Amid the ongoing Adderall shortage, students across the U.S. are feeling the consequences. An essential treatment for attention deficit hyperactivity disorder (ADHD) and narcolepsy, Adderall is an amphetamine that acts as a stimulant within the central nervous system.1
The FDA first announced the shortage of Adderall in October of 2022.2 Ever since, patients have been scrambling to find effective ADHD treatments at a reasonable cost. Students with ADHD rely on this medication or its generic versions to maintain focus and succeed academically, so colleges and universities need to be proactive about ensuring their students receive the right care.
Below, we’ll discuss the current shortage of generic versions of Adderall and Concerta. Then we’ll outline how Wellfleet Rx is providing support for students during this time of uncertainty.
What is Adderall?
Adderall is a medication used to treat ADHD, a condition that causes difficulty focusing, restlessness, and impulsiveness.3 Adderall and other stimulants are also used to treat narcolepsy, a condition that causes individuals to fall asleep spontaneously.
The mainstays in the treatment of ADHD divide into two categories, amphetamines (Adderall, Vyvanse) and methylphenidates (Concerta, Ritalin).4 These medications and their generic forms help patients increase focus and decrease hyperactivity because of their effects on the central nervous system.
While it is still unknown what mechanism improves ADHD symptoms, amphetamines are thought to be effective at treating ADHD because they increase the amount of norepinephrine and dopamine between the neurons.1
Neuron biomarker in patients with ADHD. Source: International Journal of Molecular Sciences
What’s causing the ADHD medication shortage?
The shortage of amphetamine mixed salts like Adderall has stemmed from manufacturing delays as well as the inability of producers to keep up with increases in demand.2 Demand for ADHD medications has risen since Covid-19, one of the many mental health effects of the pandemic, with prescriptions for Adderall rising by 30 percent in the last five years, according to The Washington Post.5
The increase in prescriptions can be attributed to a higher demand, partially caused by the rise in telehealth utilization. This leads to an unexpected increase that the supply chain cannot keep up with.5
Impacts of the Adderall shortage on college students
It’s important to understand the downstream effects your students may experience because of ADHD medication inaccessibility. Here are four impacts of the Adderall shortage on students.
1. Alternative therapy regimens
Because of the Adderall shortage, students have needed to turn to alternative therapies, dosages, and medications to control their mental health. This can mean patients are put on suboptimal regimens. The brand-name Adderall has more availability than the generic, so patients may need to switch to the brand name, which can cost hundreds of dollars more per month than the generic form.6 College students generally do not have the capital to spend this much on medications.
Many patients are rationing their medication by taking smaller doses or skipping medication on weekends.6 These alternative strategies are only a temporary means to get through the ADHD medication shortage, and patients are eagerly awaiting the return of a stable supply so they can get the best therapeutic effect.
2. Reemergence of symptoms
Patients who are undertreated or treated with a less effective substitute often notice their symptoms return. Those with ADHD can experience a range of symptoms, such as:
- Difficulty focusing
- Excessive talking and moving
- Impulsive decision making7
3. Behavioral issues
Because of the Adderall shortage, students with ADHD may have more difficulty maintaining healthy and acceptable social behavior. Untreated ADHD patients can experience a wide range of behavioral issues, including:
- Struggling to wait in line
- Difficulty following directions7
ADHD’s behavioral effects can have a negative impact on college students’ friendships and social circles, as well as their relationships with professors and faculty.
4. Decreased academic performance
Perhaps one of the most notable struggles that college students face because of the unavailability of ADHD medications is academic difficulty. The effects can enter the classroom in many forms.
The inattention symptoms of ADHD can emerge as students have difficulty focusing and listening during class. They can also get easily distracted and lack the organizational skills needed to study independently. The hyperactivity symptoms of ADHD can make it hard for students to sit still and learn quietly in the classroom setting.7
College students deal with high expectations and a lot of responsibility. They need to manage their academic life along with their mental, emotional, and social health. Providing college students with the best possible resources is key to solving the mental health challenges on campuses brought about by the Adderall shortage.
When will the shortage end? What to expect
According to the FDA, the ADHD medication shortage is due to an increase in demand as well as shortage of the active ingredients needed for these medications. Once supply can keep up with the new demand, we should see a resolution of the shortage. The FDA predicts that amphetamine shortages should resolve sometime between April and June 2023, depending on the manufacturer, though the exact timing is unknown.8
How Wellfleet Rx is addressing the shortage
As we wait for ADHD medication supply to rise to meet the demand, Wellfleet Rx is committed to doing all we can to ease the burden on colleges and students.
Here are a few of the steps Wellfleet Rx is taking to give our students the right care amid the Adderall shortage:
- Temporary extension of quantity limits on lower strengths of covered generics to allow pharmacies to give more units of lower-strength medications if higher-strength medications are unavailable.
- Offering case-by-case overrides to cover brand Adderall, Adderall XR, and Concerta if a pharmacy cannot access generic forms of the medications.
- Active monitoring of ADHD medication supply. If both brand and generic forms undergo shortage, we will provide access to clinically appropriate alternative treatments.
Learn more about Wellfleet’s response
1 FDA. (2007, March). Adderall (CII). U.S. Food and Drug Administration. Retrieved April 4, 2023, from https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf.
2 FDA. (2022, October 12). FDA announces shortage of Adderall. U.S. Food and Drug Administration. Retrieved April 4, 2023, from https://www.fda.gov/drugs/drug-safety-and-availability/fda-announces-shortage-adderall.
3 Mayo Foundation for Medical Education and Research. (2023, January 25). Adult attention-deficit/hyperactivity disorder (ADHD). Mayo Clinic. Retrieved April 6, 2023, from https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878.
4 Barlow, R. (2022, December 5). What’s behind the Adderall shortage and what does it mean for those being treated for ADHD? BU Today. Retrieved April 6, 2023, from https://www.bu.edu/articles/2022/behind-the-adderall-shortage/.
5 Gilbert, D., & Amenabar, T. (2023, April 4). An Adderall shortage has not let up. Here is why. The Washington Post. Retrieved April 5, 2023, from https://www.washingtonpost.com/business/2023/03/14/adderall-shortage-telehealth-prescriptions/.
6 Heubeck, E. (2023, March 3). Some ADHD medications are in short supply. Schools are feeling the fallout. Education Week. Retrieved April 4, 2023, from https://www.edweek.org/teaching-learning/some-adhd-medications-are-in-short-supply-schools-are-feeling-the-fallout/2023/03.
7 National Institute of Health. (2021). Attention-deficit/hyperactivity disorder in adults: What you need to know. National Institute of Mental Health. Retrieved April 5, 2023, from https://www.nimh.nih.gov/health/publications/adhd-what-you-need-to-know.
8 FDA. (2023, April 5). FDA drug shortages. FDA Drug Shortages. Retrieved April 5, 2023, from https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Amphetamine%20Aspartate;%20Amphetamine%20Sulfate;%20Dextroamphetamine%20Saccharate;%20Dextroamphetamine%20Sulfate%20Tablets&st=c&tab=tabs-1.