Cate Osborn was having a panic attack standing in her kitchen Halloween night—the direct result of having gone without prescribed medication to treat her attention deficit hyperactivity disorder (ADHD) for about a week.
“I was literally holding a box of Halloween candy, and there was no clear surface on which to set it down,” Osborn explains. “There was just something about looking around and not having a single spare area and watching my house deteriorate around me.”
Earlier this week, they had forgotten to show up for a paid appearance as part of her job as a full-time content creator. “I can see that on the 27th I responded and confirmed, but I have no memory of sending that,” they recall.
As one of 10 million American adults who live with ADHD, Osborn has been impacted by the recent Adderall shortage, a popular medication for managing ADHD. Last month, the U.S. Food and Drug Administration announced that Teva, one of the manufacturers of amphetamine mixed salts, which are used in Adderall, is experiencing delays, while other manufacturers are struggling to keep up with demand, which is impacting people with ADHD on a personal and professional level.
Symptoms of ADHD may include trouble with paying attention, executive function, and working memory. While it’s usually diagnosed in childhood, many people, like Osborn, are diagnosed later in life. People with ADHD may also have “inconsistent performance at work or in their careers; have difficulties with day-to-day responsibilities; experience relationship problems; and may have chronic feelings of frustration, guilt, or blame,” according to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
“The thing with ADHD I wish more people understood is that it’s not just the struggle to keep something clean, to send the text or the email, or show up at the party. It’s that initial embarrassment, shame, and guilt that you forgot to come to this thing,” explains Osborn, who hosts a podcast about ADHD and shares information on TikTok under the handle, @Catiaosaurus. “Then there’s a secondary guilt or shame that the systems I worked so hard to build to make sure that I’m not late or my house stays clean have failed. And there’s the third level of knowing this has happened before and it’s probably going to happen again. You could be doing everything right, but there’s a part of the system that you can’t control, like the Adderall shortage.”
Treatment of ADHD in adults typically includes medication and behavioral management techniques. Medication types include psychostimulants, such as Adderall, and nonstimulant medications, such as Strattera. While medication does not cure ADHD, it can help ease symptoms when it’s effective.
In 2021, there were 41.4 million prescriptions dispensed for Adderall—an increase of 10.4% from 2020, according to IQVIA, a health care data analytics company, as mentioned on NBC News.
“Every person who gets Adderall has to have a new prescription every month because it’s such a difficult and controlled substance,” explains Osborn.
But as with many prescription drugs, Adderall isn’t exactly cost-effective, even with health insurance. Olivia Thompson, vice president of marketing for Sesh, a mental health platform, says she’s paid anywhere between $60 and nearly $200 for a 30-day supply.
“I also have friends who are paying out-of-pocket, and I’m scared for them. Because if they’re paying $200 now, is that going to double or triple? Are they going to be paying $600 for a drug that gets them through the day?” says Thompson. “That’s a huge concern…I think there’s going to become a black market for it, and that’s kind of sick.”
Until the Adderall supply is restored, the FDA recommends alternative treatments, including the extended-release version of amphetamine mixed salts. In addition to ADHD, Adderall is used to treat narcolepsy. Patients are advised to work with their health care professionals to determine the best alternative treatment.
“Adderall is not just about writing term papers or helping you send that email; it’s a lifesaving mental health medication in the same way that antidepressants are,” says Osborn. “For people in the ADHD community, it’s not an optional thing or a nice-to-have. It’s something they fundamentally need to get through the day.”