Adderall Safari
You may have noticed that finding your ADHD medicine has become rather difficult. The Adderall shortage has been ongoing for a few months now and there does not appear to be any end in sight. There are many reasons for this shortage and it's almost a perfect storm of factors that have converged to leave many patients without their medication. Supply and demand are still in effect and the biggest issue has been that demand for Adderall has been growing substantially. The supply side has been littered with road bumps as well everything from supply chain disruptions limiting the availability of raw ingredients to foreign labor disputes halting factory production.
The increase in demand should come as no surprise. Adderall has become a household name, like Xanax and Oxycontin it is more popular than Taylor Swift. Pharma advertising is often blamed for this but it's also the reality that these drugs are incredibly effective. Clinicians that treat ADHD are overwhelmed with patients and the next available appointment can be months out in some areas. This led to an increase in patients seeking these prescriptions through telehealth or direct servicing apps.
You may be familiar with some of these companies that market to men; Roman, Hims, Bluechew, all these companies remove the hassle of finding a doctor and getting a prescription for Viagra. Cerebral was one of the first companies to apply this model to Adderall but it did not go so well, resulting in the company falling under investigation by the DEA & DOJ. Who knows how the court case will be decided but it does not look good for the company who is already losing the battle of public opinion. CBS News recently interviewed a mother who blames Cerebral for inappropriately prescribing stimulants that played a role in her son’s death.
One report from Trinity Health concluded that the number of prescriptions written for Adderall far exceeds the number of formal ADHD diagnoses. While this is a little obvious it creates a supply snare trap further down the line. As the prescription to diagnosis discrepancy grew larger a shortage would become almost certain. Manufacturing of Schedule II controlled substances is tightly regulated by the controlled substance act and enforced by DEA scientists who use mathematical models to predict demand. The problem is the amount of diagnosis is likely an input into those models. This resulted in an inaccurate forecast and contributed to the current supply crunch.
Teva is one of the largest generic manufacturers that produces Adderall, but they were plagued with labor shortages in their packaging plants which became a choke point producing further delays in other drugs as well. These companies only have so many manufacturing facilities and they are making one product at a time, so everything gets backed up. In the background of all these issues is a looming global recession that has these vital companies not expanding to meet demand but predictably shrinking to protect profitability. Teva has been steadily closing manufacturing facilities around the world despite that though they are currently operating 56 production facilities that make 76 billion tablets/capsules a year. They produce 3700 products spread across those 56 plants, so it is very easy to see why bottlenecks occur.
Jacob Hyatt Pharm D.
Father of three, Husband, Pharmacist, Realtor, Landlord, Independent Health and Medicine Reporter
https://substack.com/discover/pharmacoconuts
@hyattjn
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Further Reading and References
https://www.cnbc.com/2022/12/07/adhd-medication-demand-us-healthcare.html
https://www.cbsnews.com/news/adderall-online-prescription-cerebral-mental-health-elijah-hanson/
https://pubchem.ncbi.nlm.nih.gov/compound/DEXTROAMPHETAMINE#section=Human-Metabolite-Information
