ADHD meds contain controlled substances, and there's an annual production quota for them set by the DEA. The quota is intentionally set very tightly, so it's easy to hit it when the demand increases even slightly above projections.
Most international pharmaceutical companies have some presence in the US, so the US quota has a world-wide effect.
Additionally, prescriptions are for very specific doses of specific variants of the meds. Because it's a controlled substance, pharmacies aren't allowed to use any substitutes (not even something common-sense like dispensing 2x30mg for a 60mg prescription). This makes shortages happen even before all of the quota runs out, because some commonly used doses run out sooner.
Why would they do anything about that? It’s their job to set and enforce quotas, not to ensure access. From their perspective, I’d imagine that tight quotas make them feel reassured that they’ve got a lid on diversion concerns.
It does sound like the quota-setting system was designed for an era where the “legitimate” growth wasn’t on the order of “10% a year for 15 years”:
You're right that the DEA's quota system prioritizes diversion control over access, and it's clearly stuck in a bygone era unfit for todays demand growth. But it's baffling that Big Pharma, with its lobbying muscle, hasn't pushed Congress to modernize this bottleneck. Surely they'd profit from looser quotas.
Instead of hoping for a Trump EO to nuke the DEA (literally or figuratively), why not redistribute Controlled Substance Act enforcement? Agencies like the FBI or HHS already handle overlapping domains. The DEA's rigid gatekeeping, especially on research and quotas, stifles innovation more than it curbs abuse.
Or if the court overturned Wickard v Filburn. The Federal power to regulate substances like this at all is based on a butterfly effect version of the commerce clause.
Most international pharmaceutical companies have some presence in the US, so the US quota has a world-wide effect.
Additionally, prescriptions are for very specific doses of specific variants of the meds. Because it's a controlled substance, pharmacies aren't allowed to use any substitutes (not even something common-sense like dispensing 2x30mg for a 60mg prescription). This makes shortages happen even before all of the quota runs out, because some commonly used doses run out sooner.