The current shortage of Adderall, a prescription drug used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) has many students concerned, and with no sign of a resolution, they have a reason to be.
The American Journal of Psychiatry defines ADHD and ADD as an imbalance of dopamine and norepinephrine in the frontal cortex of the brain — the neurotransmitter chemicals responsible for translating signals to neurons, primary cells in the central nervous system that dictate certain behaviors. This chemical deficiency causes neurons to “misfire” information to the body, resulting in: inattentiveness, trouble focusing on specific tasks, poor memory retention, thought disorganization, fidgeting, impulsiveness, mood swings and hyperactivity that are characteristic of ADHD and/or ADD.
Adderall gives ADHD/ADD individuals the opportunity to function in daily life and, for college students, the opportunity to cope with the rigorous demands of academic studies.
“This is a society where we are expected to remain focused and still for prolonged periods of time. Some people are just not hard wired that way. In order to keep up with the challenge college brings, ADHD students need these drugs,” Dr. David Sneed of Austin Family Medicine said.
Adderall belongs to a class of drugs known as Central Nervous System Stimulants (CNS). The chemical makeup of Adderall is a mixture of amphetamine salt properties called dextro-amphetamine and amphetamine. Amphetamines cause an increase in dopamine and norepinephrine levels in the brain providing an individual with ADHD the ability to better regulate behavior and perform daily functions. Stimulants, like Adderall, are the most commonly used treatments for ADHD.
“Proper treatment can be the factor that makes it or breaks it for someone with ADHD or ADD. It can be the difference between a college graduation or flunking out,” said Austin, Texas H-E-B pharmacist, Kim Tran.
Tran also reports that H-E-B, a super market chain, has a limited supply of Adderall in stock and it is not unusual to have to send consumers from store to store in search of their needed Adderall prescriptions.
Because Adderall is classified as a CNS drug, it is regulated by The Drug Enforcement Administration and is documented as a Schedule II Controlled Substance. The Controlled Substance Act (21 U.S C Section 802) defines a controlled substance as a drug chemically structured to have a depressant, hallucinogenic, or stimulant effect on the central nervous system.
Scheduling is assessed by determining a drug’s accepted medical purpose and the drug’s level of risk of abuse with Schedule I defined as the highest risk level. Schedule I drugs are considered the most dangerous and determined to have no medical benefit, including drugs such as heroine, LSD and other street drugs.
Schedule II drugs are defined as having a limited medical purpose and are associated with a high risk of abuse level. Prescriptions for scheduled controlled substances can only be written on specially formatted hard copy prescription pads and may not be faxed or called in to pharmacies. Schedule II drugs cannot be refilled and require a new prescription each month or at the respective beginning of a new treatment period.
IMS Health, the U.S. prescription drug data tracking agency reported that in 2010, 18 million prescriptions for Adderall were written, a 13.4% increase from 2009.
Contributing to this spike in demand is the growing popularity of Adderall abuse in the college community.
Non- ADHD diagnosed students commonly take Adderall for its performance enhancing effects. Others have reported that taking Adderall enhances the high feeling when taken simultaneously with marijuana or alcohol.
An individual with normal levels of dopamine and norepinephrine and who is not considered to have ADHD or ADD may experience extended periods of intense focus, a loss of desire for sleep, and a sense of euphoria similar to the effects of cocaine or speed under the influence of Adderall due to an overflow in the brain of neurotransmitters.
Many have been able to manipulate physicians into writing prescriptions by feigning ADHD symptoms. This factor combined with lax and negligent prescription writing policies despite state regulations among medical doctors, puts a strain on the Drug Enforcement Administration controlled inventory of pharmaceutical companies such as Shire, CorePharma, Teva and Sandoz, all manufacturers of Adderall and its generic affiliates.
Several physicians have switched their patient’s medications from Adderall to alternative medications such as Ritalin but several patients have experienced negative outcomes from a switch.
The DEA releases amphetamine salts — Adderall’s base property according to what the agency considers the nation’s “legitimate need,” and pharmaceutical companies have struggled to meet the increasing consumer demand with their allotted inventory — the source of the United State’s shortage.
President Barack Obama signed an executive order in October of last year ordering drug shortage relief. In response, the DEA increased the allowed dispense figure of amphetamine salts in December of 2011 but it had only provided temporary relief and a full agreement has yet been reached.
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