Monday, June 25, 2012

Adderall Shortage Set To Continue

Adderall is a stimulant used to treat ADHD, but it's also a controlled substance due to the addictive qualities of the drug. The DEA (Drug Enforcement Agency) monitors and controls how much of the base ingredients to manufacture the drug can be distributed to pharmaceutical companies.

This bottle-neck means that manufacturers are left without the active ingredients they need to make the drug for commercial and medical use. Ironically, the system is specifically designed to prevent stock-piles of the controlled ingredients and the drug itself, that could be subverted for illicit use.

DEA assesses how much legitimate usage is likely for the year, and accordingly releases the mixed amphetamine salts to the manufacturers. However, drug makers are facing soaring demand and are finding themselves at loggerheads with the DEA. In 2010, more than 18 million prescriptions were written for the drug, a 13 percent increase from the previous year.

The drug has become popular with students who might not actually have ADHD, but seek prescriptions for it to boost their concentration during studying and examinations. It has also become quite a popular weekend party drug, as it makes a person feel more aware and confident, more focused, and when combined with other drugs, such as alcohol or marijuana, makes for a better "high".

Patient groups and doctors are beginning to complain about the shortages and are concerned that the 2012 quotas are going to be used initially to fill 2011 orders that are in the system. The manufacturing process obviously takes time as well, so it could be several months before the shortage can be relieved. Genuine patients and medical practices look set to suffer due to what can only be described as governmental red tape.

Ruth Hughes, chief executive of Children and Adults with Attention Deficit/Hyeractivity Disorder (CHADD) said :

"I am very concerned about the future ... No one seems to have much inventory to get us through the months ahead."


ADHD is a very common childhood disorder, with around 9 percent of children from five to seventeen suffering from the problem. ADHD and its treatments have triggered considerable controversy, including inputs from well known figures, such as Neil Bush (the former president's brother), who took a strong stand against medicating children.

Research does show that ADHD medications help those who cannot concentrate in school, or are unruly and hyperactive at home. Lately, research has started to show that the typical young male problem is not so noticeable in young females, who may simply appear depressed or under performing. Therefore, the 9% figure may well be an under estimate, with many young girls currently not recognizing the problem until they are adults, or even until they have children of their own who need the medication.

The DEA insisted that its quota for 2011 was sufficient, but then revised it to a higher figure in December, stating that :

"We increase the aggregate so that we will have enough to respond to specific companies if their requests for more amphetamine salts are justified and needed ... The companies can and do request more amphetamine salts, and we can and do respond to those requests throughout the year."


However, just increasing the available national quota does not immediately address manufacturer complaints that it can take the DEA months at a time to permit individual requests for new ingredients.

When asked why the process was taking so long, the DEA issued a typical political type response that doesn't go anywhere near the real issues at hand :

"We do our best to accomplish both missions, and the quota system is part of the process for achieving this."


This is not good enough, say advocacy groups, who are starting to lobby both the DEA and drugmakers to sort out the shortages once and for all. The DEA controls around 400 basic substances, in addition to their derivative products, such as salts and ethers.

Whilst some doctors are switching their patients to alternative medications, such as Ritalin, it doesn't work for everyone. Switching medication during critical moments of treatment, can undermine overall effectiveness.

Take the example of Amy Alkon, 47, who writes a syndicated column on dating and manners. Alkon began taking Adderall for her ADHD because Ritalin stopped working well for her, and she says :

"I have gone to the biggest medical centers in the Los Angeles area, I've called countless pharmacies and they have no pills. Nobody has anything."


And whilst a child might get reduced grades or be edgy or nervous in class, for an adult that relies on the treatment to maintain a professional life and a sane mental state, the prospect of not having such a basic drug available, not least one that is taken daily and is known to be addictive, must be most alarming.

This is not the first time that the government has been blamed for drug shortages. President Obama recently issued an order to drug companies and the FDA to sort out the shortage of generic inject-able medicines, that manufacturers could not produce due to lack of permits.

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