I came across an article that discussed the current shortage of Adderall. I thought it might be of interest to the community.
ACSH Asks Where’s the Adderall?
The shortage of Adderall, an important medication used to treat ADHD – attention deficit/hyperactivity disorder – is a story of supply, demand, the invisible hand of market forces. It’s also about a bureaucracy focused on regulation rather than outcome. It has all the hallmarks of the opioid crisis. We have learned nothing.
ADHD is a syndrome, a constellation of symptoms grouped to define a spectrum of disorders involving attention to “detail, organization skills, memory, and self-control.” There is no specific finding, objective or subjective, what physicians would call a pathognomonic marker, that says this person has ADHD, and this is its severity.
The diagnosis of ADHD is made by considering a checklist of symptoms, guidelines developed by the American Psychiatric Association (APA). The group has identified three types of the disorder:
One needs six symptoms in either column and “a few in the other” to make a clinical diagnosis. [1] The symptoms must have persisted for at least six months, beginning before age 12. The symptoms must have been present in two or more social settings, i.e., home and school, and significantly affected the child.
The requirement of an “impairment” is a two-edged sword. It certainly is meant to raise the bar on when behavior becomes a liability, but it is a subjective judgment prone to cultural bias. In addition, since behavior is judged in the context of varying social circumstances, it is quite possible for an individual to “outgrow” and “redevelop” the impairment as their life changes. Up to 50% of patients carry these symptoms into adulthood.
In a chart review of “1594 patients across 188 pediatricians at 50 different practices,” only 70% of children diagnosed with ADHD had documentation meeting the APA criteria. Fewer than half of the patients started on medication had a follow-up in the next month to assess whether that therapy was effective. Only 13% of patients were started on cognitive behavioral therapy, which makes sense to the degree that getting patients to focus is the prime difficulty. The overwhelming majority, 93.4%, were started on medications. And that brings us to Adderall.
This is a very detailed analysis, if you wish to dig deeper, I have added the link at the beginning.
05 Apr 2023, 7:54 am
