FDA and DEA 2023: stimulant shortages, record prescribing, and a quota that makers did not fill
In August 2023 the heads of the FDA and DEA wrote that stimulant dispensing rose 45.5 percent from 2012 to 2021, and that amphetamine makers sold about 70 percent of their 2022 quota, about 1 billion doses short.
We have not finished checking this source. No judgement either way. how we score evidence
Caveat on this rating: Regulators describe both an access problem and a prescribing-volume problem without weighing them; figures describe 2022 to 2023.
A joint letter from the two federal agencies that control stimulant supply, explaining the shortage in their own words.
Significant findings
On 1 August 2023 the leaders of the FDA and the DEA wrote an open letter on the shortage of prescription stimulants used for ADHD, binge eating disorder and narcolepsy. They said the shortage "began last fall due to a manufacturing delay experienced by one drug maker. While this delay has since resolved, we are continuing to experience its effects in combination with record-high prescription rates of stimulant medications." Dispensing of stimulants "increased by 45.5 percent in the United States" from 2012 to 2021, with some age groups growing by more than 10 percent during 2020 to 2021, when virtual prescribing was widely permitted.
On supply, DEA sets production quotas, and "for amphetamine medications, in 2022, manufacturers did not produce the full amount that these limits permitted them to make... manufacturers only sold approximately 70 percent of their allotted quota for the year, and there were approximately 1 billion more doses that they could have produced but did not make or ship." The agencies asked manufacturers to raise production or give up unused quota for redistribution, and said "The FDA and DEA do not manufacture drugs and cannot require a pharmaceutical company to make a drug, make more of a drug, or change the distribution of a drug."
The other direction
The letter says "We want to make sure those who need stimulant medications have access," and in the same paragraph that "it is also an appropriate time to take a closer look at how we can best ensure these drugs are being prescribed thoughtfully and responsibly." It describes stimulants as "controlled substances with a high potential for abuse". Both readings, an access problem and a prescribing problem, are in the regulators' own text; the letter does not settle which matters more.
What this does not show
It does not say whether any one person's prescription is appropriate, and it describes 2022 to 2023 supply, not today's. It is not a reason to change or stop a medicine.
Worth asking
If my pharmacy cannot fill my dose, what are the safe options my prescriber would consider?
Source
Joint letter from the FDA and DEA to the public on the ongoing shortages of prescription stimulant medications — US Food and Drug Administration; Drug Enforcement Administration (2023)
Regulator or national health body
How this was scored
- Study design
- Regulatory safety determination
- Funding
- not recorded
- Published in
- Regulator or national health body
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
We have not finished checking this source, so there is no scoring to show yet. “We have not checked this yet” and “this is disputed” are different statements, so no scored band is shown rather than a low one.
Read the full scoring rubric, including what it can't tell you.
Published October 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "not yet assessed". We have not finished checking this source. No judgement either way. One caveat travels with that badge: Regulators describe both an access problem and a prescribing-volume problem without weighing them; figures describe 2022 to 2023. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Joint letter from the FDA and DEA to the public on the ongoing shortages of prescription stimulant medications — US Food and Drug Administration; Drug Enforcement Administration (2023). Published in: Regulator or national health body. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Regulatory safety determination. Funding: not recorded. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.