Nationwide Stimulant Shortage

 Last October, the Food and Drug Administration announced that there was a shortage of Adderall. The problem has only gotten worse, affecting nearly every type of medication for ADHD.  

Unfortunately, the stimulant shortage does not look like it will end soon. The predications are it will last at least 6 more months, and possibly all of 2023. Make sure to attend all of your in- person appointments. During your appointment, make a plan of how to manage and cope when you are not able to obtain medication for a few days. Discuss if there are other medications that you are a candidate for. We are in this together and are here to support you and your loved one.   

The following are excerpts from The worst it’s ever been: mysterious US Adderall shortage puts ADHD patients at risk. Wilfred Chan, The Guardian, 1/30/2023. 

…Official explanations have offered little clarity. The FDA’s announcement mentioned “intermittent manufacturing delays” at Teva, the producer of the branded version of Adderall, but few other details. The American Society of Health Pharmacists reports shortages of multiple ADHD drugs but says manufacturers have given no explanation.

Meanwhile, the Drug Enforcement Administration (DEA), which controls the supply of the drugs, announced last month that it would not increase manufacturing quotas for 2023, despite the shortage – again, without providing a reason. One congresswoman, Abigail Spanberger, wrote to the DEA and FDA to demand an explanation last December, but Spanberger’s staff told the Guardian she had yet to receive a response. The situation has left patients in turmoil. Since the mid-2010s, adults have overtaken children in receiving prescriptions for ADHD drugs. Studies show stimulants offer dramatic benefits to ADHD patients, improving their performance at school and at work, and reducing their risk of depression, anxiety, substance abuse and suicide. 

As the coronavirus spread 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. 

Many patients were especially drawn to Cerebral, a telemedicine startup that offered mental health counseling and medication for an introductory price of just $30 a month. But ex-employees say Kyle Robertson (CEO) was only focused on profit. He saw a golden opportunity to prescribe ADHD stimulants online, and Cerebral’s pitch deck to investors contained a image of controlled substances next to the words “Now is the time to capture growth”, the Wall Street Journal reported. Ex-employees allege that Robertson, who has no medical background, was pushing his hired nurse practitioners to prescribe stimulants to as many 30 new patients a day, in online evaluations that lasted as little as 10 minutes. The gambit worked. Word spread quickly about Cerebral, and by late 2021 it had served more than 200,000 patients, had signed the gymnast Simone Biles as “chief impact officer”, and was valued at an eye-popping $4.8bn. Then things fell apart. In March 2022, a group of former staff publicly accused Cerebral of fueling a new addiction crisis by pushing the drugs. Regulators responded quickly: in May, federal investigators subpoenaed Cerebral as part of an investigation into “possible violations of the Controlled Substances Act”. The Federal Trade Commission opened a civil case into whether the company used deceptive marketing practices. (Kyle Robertson was replaced as CEO in May 2022. Simone Biles ended her endorsement in December 2022). Pharmacies including CVS Health and Wal-Mart said they would no longer fill prescriptions for controlled substances from Cerebral and Done, and in July Wal-Mart began rejecting all telemedicine prescriptions for controlled substances from patients who had not made an in-person visit.