What's Really Behind The Adderall Shortage?

You may have heard that there's an ongoing shortage of the medication Adderall. But there's a lot more going on here than you may expect, and the real culprit behind the shortage isn't what you might think.

Hosted by: Hank Green with Jessica McCabe

Credit correction:
Writer: Tori Espensen
Fact Checker: Karen Turton
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[Bargadiel]

I took Adderall for ADHD when I was in elementary school, all the way to highschool when I stopped. Through my college years, I really struggled and had to work 2-3x harder than my peers to do the same work. I also struggled with depression and anxiety, and just felt inadequate all the time. Fast forward to my 30s, and I was re-diagnosed with ADHD, and was prescribed Adderall. Turns out this condition that everyone, myself included, thought that I "grew out of" was still absolutely affecting my daily life. Because of the shortage, I don't take my Adderall every day, but when I do it's a night and day difference. It makes me finally feel normal.

[loraleitourtillottwiehr]

I want to add that part of the issue is also insurance companies refusing to cover similar or even identical meds when the usual ones are out of stock. At least for us. Our pharmacy almost always has something in stock for my daughter's prescription but every couple months the insurance denies it because it's the wrong manufacturer. Love that you got Jessica on the show for this one!

[spooklass]

5:13 From experience, the main reason I see that people got treatment for ADHD during the pandemic is because people with ADHD struggled a lot more during it. Telework and online school were a struggle for us (me, my mom, and some of my friend group) since we were no longer in a structured environment.

[amylizbrarian]

Also gotta love the irony of doctors only being allowed to prescribe 30 day supplies with no refills, so you have to try to remember to call or go in for your next script at the exact right date (usually day 28). Then if you miss that date, or if the pharmacy has a shortage and you have to wait to get it, you’re asking your unmedicated brain to remember to get your meds. “Ah, a condition that affects working memory and can make people forgetful? Let’s make the medication require multiple steps that only a non-ADHD brain could reasonably complete in a timely manner.” 🙄

[hannersandrews]

Drs: this drug is highly addictive.
ADHD people: I forgot to take my meds again....

[Brett_trejo]

Adderall, lsd and psilocybin are amazing. I was severely traumatized years ago as a teenage, got diagnosed with ADHD. Spent my whole life fighting ADHD. I suffered severe depression and mental disorder, Not until my wife recommended me to psilocybin mushrooms treatment. Psilocybin treatment saved my life honestly. 8 years totally clean. Never thought I would be saying this about mushrooms.

[TXWatson]

The fact that the rate of apparent misuse has declined as the number of diagnoses has increased went up—as well as the fact that people who self-reported misusing stimulants had worse academic outcomes than people who didn't—suggest to me that it's not just that newly diagnosed people aren't selling their meds, but that a lot of people who were "abusing" stimulants were self-medicating for undiagnosed ADHD. Have any of those studies followed up with people who reported misusing stimulants to check whether they were later diagnosed?

[forestw]

I typed out a huge thing, but I’ll just say this - I’m in my 30s and have been on medication since my early 20s. It changed my life. Now I’m going around 2-4 weeks without medication every few months because of stock issues or clinical organizational issues because doctors are more afraid to serve adhd patients than opiate patients now.

[anthonymarquez]

As a nurse who works in a hospital their have been a shortage of a lot of drugs and supplies these past few years. I have never seen anything like it before.

[yoonsikp]

As somebody currently going through medical residency, I can see that there is a lot of stigma against ADHD. My supervisors are quick to dismiss patients requesting ADHD medications as drug seekers. As stated in the video we are in an interesting but unfortunate scenario where there is both over diagnosis (stimulant abuse) and under diagnosis (legitimate patients) of ADHD.

[peterbathum]

Over 60 here and just realized … there was no awareness or definition even when I was a kid. How to ADHD with Jessica saved my life.

[Claire-xncw]

It’s not just adderal anymore. The shortage is affecting other Adhd medications.

It’s made worse by insurance companies. They can limit which adhd medications you can take. They can also restrict you to only taking generic, making it more difficult to find your medication. Last month every pharmacy in a 20 mile radius was out of my prescription. Walgreens had the name brand version in stock, but my insurance wouldn’t cover the name brand.

[minutestomidnight]

Regulations targeting medication misuse often make getting those medications MUCH harder for those who need them, and some of those regulations will make no difference to those who misuse them but make things so much harder for patients with legitimate conditions. 

The misuse of opioids is heavily complained about, and is a real issue, but what everyone loves to forget - including doctors - is the chronic pain patients who continue to suffer. Any medication has to be carefully managed so the patient doesn't end up taking too much and suffering from side effects and consequences, but many doctors, including those who specialise in chronic pain, will outright ignore the patient's suffering and quality of life, or unfairly label patients as drug seekers because they're complaining of pain or other symptoms.

[tashenamason]

I have ADHD and Narcolepsy (sleep disorder)... Simulants are used for both, so I take high doses. I literally cannot function without them. The shortage has been devastating.

[Dasycottus]

PhD student, diagnosed at age 8.The last two years have been hell.

Thanks for getting Jessica in here. She's amazing.

[Kaltag]

I first got diagnosed at 29. I remember being so mad that I had to struggle for so long when I could have had meds. I felt like I was awake for the first time in my life and cried for 45 minutes.

[foxwaffles]

The only reason i have my meds is because my mom takes hours out of her days every 30 days to call all the pharmacies nearby to see who has it and get the prescription filled through them. If it wasn't for her, my ADHD would make it basically impossible for me to jump through those hoops

[carlyar]

I’m one of those diagnosed as an adult.
As a kid I was a quiet and daydreaming girl…. I was diagnosed only AFTER my son was diagnosed.
Starting a stimulant immediately helped me with things I struggled with my ENTIRE LIFE!!! It was a game changer at age 36.

[theoccasionalsnickerdoodle]

It's not just Adderall, it's Focalin and Ritalin. Focalin is not running low in stock, the companies refuse to manufacture it in PA until the government gives them subsidies

[RJHarvey]

Thanks for representing neurotransmitters as multifunctional molecules!
My pet peeve as a neuroscientist is the one-dimensional representations of neurotransmitters' roles by health professionals and science educators.
It's not a BIG deal that people believe and say silly things about serotonin and dopamine in everyday language; it's nice that they're interested at all! But it annoys me all the same, since I research the "non-traditional" functions of these neurotransmitters.
Science educators taking a second to promote a multi-tool analogy over the lock-and-key analogy is a great step to improving public understanding of neurobiology, and perhaps eventually alleviating the pain I feel whenever someone talks about "filling their dopamine tank up."