The New York Times and The Boston Globe both ran articles about the shortages of generic ADHD medicines on New Year's Day.  The Times described a tug-of-war between the FDA and the DEA regarding its cause...and even its existence!  A spokesman from the DEA stated that there were plenty of ADHD medicines.  He went on to say that the problem was that manufacturers had chosen to make more brand name medicines rather than funneling their allotted active ingredients to the cheaper generic drugs.  He did not address the fact that companies which make only generic medicines suffered equal shortages nor did he acknowledge the shortages of brand name versions as well.

 

According to the articles, the DEA believes that the increased demand for Adderall is principally abusive.  One statement described college students taking the pills to stay up all night and liking the sensation so much that they continued to use it after they graduated.  Another DEA spokesman cited the ongoing shortages of non-controlled generic medications as being evidence that DEA regulations did not contribute to the shortage of controlled generic medicines.  (Manufacturers of "old fashioned" generic injectable medicines have stopped making them in favor of newer medicines that bring in more profits.  This is causing problems in hospitals since the "tried and true" remedies are often safest and most effective for the majority of patients.)

 

The Food and Drug Administration (FDA) on the other hand, has been fielding dozens of calls every day from patients who cannot get their legitimate prescriptions filled.  Spokesmen from CHADD and an organization of child psychiatrists both cited serious problems for patients who risked school failure, car crashes and job losses without their prescribed medication.

 

Personally, I am conflicted about the issue.  On the one hand, there is a big problem with the abuse and misuse of stimulants.  Regulation by the DEA and DPS is necessary at all levels: manufacturers, distributors, pharmacies, prescribers and consumers.  The short-acting generics are more likely to be abused than are the more expensive, longer-acting medications and so there is some justification for limiting the availability of the short-acting substrates.  On the other hand, some patients simply cannot afford the higher priced pills with better availability.  There are also patients who  do not tolerate the longer acting medicines and others for whom they do not work as well.

 

The good news is that regulations have allowed for more medications to be available in 2012 than were present in 2011.  It remains to be seen whether the increases are sufficient to prevent any shortages... and whether abuse becomes more common.  It will be interesting to review the investigations of stimulant misuse and abuse.  Which side of the controversy would be supported if the number of reported violations was significantly lower than expected?