For some, Adderall is a life-changing drug. But prescriptions spiked during the COVID-19 pandemic, creating increased demand and restricted supply that’s gone on for months now.
In fact, more than seven months after the FDA first announced a nationwide shortage of the drug, many are still struggling to fill their prescriptions.
“I’m not taking my full dose because I don’t know if I’m going to get it every month,” said Cape Coral resident Sara Lamb.
Lamb, a widower, and mother, has lived with ADHD for most of her adult life, all while taking care of her two sons, working full-time, and going to school.
Attention-deficit/hyperactivity disorder (ADHD) is a common mental health disorder affecting millions of Americans.
“It’s difficult enough to be in college in your 40s, but then to be in college in your 40s with a neurodivergent issue that directly affects your ability to break things down and retain information and take that information and put it to use,” Lamb said.
Without her ADHD medication, Lamb struggles to function.
“I barely was able to finish winter semester, and spring semester, I was not able to complete my classes,” she said. “Consequently, I lost my financial aid.”
The Adderall shortage has far-reaching consequences in Lamb’s life and for many others.
“We’re getting patients from all over that are looking for Adderall, their previous pharmacy couldn’t get it because they are just not selling as much as there used to be,” said Cypress Pharmacy manager Justin Ceravolo.
For months, Ceravolo has turned away new patients seeking Adderall, a controlled substance. He said there are many reasons for the shortage, such as manufacturing delays and tight regulations, but traces much of it to the COVID-19 pandemic when telehealth visits became the norm.
“So with medications like Adderall, those usually require an office visit to be fully evaluated,” Ceravolo said. “So these doctors have been able to get away with just doing telehealth, and I think that’s kind of what’s got us a little bit to this problem too, is the overprescribing.”
But Ceravolo pointed out that’s just one piece of the puzzle. Manufacturers are also dealing with a lack of the drug’s active ingredient, amphetamine. Every year, the Drug Enforcement Administration (DEA) sets production quotas for that ingredient.
An agency spokesperson directed WINK Investigates reporter Kellie Miller to their response posted online in Dec. 2022. It says, in part:
“DEA is aware of patient reports that pharmacies are unable to fill prescriptions for their prescribed Adderall or one of its generic versions. DEA consults with FDA to set the APQ for amphetamine each calendar year….
According to DEA’s data, manufacturers have not fully utilized the APQ for amphetamine in support of domestic manufacturing, reserve stocks, and export requirements for the past three calendar years 2020, 2021 and 2022. Based on this trend, DEA has not implemented an increase to the APQ for amphetamine at this time.”
“The drug makers can’t make enough due to DEA restrictions, the suppliers are causing the pharmacies to not be able to buy as much, so they’re only allocating a couple bottles here and there, and the pharmacist has to do extra work every day to constantly check to see if the suppliers are allowing you to buy more and then help service patients,” Ceravolo said.
It’s a ripple effect, and unless health authorities collectively agree on a solution, Ceravolo expects the problem to continue.
“Some people just say Adderall is the only thing that works for me, and that may be the case, but with this shortage, they really need to talk to their doctor or even come to the pharmacy and talk to us about what the problem is to see if there’s another option that they can try,” Ceravolo said.
Currently, at least five drug companies are reporting shortages of adderall, and that’s why Dr. Eddie Maristany, internal medicine physician in Naples, is doing what he can to help patients who can’t get the medication they need.
“I think Adderall is a really amazing drug and works really well,” Maristany said. “But if you combine some natural approaches with the medicine, you can reduce the dose you need, and if you’re running short on the supply, then maybe that would help you get through the interim.”
Maristany is one of the 1,200 Institute of Functional Medicine certified practitioners (IFMCP) worldwide. He believes doctors need to better discuss alternatives with their patients, and help them understand why they are experiencing ADHD symptoms in the first place.
“So, some people genetically have higher dopamine levels, and that will make them more fidgety,” he said. “So high dopamine makes you want to move a lot.”
Luckily, there are ways to adjust your dopamine levels naturally.
“So, there are some herbals that can reduce dopamine,” Maristany said. “I would consult your doctor but there’s an herbal called Bacopa, and it can help some people reduce their hyperactivity.”
Another reason you may be experiencing ADHD symptoms: Low levels of norepinephrine or adrenaline.
“If a Tiger’s about to attack you, you’re going to be focused, right? So you want a little bit of norepinephrine,” Maristany said. “If you want to read for four hours, you are going to want to have norepinephrine…So if someone were to exercise three times a week for about 30 minutes, that’s going to just by itself, assist with your focus, and increase norepinephrine.”
Some other options to help mitigate and control ADHD symptoms include Vitamin C, Omega-3s, Zinc, Magnesium, quality sleep, and diet.
“I think every parent in the world knows this, but if you give a kid a piece of cake and a Pepsi or a Coke, and then you ask the kid to relax and stay focused, it’s not going to happen,” he said. “So sugar has to be limited.”
Maristany also discussed the benefits of morning sunlight exposure.
“If you get the infrared spectrum, that helps reset your circadian rhythms, and that can also potentially be very beneficial for your brain function,” Maristany said.
Millions of Americans are suffering from ADHD, and many rely on Adderall to function. At the end of the day, Maristany just wants people to know that there are alternatives readily available.
“I have a lot of patients that have weaned themselves down from daily Adderall use to just using it two or three times a week when they really need it,” he said. “I think it’s better long term. They’re less dependent on it, and they also feel better.”