Violating any of the DEA’s rules can mean big trouble: anything from civil penalties to criminal prosecution.

Every link in this supply chain must also refuse and report any “suspicious orders” of unusual size, frequency or “deviating substantially from a normal pattern”. Doctors, of course, must screen their patients. Pharmacies must guard the substances under lock and key, and fill out forms if they lose even a single pill. After the agency decides its annual production quotas, manufacturers and distributors must set limits on how much of the meds each pharmacy can buy. The DEA controls their supply, under what it calls a “closed system of distribution”. That’s why amphetamine and methylphenidate are Schedule II controlled substances in the US – accepted for medical use, but with “a high potential for abuse”.

In recent months, patients have reported problems filling nearly every type of ADHD medication. The medications’ side-effects include insomnia, elevated heart rate and high blood pressure, but in larger doses they can cause panic attacks, psychosis and seizures. And like all things that get people high, they can be addictive. What they do give other people is an elevated mood – a high. Studies have found prescription stimulants have little to no effect on the cognitive performance of adults without ADHD. A 2017 analysis of millions of patient records even found that adults with ADHD taking stimulant medications were far less likely to get into a car crash.īut the drugs can also give a different kind of boost to people without ADHD. Studies show stimulants offer dramatic benefits to ADHD patients, improving their performance at school and at work, and reducing their risk of depression, anxiety, substance abuse and suicide. Since the mid-2010s, adults have overtaken children in receiving prescriptions for ADHD drugs. The situation has left patients in turmoil. One congresswoman, Abigail Spanberger, wrote to the DEA and FDA to demand an explanation last December, but Spanberger’s staff told the Guardian she had yet to receive a response. Meanwhile, the Drug Enforcement Administration (DEA), which controls the supply of the drugs, announced last month that it would not increase manufacturing quotas for 2023, despite the shortage – again, without providing a reason. The American Society of Health Pharmacists reports shortages of multiple ADHD drugs but says manufacturers have given no explanation. The FDA’s announcement mentioned “intermittent manufacturing delays” at Teva, the producer of the branded version of Adderall, but few other details. Official explanations have offered little clarity. Is it some kind of supply chain issue? A pandemic-era surge in demand? A government crackdown? What’s stranger is that no one seems to know why. Last October, the Food and Drug Administration (FDA) announced a shortage of Adderall, one of the most common stimulant medications for ADHD. For people like Faati and Erik, ADHD medication is a prerequisite for basic functioning – and over the last year it’s become dramatically harder for patients like them to access care.

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