You may not be able to refill your Adderall prescription. What’s causing the shortage?

Last week, on Oct. 12, the Food and Drug Administration announced a shortage of Adderall, a stimulant used to treat ADHD and narcolepsy that a large and growing number of Americans are prescribed.

Until the shortage is remedied, many patients across the country may be forced to consider alternative treatments, according to a release from the FDA.

What is causing the Adderall shortage?

As with many product shortages, an imbalance between supply and demand has factored into the Adderall scarcity. A growing demand for the drug, an amphetamine, fueled in part by increases in ADHD diagnoses, in addition to constraints on supply are contributing to the shortage, officials and experts say.

In recent years, there has been a large increase in the use of stimulants more broadly in the United States, with amphetamine use more than doubling from 2006 to 2016, according to a PLOS One study.

Adderall, first introduced in 1996, is no exception. In 2020, the medication used to treat ADHD was the 22nd most prescribed drug in America, with 3.6 million patients and 26 million total prescriptions, according to clincalc.com.

The rise in Adderall usage followed a substantial increase in the diagnoses of ADHD in both children and adults, prompting some to question whether the disorder is being overdiagnosed, leading to overtreatment.

“The increase in the prevalence of adult ADHD reflects the effects of many forces,” writes Joel Paris and his coauthors in a study published in the Canadian Journal of Psychiatry. “Physicians are faced with complex clinical problems for which a simple solution, leading directly to a prescription, is a tempting option.”

The lockdowns and isolation resulting from the COVID-19 pandemic also appear to have coincided with an increase in ADHD diagnoses, particularly among boys, according to Athenahealth, a healthcare company.

Telehealth companies, which were increasingly sought out during the pandemic, expedited diagnoses as well, Dr. David Goodman, director of the Adult Attention Deficit Disorder Center of Maryland, told the New York Times.

“I can understand why there are shortages, because there’s an increased demand of people who are seeking these medications,” Goodman told the outlet.

On the supply side, manufacturing disruptions have also played a role in the Adderall scarcity.

Teva, an Israeli pharmaceutical company, has experienced “intermittent manufacturing delays,” according to the FDA’s Oct. 12 release.

“Other manufacturers continue to produce amphetamine mixed salts, but there is not sufficient supply to continue to meet U.S. market demand through those producers,” the release stated.

Teva, the country’s largest manufacturer of Adderall, according to NBC News, first reported workforce shortage in August, leading to an inability to fulfill orders quickly.

The company, headquartered in Tel Aviv, said in August it was dealing with “supply disruptions,” resulting from “packaging capacity constraints” at one manufacturing plant, according to Fierce Pharma.

A spokesperson for the company told NBC that they expect “intermittent delays through [the] end of [the] year.”

Teva said in a statement to ABC News that “the supply that we are manufacturing/distributing right now is on pace to be consistent – or greater than – our supply at this time last year by the end of this year. The demand is not.”

It said it’s facing “intermittent backorders” amid “a significant rise in national prescription rates” but that it expects its inventory to be restored within months, according to ABC.

Teva is not alone in their struggle to work out the kinks in supply. A “perfect storm” of supply chain issues, including labor shortages and changes in demand, occurred during the COVID-19 lockdown, according to a J.P. Morgan report. More recently, the war in Ukraine has exacerbated problems with supply.

Representatives for Teva and the FDA did not immediately respond to a request for comment from McClatchy News.

This story was originally published October 17, 2022 at 11:39 AM with the headline "You may not be able to refill your Adderall prescription. What’s causing the shortage?."