People Suspect There's Something Off With Their Adderall. Is the Shortage to Blame?

In October 2022, the FDA confirmed that we were in the midst of an Adderall shortage, and unfortunately for many people, it's still ongoing.

Adderall — also referred to as amphetamine mixed salts — is a medication used to manage the symptoms of attention deficit hyperactivity disorder (ADHD) and narcolepsy (a chronic sleep disorder). The FDA stated in October that the organization was "in frequent communication with all manufacturers of amphetamine mixed salts, and one of those companies, Teva, is experiencing ongoing intermittent manufacturing delays."

The statement also said that "Other manufacturers continue to produce amphetamine mixed salts, but there is not sufficient supply to continue to meet U.S. market demand through those producers."

Since then, patients have complained that Adderall is still in short supply and whatever they are getting their hands on appears to be less effective. Here's what we know about the Adderall shortage so far and why the drug might seem different now.

The current shortage has not come as a shock to many experts — nor is it the first time there's been an Adderall shortage.

From September 2019 to May 2022, the FDA had previously reported a short supply of Adderall. The reasons for the recent shortage are complicated, but it seems to be in part due to the COVID-19 pandemic, which saw the explosion of telehealth services — making it easier for patients to receive an ADHD diagnosis and get a prescription. The New York Times also cites the "teenage mental health crisis" that emerged during the pandemic as a contributing factor. In recent years, the number of prescriptions for Adderall and its generic equivalents jumped 16 percent, from 35.5 million prescriptions in 2019 to 41.2 million in 2021, per the Times.

"As an ADHD coach for over five years, I noticed a spike in ADHD diagnoses and treatment since 2020 with my clients," says Brooke Schnittman, MA, ADHD coach. "It is reported that many manufacturers still cannot keep up with the demand."

It's also important to remember that Adderall and its generics are highly regulated substances in the United States, making it difficult for pharmacies to shift to other suppliers amid supply issues.

A survey by the National Community Pharmacists Association found that from July 25 through Aug. 5, 2022, almost two-thirds of the 360 independent pharmacies surveyed were having trouble stocking Adderall.

The FDA estimates that some producers of the drug will have more product available sometime in April, though it's difficult to know for sure. Teva, specifically, is listed as having many of its Adderall products available but in low inventory due to an "unprecedented increase in demand."

Since the nationwide shortage, many people on social media have complained of being given ineffective Adderall. "My Adderall is not working," one user said in a TikTok video about her most recent refill. "Does anyone else feel like their Adderall isn't working and they're low-key going crazy?" another user asked in a TikTok discussing the recent shortage.

Is the Adderall available now actually different than before? The short answer is: possibly.

"To date, the FDA has not identified safety or quality issues with Adderall products, or signals indicating a loss or change in efficacy," a representative for the FDA said in a statement, per The New York Times. But that doesn't mean the Adderall you're getting now is exactly the same as before.

There are several generic versions of the brand name Adderall, and if you've switched prescriptions, your body could be reacting to the slight change, Schnittman says. The FDA reports that "variability can and does occur during manufacturing, for both brand-name and generic medicines. When a medicine, generic or brand-name, is mass produced, very small variations in purity, size, strength, and other parameters are permitted."

"Due to the shortage, some pharmacies needed to get their amphetamines from different manufacturers. Different manufacturers can have different variations in the medication," Schnittman explains.

Another possible cause for the perceived change in Adderall? Having built up a tolerance to the drug. "Clients should consider talking to their prescriber to see if this might be the case for them, in which case they might need to get on a higher dosage or try a different medication altogether," Schnittman explains.

Right now, the FDA recommends patients work with their doctors and healthcare providers to go over their treatment options. "You can also talk to your doctor about the generic brand that works for you," Schnittman says.

In the meantime, manufacturers are working to address supply issues. "We will continue to monitor supply and assist manufacturers with anything needed to resolve the shortage and will update our website with new supply information as it becomes available," the FDA says.

"If you are at a loss, cannot find, or can no longer afford your medication, there are also natural ways to increase dopamine in the brain that can help with symptoms of ADHD," Schnittman says. This includes exercise (that you are excited about doing), walking in nature, practicing mindfulness, deep breathing, and getting reliable sleep.

You may also consider tapping a friend, coach, therapist, or mentor to help manage your time, set boundaries, and reduce stressors that can cause low dopamine levels, Schnitman says. "Try to notice your small wins as well, and carve out several moments throughout your day to notice something you are proud of; this will increase your dopamine levels."