In Crosshairs of US Opioid Crisis: Secret Pharmacy Order Triggers Shortage of Xanax & Adderall

Amid the raging opioid crisis in the United States, in line with a 2021 settlement with three of the largest drug distributors in America, limits are currently in effect that sometimes block pharmacies’ orders of controlled substances, such as Adderall and Xanax, in cases where they exceed a specific threshold.

Individuals struggling with insomnia, anxiety, and attention disorders are having a hard time getting hold of their prescribed medications due to a ‘secret’ pharmacy order limit, US media outlets have reported.

In effect, patients with legitimate needs to use controlled substances have fallen victim to the crackdown on opioids. The United States has been in the grips of a deadly nationwide opioid epidemic. Amid the heightened scrutiny, an agreement was reached last year between the attorneys general of 46 states and three major drug distributors: AmerisourceBergen Corp., Cardinal Health Inc., and McKesson Corp. New requirements are now in place for companies that provide medications to pharmacies.

The $21 billion settlement was tailored to correct previous practices that resulted in the US being inundated with prescription painkillers - something that fed into the nation’s opioid crisis. Now, distributors set strict limits on drug supplies to individual pharmacies. As algorithms are used to cap the quantities of controlled substances a certain pharmacy can sell in a month, it has affected the ability to dispense medication to patients with legitimate medical needs.

"It’s disrupting patient care," Ilisa Bernstein, chief executive of the American Pharmacists Association, was cited as saying of the July 2022 agreement.

“I understand the intention of this policy is to have control of controlled substances so they don’t get abused, but it’s not working. There’s no reason I should be cut off from ordering these products to dispense to my legitimate patients that need it,” Richard Glotzer, an independent pharmacist in Millwood, New York, was quoted as saying.

The US media report did not clarify whether the cap was having a similarly disruptive effect on major chain pharmacies.

"Irresponsible" drug company marketing and prescribing have been blamed for the opioid crisis, triggering lawsuits and a move to install tighter regulations on aspects of the health system.

The overall number of general drug overdose deaths has also skyrocketed in the United States, with 107,375 people dying in the country due to drug overdoses and drug poisoning in 2021. The Centers for Disease Control (CDC) specifically noted that illicitly-made fentanyl have played a considerable role in the surge in drug-related deaths. With only 3,105 synthetic opioid overdose deaths reported in 2013, the number reached 36,359 in 2019, with 56,516 and 70,601 deaths reported in 2020 and 2021 respectively.