The back-to-school hunt for Adderall is on
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For a third year, back-to-school preparations will include a scramble to find popular drugs used to treat attention deficit hyperactivity disorder.
Why it matters: Despite signs from the Food and Drug Administration that manufacturers were catching up to outsized demand, the stimulants remain hard to track down with pharmacies out of stock and the Drug Enforcement Administration taking a harder line policing them.
- It's renewing concerns around access at what's traditionally a high demand time of year.
The big picture: Parents can't simply call around to other pharmacies and transfer the script since the drugs are controlled substances.
- That requires a call to a doctor — and for prescribers to track down and reroute the prescriptions themselves.
- "I ended up being on the phone to the doctor's office crying because no one has it, and I've asked them, 'What do I do?'" one parent, Jennifer Dykes, told KSLA News in Shreveport, Louisiana.
The big picture: While databases maintained by the FDA and the American Society of Health-System Pharmacists show a number of branded and generic ADHD drugs have come off shortage lists or soon will, supplies remain tight.
- Drugs like Adderall and other amphetamines like Vyvanse, as well as methylphenidate products like Concerta or Ritalin, are routinely missing from pharmacy shelves, said Adelaide Robb, the chief of psychiatry and behavioral sciences at Children's National Hospital.
- That's particularly the case for long-acting formulations that "last the whole school day," Robb told Axios. "Families are really struggling."
The FDA for 2024 predicted an average 3.1% increase in domestic use of what are known as Schedule II stimulants, which not only are used for ADHD but are prescribed off-label to treat patients with long COVID suffering from brain fog, fatigue and cognitive impairment.
Catch up quick: Federal officials officially declared a shortage of immediate-release Adderall tablets in October 2022.
- They cited a sharp rise in demand for the drug driven by telehealth diagnoses and prescribing that took off during the pandemic.
- There was a 20% increase in demand for ADHD medications in the U.S. between 2020 and 2021 alone, per data analytics company Xevant.
- But manufacturers' efforts to respond were stymied by DEA crackdowns, on plants and prescribers, driven by concerns about unleashing another addiction epidemic.
"People are trying to look for alternatives where they can but just that category, in general, is just seeing such a shortfall there's not really one shift that's solving the problem," Xevant's PBM vice president, Shane Garduno, told Axios.
The bottom line: The shortfall is creating a chokepoint in the nation's already stretched behavioral health system.
- Robb found sending prescriptions to grocery store pharmacies with regional distribution networks was more likely to get results for her patients. But that also often requires an insurer's approval to send drugs to a non-preferred pharmacy.
- "There's no flexibility in the system to meet that demand," she said. "And so then what happens is people have to go without."
