Officials are sounding the alarm over skyhigh rates of Adderall prescriptions – warning that abuse of the drug could lead to the next opioid-esque epidemic.
A Drug Enforcement Administration chief compared the influx of new prescriptions and high risk of abuse to that of opioids in the early to mid-2000s.
The drugs have been linked to insomnia, anxiety, seizures, hallucinations and psychosis – and there is some evidence they may raise the risk of heart disease.
Matthew Strait, deputy assistant administrator in the diversion control division at the DEA, said: ‘I’m not trying to be a doomsday-er here… It makes me feel like we’re at the precipice of our next drug crisis in the United States.’
Prescriptions exploded during the pandemic with the rise of telehealth firms – with prescriptions jumping from 35.5 million in 2019 to 45 million last year.
Elijah Hanson (pictured), 21, died by suicide in June. He had suffered mental health issues for years. His family said that a recent Adderall prescription he obtained through Cerebral played a role in his death
The CDC graph shows the percent of children with a parent-reported ADHD diagnosis. One in seven boys now have attention-deficit hyperactive disorder in the US. For boys and girls aged five to 17 combined, the prevelance was 11.3 percent, or roughly one in 10
The DEA is working on new safeguards for over prescriptions of the controlled substance, which will affect how much of the drug is manufactured and how many people can access it.
The opioid epidemic in the US has killed roughly 600,000 people, and the effects are still being felt today despite prescriptions being tightened. Many experts believe the fentanyl crisis was fueled by patients addicted to opioids who had their prescription meds cut.
Deaths due to Adderall use alone are uncommon, and it’s typically involved with other fatal substances such as heroin which can lead to overdose.
But the drug, which is a stimulant similar to methamphetamine and cocaine, is highly addictive and people sometimes turn to street versions, which may contain even more harmful substances.
The above shows the number of prescriptions for Adderall given to age groups by year. It shows under-21s (light green), 22 to 44 year olds (light blue) and over-45s (dark blue)
During the pandemic, when millions of Americans were trapped in isolation in an effort to stave off infection, telehealth firms like Cerebral flourished, offering people a lifeline when they couldn’t otherwise see their normal doctors.
But Cerebral, which requires users to be 18, and others have come under sharp scrutiny for what investigators have deemed overly liberal diagnoses of ADHD.
Over diagnosis is a problem because it leads to overtreatment.
Arrive Health, a health technology company based in Denver, Colorado, estimates that ADHD drugs now makes up 2.3 per cent of all prescriptions written in the US.
This is more than double the figure from January 2020 – just before the pandemic started – when the drug made up just one per cent of scripts.
David Goodman, a psychiatrist and assistant professor at the Johns Hopkins University School of Medicine, told Bloomberg: ‘The crisis, if you will, is not in the prescription of the medication.
‘The crisis is in the accuracy of the diagnosis.’
In the US, an estimated 6.1 million children and adolescents have been diagnosed with ADHD, compared with around 3.3 million in the EU.
Overprescribing has had disastrous consequences. For example, Elijah Hanson, 21, was found dead by his family on the kitchen floor in Tacoma, Washington, on June 25 after filming himself playing Russian Roulette with a loaded handgun.
He had been abusing Adderall in the months leading up to his death, having been able to secure a prescription online by lying to telehealth providers – even though he had previously suffered from other mental health issues.
There currently are no standards for diagnosing adults with ADHD, though specialists have been working for about two years to establish them, according to the Wall Street Journal.
ADHD affects adults, though it is commonly diagnosed in children, who are also prone to overprescription and overdiagnosis.
An estimated one in four US teens at some schools are abusing prescription stimulants such as Adderall, according to research from the NIH.
Meanwhile, the CDC reported that the percent of children with a parent-reported ADHD diagnosis has increased steadily over time.
The agency found 14.5 percent of American boys have the developmental problem linked to poor concentration — up from just under ten percent in 2000.
One in seven boys now have attention-deficit hyperactive disorder in the US. For boys and girls aged five to 17 combined, the prevelance was 11.3 percent, or roughly one in 10.
A major report in 2021 found that the diagnosis of ADHD has increased worldwide since the 1980s, yet there was no corresponding increase in ADHD symptoms during that time.
Dr Luise Kazda, a researcher at the University of Sydney involved in the study, said: ‘Children now, on average in the population, are just as symptomatic as they were 20–30 years ago,’ she said.
‘So there hasn’t been this huge increase in all these children being now hyperactive or inattentive; that’s really remained very steady.’
The paper concluded there was ‘convincing evidence’ of ADHD overdiagnosis and overtreatment in children and adolescents.
Overprescribing is what kicked the opioid epidemic into high gear. It arose from the pharmaceutical company-peddled messaging that pain is another vital sign that must be addressed by doctors and should always be treated to the best of their ability. That included prescribing painkillers.
In the mid-2000s, opioids flooded cities big and small. In Cabell County, West Virginia, which was once dubbed the ‘epicenter’ of the epidemic. Drug wholesalers AmerisourceBergen, Cardinal Health and McKesson shipped roughly 81 million highly addictive opioid pills to pharmacies in Huntington, located in the county.
Overprescribing gave way to an explosion in heroin use on the streets, followed by much cheaper fentanyl, a synthetic opioid that has permeated the drug supply and snuck into other drugs like heroin and Xanax, drastically increasing the odds that a person will overdose and die.
The amount of fentanyl that could prove fatal could fit on the tip of a pencil, and it’s about 100 times more potent than morphine.
