You may have heard back in October of 2022
that there was a shortage
of the ADHD medication Adderall.
But that shortage is ongoing,
all the way in early 2024 as we’re posting this video
And it’s been a tough year for the millions of peole
who take this kind of medicine.
Yeah, no kidding!
Oh, hello!
It’s Jessica McCabe,
from How To ADHD!
Hi there, Hank!
Hello Brains
Today we thought we’d hand over this particular topic
to someone who specializes in it.
So Jessica is gonna explain the real reasons
behind this medication shortage.
Take it away, Jessica!
Let’s do it!
Over the last year, the Adderall shortage
has raised questions about
how tightly regulated stimulant medications are,
and whether those regulations work
to prevent drug misuse.
But the thing is,
the reason these pharmaceuticals
are hard to find right now
isn’t just regulations,
and certainly not misuse.
There’s another perfectly good reason
this is happening.
So let’s get into the real story
behind the Adderall shortage.
[Intro music]
When people talk about
the shortage of stimulant medications for ADHD in the U.S.,
they often point a finger at
Food And Drug Administration quotas first
The FDA limits the maximum amount of these drugs
each manufacturer is allowed to make,
so if we don’t have enough,
that seems like a logical place for the problem to start.
But according to the FDA,
the manufacturers aren’t even hitting those numbers,
and are currently
only making about 70% of what they could be.
So while the quotas may have
made pharmaceutical companies less nimble
in reacting to shortages,
they’re not the only cause.
Why do quotas even exist?
Primarily, due to concerns
about the potential for misuse.
But despite how often stimulant misuse
ends up in the news,
it’s a lot more complicated than you might think.
To start, let’s get into how
Adderall and similar medicines work.
ADHD is believed to involve two neurotransmitters:
dopamine and norepinephrine.
Neurotransmitter systems
can’t really be simplified to
“this neurotransmitter does this one thing”.
They’re more like multi-tools than a key and a lock.
But we do know there are a lot of dopamine receptors
in the areas of the brain involved
in reward, learning, memory, and movement.
And norepinephrine
can impact working memory.
All of those systems are affected by ADHD.
Stimulants like Adderall increase
the amount of dopamine and norepinephrine available for neurons
by slowing down how quickly the neurons suck them up.
In people with ADHD,
the right type and dose of stimulants
can improve focus and attention and reduce hyperactivity
and impulsivity.
In people without ADHD,
who don't need this additional dopamine and norepinephrine
the effect is… different.
Stimulants can make them feel
euphoric, energetic,
and confident that they’re crushing it,
smarts-wise.
Combine that with a drug that impacts dopamine
and the reward system,
and yeah,
Adderall definitely has the potential
to be addictive and abused by people
without an associated condition.
So as demand for Adderall increases,
the next question is,
how much of that demand is coming from misuse?
Estimates of stimulant misuse vary widely,
but studies suggest about 3.5 million people
in the U.S., have misused stimulant prescriptions.
And around 1.5 million
have met the criteria for prescription stimulant disorder
in the last year.
So it is a problem that exists,
especially among college students.
One meta-analysis found
that up to 17% of college students misuse stimulants
at some point during their academic career.
Most of the students
that report misusing stimulants use them
to do better in school, concentrate better, study longer,
and improve their skills.
But studies show that college students
who misuse stimulants
tend to spend less time studying than their peers,
and overall have either similar or lower GPAs.
And importantly, we haven’t seen a rise in misuse rates
as the number of prescriptions has gone up.
In 2019,
5.8% of young adults reported prescription stimulant misuse
in the last year.
In 2021, that dropped to 3.7%.
That seems to suggest that newly diagnosed people
are taking their drugs themselves,
not selling them to others for misuse.
So if the quotas aren’t the primary problem,
and misuse isn’t going up,
what is leading to this debilitating shortage of meds?
It turns out, there has been a major uptick
in legitimate ADHD diagnoses
in the last several years.
And the main demographic getting these diagnoses
is a group of people
who often got overlooked in the past: Adults.
For one thing, as we learn more about ADHD
the diagnostic criteria was revised in a way
that it became broader in 2013,
which meant more people qualified for a diagnosis.
On top of that, more adults
began seeking out diagnoses for something
they likely struggled with for their whole lives.
Even though the traditional view
was that people grew out of ADHD
as they aged out of childhood,
up to 90% of people diagnosed with ADHD as kids
continue to show symptoms in adulthood.
And one study showed that 75% of people
with ADHD received their diagnosis as adults.
It’s also important to consider
that there are major systemic problems
with who gets diagnosed with ADHD as a child in the first place.
The diagnosis rate for males versus females in childhood
is 3 to 1.
But in adults, it’s closer to 1 to 1.
Which suggests that
there are a whole lot of young girls
who aren’t being diagnosed when they should be.
And as you might expect,
the increase in ADHD diagnoses
has also led to an increase
In prescriptions meant to treat this condition
Prescriptions for stimulant meds jumped 10%
during the COVID pandemic, between 2020 and 2021
and have nearly doubled overall since 2011.
Part of this may be due to more awareness
as people recognize themselves
in conversations about ADHD on social media.
The pandemic itself also seems
to have played a role.
Telehealth made it more convenient
to see a doctor about these issues.
So in a weird way,
COVID may have provided a sort of breakthrough
in getting people access to treatment—
only for this shortage to take it away again.
Regulations are a real factor
in the current shortage of ADHD medications.
But a bigger one is the rise in legitimate diagnoses.
The system wasn't prepared
to handle the influx,
and we're seeing growing pains
as it struggles to catch up
with the real prevalence of this condition.
Whatever solutions governments
and pharma companies pursue,
they should keep that in mind.
Unfortunately,
many of the policies targeted at avoiding misuse
make it disproportionately harder
to obtain medication
for those who actually need them.
As the Adderall shortage continues to unfold,
it’s worth making sure that the quest
to keep stimulants out of the hands
of people who don’t need them isn’t coming
at the expense of the people who do.
Thank you Jessica
for getting into all the nitty-gritty
here with us.
You should definitely check out her channel
How To ADHD for more of her content
which is very awesome -
I’ve been following it for years
the link down below.
I also want to give a big thank-you
to our patrons
We only get to do fun,
out-of-the-box videos
like this thanks to their support,
and it means a lot.
So, to all of them. Thank you for supporting
And to everybody else thank you for watching.
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