K., a 51-year-old pharmacist in Bergen County, New Jersey, wasn’t surprised when the United States Food and Drug Association announced a national shortage of Adderall in October.
In recent years, she’s seen so many people come into her Walgreens with an Adderall prescription that she can rattle off their archetypes: “The workers who want to keep up with the competition, to get the edge on the story, to get the promotion in the law firm, doctors trying to work extra hours,” she said. Due to Walgreens company policy, K. requested anonymity.
One patient recently came in with a prescription for 100 milligrams a day, more than double the 40 milligrams on his previous medication and above the FDA-recommended amount of Adderall, which varies based on a person’s height and weight.
K. says she’s flagged suspicious activity twice in the past year to the Drug Enforcement Administration when patients came to her pharmacy with high-dosage prescriptions. Later, she discovered those two doctors’ licenses had been revoked.
Adderall is a drug that stimulates the nervous system. It’s in a category of drugs commonly referred to as “uppers,” the type of medical drugs misused the most frequently. According to Iqvia Holdings, 41.4 million people were prescribed Adderall in 2021, which is up 10.4% from 2020.
K’s years of pharmaceutical experience lead her to believe that Adderall prescriptions have become a fad and that lasting problems will occur.
The shortage is her fears coming to fruition.
“There’s a decreased medication availability because of the shortage, people are suffering, having side effects, and you don’t know what they’ll turn to on the street,” she said.
“This is how the opioid crisis started.”
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Adderall treats mental disorders like Attention Deficit Hyperactivity disorder (ADHD). Since 2019, Adderall prescriptions have steadily increased across the United States, predominantly among adults aged 22-44. In 2018, more than five million prescribed Adderall users were misusing the drug, and the National Institute of Drug Abuse recommended a decrease in prescribing amphetamines. But especially among young adults, usage has only increased.
Following the opioid crisis, Walgreens and other pharmacies created a policy that allows pharmacists to deny prescriptions if they fear a patient is misusing the drug. K. says the drug she and her colleagues most often refuse to fill is Adderall.
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Mike Young’s reasoning for his Adderall prescription is blunt.
“I didn’t think I would have been capable of going out and getting an impressive job and being able to grind away for 8, 10, 12 hours a day if needed without it,” Young said.
Young, 24, said he began regularly taking Adderall when he was 22. He graduated from Rutgers University in May 2020 amid the COVID-19 pandemic. While searching for a finance job, he sought an Adderall prescription to help him focus. When he moved to Manhattan and started at Bloomberg as an FX Analyst, he quickly noticed that he wasn’t the only one with a prescription.
“I became pretty close friends with most of my co-workers. Most of them were prescribed Adderall,” said Young.
Young left Bloomberg in 2021 and began working at AscendX, a global cryptocurrency platform. As Young entered the New York dating scene and expanded his social circles outside of work, he noticed many other people had Adderall prescriptions, too.
“It was a crutch that most people seem to rely on to some degree,” he said.
Young received his prescription from his primary physician, but the COVID-19 pandemic and push toward telehealth allowed many others to get theirs online. When the United States declared a health emergency in January 2020 during the pandemic, telehealth companies could bypass the Haight Act, which previously prohibited prescribing controlled substances to a patient in the United States without an in-person doctor visit.
Emily Malachane, 23, graduated from Fordham University in 2021 and was prescribed Adderall that same year by her psychiatrist. She was asked questions about her concentration, forgetfulness, and mental health. Malachane was diagnosed with ADHD, then worked with a psychiatrist to find an Adderall dosage that fit her. For people with ADHD, said Malachane, Adderall improves productivity and mental health. But she doesn’t think everyone who has a prescription actually needs it.
“More people are on Adderall now because it’s easier than it was in the 2000s and 2010s to get it. It’s so readily available,” said Emily Malachane.
“I don’t think Telehealth companies have such a rigorous process.”
Last summer, The Wall Street Journal reported the DEA launched an investigation into the prescription practices of Cerebral, a telehealth company that launched in January of 2020. Several former company employees alleged they had been encouraged to prescribe Adderall to patients to maximize profits. As a result, The United States Department of Justice is conducting an ongoing investigation into the telehealth company for possible violations of the Controlled Substances Act. In response, CVS, the largest pharmaceutical company in the United States, announced that they would no longer fill prescriptions from Cerebral.
In the aftermath of these events, Cerebral confirmed to Insider in mid-summer of 2022 that it halted prescribing substances, including [but not limited to] Adderall. Existing patients would also lose access to the drugs they had become accustomed to taking by mid-October.
Stopping or weaning off Adderall can be tough for some patients, and can include withdrawal symptoms like depression and fatigue, according to the National Institute on Drug Abuse.
Because of the shortage, Malachane’s had her own issues accessing Adderall. Without it, she says it’s challenging to get things done.
“I feel like there’s nothing driving me to do anything,” she said.
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- doesn’t think telehealth companies are the sole reason Adderall prescriptions are so common. She believes many doctors prescribe drugs too quickly and without a proper medical evaluation.
“Doctors need to strategically pick the right medication for the person, their personality, their body’s metabolism, their body’s chemical makeup,” said K.
“It all makes a difference.”
As of February 2023, there’s still a shortage of Adderall. According to the FDA Shortage tracker, it’s due to the unprecedented increase in demand.
Young recently quit his job at the cryptocurrency firm and is now a bartender in Manhattan. As he continues searching for a career in the workforce he is more suited for, he’s also trying to wean himself off of Adderall. It scares him, he says, that because his body is so accustomed to the drug when he does not take it, he is a lesser version of himself without it.
“It’s like I’m below baseline,” he said.
Young thinks the real reason why so many young people seek out Adderall is because of societal pressure to subscribe to the social norms of a white-collar job.
“Adderall just makes all of that easier,” he said.
“And it’s just a real shame that young people need to feel that pressure in the first place. Because if they didn’t, they wouldn’t have to go out and seek these magic pills that help them do things they’re not suited for,” Young said.