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The National Adderall Shortage
Paul Skallas
March 21, 2023
Here’s a question. Why has there been so much media coverage of a nationwide shortage of Adderall?
These are the biggest news networks in the country. Why are they reporting on one drug? There are lots of drug shortages happening all the time. The FDA keeps an updated list and it goes on for pages and pages. Some of these drugs are very important and people need them to live.
Is Adderall (amphetamine) important? It’s used as a treatment for attention deficit hyperactivity disorder (ADHD) and is a type of stimulant. Yes, ADHD is real, but why is it newsworthy that there is a shortage of this one drug?
It turns out, there’s a lot of fucking people on Adderall. Over 50 million people. It’s grown 40 percent in 4 years. 1 in 6 people in America are using it.
Keep in mind these statistics are just for legal use. The illegal use pushes those numbers up by a lot more. Also, there are other brands of stimulants like Vyvanse or Modafinil that do the same thing but are not captured on this chart.
Who’s Taking Adderall?
When I was in school, it was popular to take stimulants like Adderall to pass tests. School is a game, and your grade is dependent on one or two exams. It makes sense to take a performance enhancing drug to do well on it. This is still happening at places like Medical School or Law School or Business School.
But after school ends you stop taking these drugs and just go to work. You start your life. That’s changed. People have started to take Adderall every day at their job. The rise in prescriptions are not just for kids, they are for adults.
It’s hard to find statistics on Adderall use among professionals. People aren’t going to disclose their use. It’s still a stigma. So we have to look at online threads and videos:
The mainstream media is correct to cover the Adderall shortage as big news. It really is not like other drugs. It has become this secret performance enhancing substance used by professionals who inhabit our world. It’s invisible and behind the scenes and no one wants to talk about it. Your average professional white collar worker may be on pills that make them focus 100x more than their natural state. You may be the only person in your office who is sober. Hollywood even made a mediocre movie about something like this happening a decade ago.
The human brain wasn’t built for coding or accounting. A few lucky people can do these things ten hours a day, every day, with a smile. The rest of us start fidgeting and checking our cell phone somewhere around the thirty minute mark. These are the DMs I get every so often.
Adderall works for people whether they “have” “ADHD” or not. Adderall will give everyone better concentration, and we’ve judged that it’s okay for people with terrible concentration to use it to overcome their handicap, but not okay for people with already-fine concentration to use it to become superhuman. So you need to get a prescription.
The Rise of Tele-Health and ADHD Apps
Getting an Adderall prescription has always been easy. Psychiatrists ask their patients “Do you have ADD symptoms?” and the patients say “Oh, yeah, definitely,” and then the psychiatrists give them Adderall. But you actually had to go into the office to answer this question. A few years ago, you could do it over the phone.
During the Covid epidemic 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.
Adderall prescription startups started proliferating. They even advertised on Tik-Tok with these cutesy vids to appeal to young adults.
@doneadhd Talking to a professional is always an option, whether you have ADHD or discover you don’t 📲 #adhd #adhdawareness #doneadhd
These ADHD startups made a lot of money from 2020-2023 selling Adderall prescriptions. Including this company, Cerebral:
Cerebral was investigated by the Department of Justice after it’s employees said they were told to hand stimulant prescriptions to every person who called in to the service. Pharmacies stopped filling prescriptions from Cerebral and now the company does not prescribe any stimulants. The rise and fall of a company because of a legal loophole.
Taking advantage of legal loopholes has happened before in American history. During Prohibition, doctors were able to prescribe medicinal alcohol for their patients. After just six months of prohibition, over 15,000 doctors and 57,000 pharmacists received licenses to prescribe or sell medicinal alcohol. This is how Walgreens became so big.
The Biden Administration and the FDA Crack Down
The reason there is a shortage is because the Drug Enforcement Administration (DEA), which controls the supply of the drugs, announced that it would not increase manufacturing quotas for 2023, despite having much more demand than previous years.
Each year, the DEA sets production limits for the ingredients of Schedule I and II drugs, and manufacturers apply for pieces of the quotas. Total production of a drug cannot exceed the DEA's ceiling.The DEA says it determines the quotas based on the amount that is annually prescribed. But even after the FDA reported a shortage, the DEA kept the 2022 levels intact in its 2023 quotas for Adderall's ingredients
The agency sent a letter to drugmakers 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. 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.”
The Federal Government is pushing the brakes on the rise of Adderall use. It does not want this to be the new cigarette.
However, this genie is out of the bottle.
Adderall and Us
The rest of this Newsletter will focus on:
Modern Work: Is there something about our modern work environment that causes us to reach for this substance? Are careers starting to resemble professional sports where we have to choose whether to take performance enhancing drugs to compete with our coworkers?
Adderall and Lindy: Is Adderall going to be the next Lindy stimulant? We started with Tea, we moved on to coffee and now are we going to be popping amphetamine pills in the morning? That seems extreme. What are the long term health effects?