from 2018 to 2022 versus a 35% increase for Adderall over time". - David (CareTalk)
What is Adderall and How Does it Work?
Adderall is a prescription medication commonly used in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). It is a central nervous system stimulant that contains a combination of two active ingredients: amphetamine and dextroamphetamine. These stimulant medications work by affecting certain chemicals in the brain and nerves that contribute to hyperactivity and impulse control.
Adderall helps individuals with ADHD by increasing the availability and activity of neurotransmitters, such as dopamine and norepinephrine, in the brain. These neurotransmitters play a crucial role in regulating attention, focus, and impulse control. By enhancing their effects, Adderall helps to improve attention span, reduce hyperactivity, and enhance cognitive functioning.
The medication is available in both immediate-release and extended-release formulations. Immediate-release Adderall is typically taken multiple times a day, while the extended-release version is designed to provide a longer duration of action and is taken once daily. The dosage and treatment plan is determined by a healthcare professional based on the individual's specific needs and response to the medication.
It's important to note that Adderall is a Schedule II controlled substance due to its potential for abuse and addiction. It should only be used under the supervision and guidance of a healthcare professional who can closely monitor its effects and adjust the dosage as needed.
"Attention deficit is a real thing. I've known kids who have been prescribed it, and it could substantially help them focus in a way that they couldn't otherwise get through a structured day without it. So, for those parents, particularly with kids who have a hard time focusing, although it's a lifetime diagnosis, this drug is a lifesaver or a life complicator if it's not available".- John (CareTalk)
What is Behind the Adderall Shortage and its Rising Demand?
The Adderall shortage is a concerning situation that has been affecting individuals who rely on this medication for the management of ADHD symptoms. The shortage is primarily attributed to a combination of factors, including increased awareness and demand, manufacturing challenges, and regulatory issues.
In recent years, growing awareness of ADHD has been driven by increased research, media coverage, and advocacy efforts. Research has deepened our understanding of the disorder, while media portrayals have highlighted its impact.
Advocacy organizations have worked to raise awareness and support for individuals with ADHD. This increased awareness has led more people to recognize ADHD symptoms and seek diagnosis and treatment, improving access to appropriate care and support.
Changes in Diagnostic Criteria
The expansion of diagnostic criteria for ADHD has played a significant role in increasing awareness and diagnosis rates. With a broader understanding of the disorder, the diagnostic criteria outlined in the DSM-5 have been updated to encompass a wider range of symptoms, including both hyperactive-impulsive and inattentive presentations.
This expansion has enabled healthcare professionals to identify and diagnose individuals who may have previously been overlooked, leading to an increased number of people seeking evaluation and treatment. As a result, more individuals who may benefit from interventions such as medication and therapy are now receiving the appropriate diagnosis and support for their ADHD symptoms, ultimately improving access to tailored care.
Increased Access to Healthcare
Telehealth can be a convenient way to get medical care, but it is important to be aware of the risks. One of the risks is that people may be more likely to be prescribed Adderall if they see a doctor through telemedicine.
This is because doctors who see patients through telemedicine may not have as much time to assess the patient's needs as doctors who see patients in person. Additionally, patients who see doctors through telemedicine may be less likely to ask questions about the risks and side effects of Adderall.
Manufacturing delays have significantly impacted the availability of Adderall, primarily due to two key factors. Firstly, the global supply chain has been disrupted by the COVID-19 pandemic, leading to challenges in obtaining the essential ingredients required for Adderall production. The pandemic has caused transportation disruptions, restrictions, and closures, making it harder to acquire the necessary components and maintain a steady supply.
Secondly, plant shutdowns at manufacturing facilities that produce Adderall have compounded the shortage issue. These shutdowns may stem from financial difficulties faced by the manufacturers or other reasons that disrupt production.
The restrictions imposed by the FDA on the production of Adderall aim to address concerns regarding its potential for abuse and misuse. These restrictions are crucial for safeguarding public health and ensuring that the medication is used appropriately. However, a consequence of these restrictions has been the increased difficulty in bringing Adderall to the market, thereby exacerbating the shortage.
While the FDA's regulations on Adderall are necessary and serve a valid purpose, they have also presented challenges for individuals with ADHD who rely on the medication. The shortage has resulted in limited availability, making it more challenging for those in need to access the medication that effectively manages their symptoms.
What is Being Done to Remedy the Adderall Shortage?
The FDA is actively collaborating with manufacturers to increase the supply of Adderall and mitigate the ongoing shortage. They are also taking steps to educate healthcare professionals and patients about the shortage, providing information on alternative medications and treatment options. The FDA is closely monitoring the situation to ensure that patients have continued access to the necessary medication while upholding quality and safety standards.
To cope with the Adderall shortage, individuals can take several measures. It is advised to consult with their doctor to explore alternative medications or treatment options that may be suitable for managing their ADHD symptoms. Engaging in discussions with their insurance company can help them navigate coverage options for alternative medications. Checking with local pharmacies periodically may reveal the availability of Adderall or potential alternatives. Importantly, individuals should not discontinue their Adderall treatment without consulting their doctor, as abrupt discontinuation may lead to withdrawal symptoms.
Looking Ahead: The Importance of Solving the Adderall Shortage
In conclusion, ADHD is a significant neurodevelopmental disorder that requires proper diagnosis and treatment. The current shortage of Adderall has created challenges for individuals in need. The FDA is actively working with manufacturers to increase the supply of Adderall and provide alternative solutions.
In the meantime, individuals can consult with their healthcare professionals to explore alternative medications, discuss insurance coverage options, and stay updated on availability at local pharmacies. Open communication and collaboration between regulatory bodies, healthcare professionals, and patients are crucial in addressing the Adderall shortage and ensuring individuals with ADHD receive the necessary support.
CareTalk is the only healthcare podcast that tells it like it is. Join hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they provide an incisive, no B.S. view of the US healthcare industry.