Your guide to understanding and managing the chaos in an extra-distracting world
Imperfect Storm: The ADHD Crises
In broad terms, living in the digital age contributed significantly. Sitting in front of screens planted the seeds. Easy access to digital doctors through telehealth made diagnosis a few clicks away.
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More Screen Time = More ADHD Risk
The internet, and social media aren’t the cause of ADHD. But there are a lot of connections. Everyone, especially young adults stayed online during the pandemic.
To put it in perspective a study revealed:
- Young people who use the internet for more than 14 online activities have a 10.5% higher increase in ADHD symptoms.
- Adolescents that used half of these activities still showed a 9.5% uptick in symptoms.
- Not participating in any online activities have a symptom occurrence of only 4.6%.
The activities included:
- Online gaming (33.3%)
- Interacting or browsing social media (53.5%)
- Messaging and video chatting (52.1%)
- Online shopping
- Reading blogs or forums
- Streaming or downloading music (38.5%), shows, or movies (25.2%)
While everyone sat online during COVID-19, telehealth services boomed. As a result, more people got diagnosed and Adderall usage ramped up. The accuracy of the diagnoses is up for debate.
Getting a prescription from the comfort of home enabled opportunities for abuse.
ADHD Abuse
Young adults, teens, and college students using pills not prescribed to them isn’t new. About 5 million U.S. adults misuse prescription stimulants. In 2020, 4.4% of high school seniors surveyed said they took Adderall without a prescription. 1.7% took Ritalin illegally.
In 2017, over half of young adults (60%) admitted to abusing stimulants that weren’t theirs. Young adults ages 18-25 have the highest risk of abusing prescription drugs. 14.4% reported they used a medication not prescribed to them in 2021. A knee-jerk reaction is to point the finger at young adults. But the prevalence of adults obtaining prescriptions shines a different light:
- From 2019-2021, Adderall prescriptions increased by 16%. This reached $41 million.
- During 2019-2020, Adderall prescriptions for adults ages 22-44 ramped up 7.4%.
- If that wasn’t enough of a strain on supply, this amount doubled (15.1%) from 2020-2021.
Band-aid solutions don`t cut it
Other reasons include manufacturing issues like labor shortages and delays in certain ingredients.
Key producers like Teva (the largest maker), Lannett, and Mallinckrodt reported shortages. The end dates of the supply slump changed ongoing. This mattered a lot. These companies produced 61.3% of Adderall sales in 2021.
Cue the domino effect. Individuals without Adderall turned to their doctors for alternatives to help. Prescriptions went up for subtitutions like methylphenidate (Ritalin) and Vyvanse. A few months later shortages of these drugs popped up. For the people who took Ritalin as their original med, this was a frustrating “plink” of the domino.
Shortage
Out of stock. Out of options.
In a world that craves attention, an announcement from the U.S. Food & Drug Administration (FDA) stole the show. One of those record-scratch moments. The sudden pause stopped 16 million inattentive individuals in their tracks. Amid the absence, headlines filled the media.
Out of stock. Out of options. This was in October 2022.
What you´ll find
What’s the big deal? Why an ultimate guide?
One of the most prescribed ADHD medicines wasn’t available at pharmacies as usual. Pharmacies filled 41.4 million prescriptions for Adderall in 2021. In generic terms, its called dextroamphetamine mixed salts.
The reasons were fuzzy. A lot of finger-pointing ensued. Skyrocketing diagnoses in adults during COVID-19 increased demand that was already high. Production issues, DEA quotas, and secrets slowed the supply.
This brought another gap to the surface. There is another shortage – of current ADHD resources online. This inspired the ultimate guide you’re perusing right now.
This resource guide aims to tackle two shortages and fill in the blanks. This is for both non-ADHD and ADHD-diagnosed individuals.
In this guide, you’ll find:
- First, we’ll focus on ADHD 101
- An up-to-date look at what having ADHD means these days.
- The nationwide crises with a focus on the digital landscape.
- Handpicked ADHD resources to care for yourself or a loved one.
Hold onto your hats as we enter the “Wild West” of adult ADHD in 2023.
Catching up with ADHD
Adderall is one of the most popular FDA-approved ADHD medications. It treats attention-deficit hyperactivity disorder (ADHD) in kids and adults. About 2.5 million individuals take the generic form of Adderall in the U.S. By the way, it’s not a childhood disorder. More on that is coming up.
ADHD Defined
ADHD is a neurodevelopmental disorder. This is a condition that changes how your brain functions. It affects around 11% of kids in the U.S. It also continues into adulthood for 50 to 86% of individuals.
ADHD causes problems with:
- Paying attention and staying on task
- Struggling to control impulsive behavior
- Extra high energy levels that don’t stop
Engage in community with folks who relate and share their experiences.
Forums, Groups, Community
(ADDA) is an international nonprofit supporting adults affected by the condition. ADDA’s virtual support groups focus on embracing the individuality and diversity of people with ADHD.
Here’s a glimpse of their options (check out the full list of virtual programs).
The ADHD alarm signals when these behaviors are inappropriate for someone’s age. Anyone can get chatty and drift into a daydream. Or forget their grocery list. When these symptoms start interfering with daily life means it’s time to talk to your doctor.
Symptoms and Diagnosis
ADHD invades how the brain prioritizes actions and thoughts. Managing this can take a heavy toll on your work and personal life. You can view a comprehensive list of symptoms for all ages here. There are three types of ADHD recognized:
Is when you have a short attention span prone to distractions. Concentrating and listening to others is difficult or impossible.
Is the stereotype of a noisy child running wild in the restaurant throwing napkins up like confetti. Talking too much, interrupting, and out of control energy are telltale traits.
Is the most common type. Individuals have symptoms from both inattentive and hyperactive-impulsive types.
Thriving with Treatment
Stimulant and non-stimulant medications are the two types of ADHD drug interventions. Combined with modified CBT therapy and wellness activities, you’re cooking with the right ingredients.
Stimulant Treatments
Stimulants for ADHD are schedule II drugs. This means they are addictive and easy to abuse. There are a lot of stipulations and rules about dispensing these. These strict rules include some ingredients in common amphetamine pills like Adderall. Once the amounts are met, no more drugs can be made for the year. There are two types of stimulant medications:
- Amphetamines (Adderall, Vyvanse, Dexedrine)
- Methylphenidate (Ritalin, Concerta), which hold the top rank of stimulants prescribed.
These fall into two main categories based on how long the effects last:
- Instant-release (IR) lasting 5-8 hours
- Extended-release (XR) lasting 10-12 hours
Stimulant meds treat ADHD symptoms in 70% of adults and up to 80% of children. The drugs wake up the chemicals in your brain to interact in harmony. Starting with slow and steady doses mimics how your brain produces these chemicals.
DEA limitations and the flurry of adults diagnosis made the pending drought inevitable. Non-stimulants/alternatives for ADHD. The anti-stimulant versions are used when stimulants aren’t doing the job or if an individual has a previous substance use disorder (SUD).
These non-addictive meds can take weeks to begin working. They can also raise the risk of suicidal ideation. The upside? They’re safer from the perils of shortage situations and cravings. Atomoxetine (Strattera) is the first non-stimulant with an advisory to watch for suicidal thoughts. Otherwise, It has a strong safety profile and mild side effects.
Other brands include: clonidine, guanfacine. Learn more about non-stimulant medications here.
Once you’re diagnosed, managing ADHD isn’t just about medication. Shortage or not, a well-rounded plan reduces the havoc of ADHD. There’s a lot of ways it does this and you probably don’t want these in your life.
Don´t forget therapy
The solution? Therapy or counseling is a highly effective treatment when paired with meds. For adults, cognitive-behavior therapy (CBT) lowered symptoms by about 20% in 31% of the participants. CBT for ADHD works well in both individual and group settings. Add to this that 69% of adults who received ADHD meds and modified cognitive therapy showed improvement. This took their “much improved” to “very improved” levels.
Find an ADHD-specific coach here.
Find an ADHD-geared psychologist or therapist here.
Diagnosis Trends
The number of people that started taking stimulants increased from 3.6% in 2016 to 4.1 in 2021. Prescription stimulant fills for females ages 15–44 and males ages 25–44 increased more than 10% from 2020-2021 (peak pandemic). Along with adults in general, females are gaining recognition. Until recent times, males led the diagnosis data.
Women aged 23-49 who received an ADHD diagnosis from 2020 to 2022 nearly doubled. Did females suddenly develop ADHD traits out of thin air? We can turn to societal factors to determine why ADHD is dismissed, misdiagnosed, and treated insufficiently for women. Women need lifestyle support too. Does this apply to you? Take this ADHD test for females. This article outlines the underrepresentation of females with ADHD and why this happened for so long. Follow up with this recommended read on How to Make Friends: Advice for Women with ADHD.
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What Now? Focusing Ahead
The Adderall shortage or more accurately, the “ADHD prescription shortage” didn’t occur overnight. This means the return to a version of normal isn’t happening fast either. The Food and Drug Administration (FDA) has stated that some prescriptions won’t be filled until 2024. Both the FDA and DEA are staying tight-lipped. Measures to prevent unique and unusual crises like this are in the works. Those telehealth troubles? The DEA (Drug Enforcement Administration) has announced proposed rules for permanent telemedicine flexibilities. These stipulations speak to the issue that created the stimulant shakeup. The regulations hone in on the increased use of telemedicine services during COVID-19. Telehealth isn’t getting banned, it’s getting safeguards. The proposal doesn’t affect non-controlled medications or prescriptions written by a telehealth doctor referred by an in-person doctor visit. What it does address is removing the option to use telemedicine services exclusively to obtain a prescription for schedule II meds. There is one catch. This suggested set of rules got a lot of attention. 38,000 comments poured in. In response, the DEA and the Substance Abuse and Mental Health Services Administration (SAMHSA) made another announcement on May 9, 2023.
This extended the telemedicine flexibilities for digital prescribing. Utilizing the easy entry to ADHD drugs isn’t gone. The extension is six months. It expires on November 11, 2023. The clock is ticking for policymakers to find a middle ground to avoid shortages and reign in the Wild West of telemedicine.
There’s also the fact that no guidelines exist for ADHD diagnosis and treatment for adults in the U.S. Just children. The surge and shortage of stimulants have proven it’s not child’s play. Efforts are underway to create the first criteria for adults.
The American Professional Society of ADHD and Related Disorders (APSARD) are working on changing this to acknowledge the essential needs of patients, the public, and healthcare providers. A group of ADHD experts are working on official guidelines. Dr. Frances Levin and Dr. Thomas Spencer lead the efforts. The new standards will provide evidence-based information on adult ADHD and address concerns about using stimulants.
What’s happening? Columbia Psychiatry News interviewed Dr. Levin to learn more. Read the interview here. The digital age has accelerated supply and demand crises like this. The addictive nature of ADHD meds estomped the gas pedal. The country is waking up to some hard truths. In a world of distractions, this is the time to pay attention. Also, set your sights on fascinating ADHD resources to dive into. Here’s a handpicked sample size of real deal resources.
The Arsenal
Your ADHD Arsenal: Essential Resources
Aside from this guide, much information awaits at your fingertips. Get into ADHD resources whether you want to log off or keep your eyes on the screen.
CHADD (Children and Adults with ADHD) speak up for those with ADHD and support them. A knowledge base of all things ADHD.
(Contact an ADHD Specialist: 1-866-200-8098, M-F, 1-5 pm ET).
ADDitude Magazine has given a voice to ADHD for over 25 years.
PsychCentral will help you unlock your ADHD mind.
ADDA (Attention Deficit Disorder Association) is the world’s largest adult ADHD organization, improving lives for over 30 years.
Failing to focus? Try a tool like this Chrome extension, StayFocusd. It cuts you off time-wasting sites.
Do I Have ADHD?: Take this short, free quiz from Psych Central.
The Adult ADHD Assessment: Access your inner- ADHD and find out.
ADHD Symptom Self-Tests: Hungry for more self-assessments? No problem. ADDitude will fill your plate.
12 No-Fail Focus Tricks for ADHD Brain: Tame your ADHD brain with these mind-strengthening strategies.
The ADHD Guide to Naturally Flowing, ‘Normal’ Conversations: It’s never too late to crack the code of conversation.
Taking Charge of Adult ADHD: Step-by-step tactics to tame ADHD.
ADD-Friendly Ways to Organize Your Life: Unleash your inner on-the-ball persona.
When ADHD and Anxiety Occur Together: It’s not in your head. Learn connections and coping techniques.
ADHD, Productivity, and Working from Home: Avoid the pitfalls of working from home.
For Adults with ADHD: ADDitude Magazine’s ebook series on managing ADHD as an adult, all in one place.
A Radical Guide for Women with ADHD: A go-to for females facing ADHD.
ADHD in Young Adults: Avoiding Symptom Collisions in College, First Jobs & Beyond: Navigate the coming of age years with ease.
Cleaning your house? Long car ride? Walking the dog? Need a distraction? Pass the time with purpose.
5 Life Skills Every ADHD Young Adult Needs: A manageable number of skills to practice.
How to ADHD: Jessica McCabe’s YouTube channel is a popular series on life with ADHD. Make sure to check out her guide to working or learning from home or her breakdown of ADHD and motivation.
ADHD 365, All Things ADHD: CHADD’s two podcasts inform and
Hacking Your ADHD: This proud owner of an ADHD brain shares tested techniques.
Taking Control: The ADHD Podcast: Choose from over 400 episodes hosted by an ADHD coach pro who knows what he’s talking about.
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