Prescription stimulant prescribing, nonmedical use, and shortages: US FDA research and response

Abstract

Shortages of prescription stimulant medications have been a challenge for patients with attention-deficit/hyperactivity disorder (ADHD) and other conditions since they began in October 2022. The US Food and Drug Administration (FDA) is committed to understanding and addressing these shortages, which are occurring in the context of significant growth in the dispensing of prescription stimulant medications to adults. Prescription stimulants are Schedule II controlled substances, defined as drugs with “high potential for abuse that may lead to severe psychological or physical dependence.” Questions remain about what is driving increased prescribing of these medications and their potential for misuse; the 2023 National Survey on Drug Use and Health estimated that 3.9 million persons aged 12 years and older in the United States used prescription stimulants nonmedically in the past year. Because the production of Schedule II substances is limited by the Drug Enforcement Administration (DEA), the usual dynamics of supply and demand in the medication marketplace do not apply.