The Business of Adderall

If you’re a young American, you're likely no stranger to the increasing prevalence of prescription medication for mental health. Whether it's you personally, a friend, or a family member, the use of powerful, mind-altering drugs like Adderall for ADHD and Benzos for anxiety has become commonplace.

But why is this happening? Is it simply a reflection of the chaotic world we live in, where stress and pressure are at an all-time high? Or is there something more insidious at play, such as the covert advertising tactics of Big Pharma on social media platforms like TikTok and Instagram?

Big Pharma Deep Dive


  • Intro
  • Adderall and Xanax
  • Marketing
  • Litigation Risk
  • Telehealth 
  • Cerebral
  • Investing Lens
  • Conclusion


The numbers speak for themselves: in 2022, over 40 million Adderall prescriptions were filled, and more than 30 million Americans are currently taking benzos for anxiety. And during the pandemic lockdown, telehealth startups that prescribe these drugs raised billions of dollars.

Ultimately, regulators thought these telehealth startups went too far. It became easier than ever to get a prescription for a controlled substance, and some nurses and doctors alleged unsafe practices.

Major pharmacies stopped filling controlled substance prescriptions from startups like Cerebral, and the FDA and DOJ opened investigations. 

But did the pandemic and telehealth startups unleash a new era of Big Pharma and the business of controlled substances, or did they merely expose a problem that had been brewing for decades?

Adderall & Xanax

Adderall and Xanax are two of the most popular drugs used to treat ADHD and anxiety, respectively.

Adderall is manufactured by the pharmaceutical company Shire US Inc., which is now a subsidiary of Takeda Pharmaceutical Company Limited. Shire initially focused on developing and manufacturing treatments for rare diseases (which are rather unprofitable) but later expanded to include medications for ADHD and other conditions.

Shire was acquired by Takeda Pharmaceutical Company Limited in 2019 for a cool $62 billion dollars.

Xanax is manufactured by Pfizer Inc., one of the world's largest pharmaceutical companies. Pfizer acquired Xanax through its acquisition of Pharmacia Corporation in 2003 for $60 billion dollars.

Adderall and Xanax both work by altering brain chemistry. Adderall floods the brain with chemicals like dopamine and norepinephrine, which increase focus and energy and improve patients’ moods.

Xanax, on the other hand, is a benzodiazepine and acts as a central nervous system depressant. It works by enhancing the effects of a neurotransmitter called GABA, which can help to reduce anxiety and promote relaxation.

Both Adderall and Xanax can be addictive because they produce feelings of euphoria and relaxation, which some people may seek to experience again and again. However, tolerance can develop quickly to both drugs, and some people may start to take higher doses than prescribed to achieve the desired effects.


​​The pharmaceutical industry is a cutthroat arena where companies battle for dominance in the market. When it comes to treating ADHD and anxiety disorders, medications such as Adderall, Vyvanse, Xanax, Ativan, and others are in fierce competition with one another. But what drives the sales of these medications? It's marketing - a critical and costly tool that drug makers use to promote their products.

The staggering amount of money spent on marketing these drugs to physicians has come under scrutiny. And it hasn’t just been since the pandemic.

Shockingly, between 2014 and 2018, physicians were showered with over $20 million worth of marketing for stimulants alone, with just under 600,000 payments made in total.

What's more alarming is that a significant portion of this marketing was targeted at pediatricians, who received over 40% of all stimulant marketing payments. As medical professionals who specialize in treating children, the ethical implications of such practices are concerning.

Litigation Risk

Drugmakers are frequently subject to lawsuits. With more Americans taking prescription medications every decade, some wonder if the ADHD epidemic is nothing more than a marketing ploy to sell more drugs.

The pharmaceutical industry has filled a void during a time where, over the last decade, the medical field has undergone a drastic transformation. Medical providers emphasize delivering medical care at a faster pace and lower cost.

This shift has created immense economic pressure to diagnose and treat all types of disorders, whether they are physical or psychiatric, in a more expedited and cost-efficient manner. 

Doctors are under immense economic pressure to diagnose and treat disorders as quickly and cheaply as possible, and some argue this leads to a reliance on prescription medication. 

Psychologists say the focus on treating patients as quickly and cheaply as possible has created a damaging stigma around mental health, with patients being told that their conditions are biological.

The truth is, there are alternative treatments such as exercise and meditation that can be just as effective, if not more so, but these options are often overlooked in favor of pharmaceuticals.


Before Covid lockdowns, patients could only get an Adderall or Xanax prescription by visiting their provider in person. But Covid lockdowns, virtual healthcare providers burst onto the scene, offering patients a safe and convenient way to receive medical care from the comfort of their own homes. 

However, as the dust settled, a troubling trend emerged: the number of ADHD diagnoses had skyrocketed, leading to a surge in stimulant prescriptions.

Some doctors argue the pandemic lockdowns made some Americans more aware of their anxiety and ADHD symptoms - the break in routine helped patients understand their shortcomings. But others think these telehealth companies exploited younger Americans especially, writing scripts for Americans that didn’t need them. Most psychiatrists don’t think these telehealth companies properly diagnosed patients before providing them with addictive, mind-altering drugs. 

But these telehealth companies were not without controversy. While controlled substance prescriptions had been big business before the pandemic, some argue telehealth startups exposed just how far the industry had gone.


As the world was gripped by the pandemic, Cerebral emerged as the trailblazer in the telehealth industry. Backed by almost $500 million in funding and a skyrocketing valuation of $5 billion, this Silicon Valley sensation became the talk of the town.

Experts hoped the flashy startup would become a force for good and revolutionize the industry. But the startup's aggressive marketing tactics, particularly on social media platforms like Facebook, Instagram, and TikTok, raised serious concerns. 

In particular, their promotion of ADHD medication has been criticized for going too far, with some ads promoting the positive effects of Adderall to younger Americans on TikTok. Other ads linked untreated ADHD to obesity and described vague symptoms associated with the condition. 

The company has stopped providing controlled substances to new patients, and laid off nearly half of its workforce.

Ultimately, Cerebral’s business practices were investigated by the Federal Trade Commission and the Justice Department. Former nurses came forward to report that they were coerced into prescribing Adderall to patients after just a brief video call, without a proper diagnosis. 

As a result of investigations, Cerebral stopped providing controlled substances to new patients and has laid off roughly 50% of its workforce. 

While Cerebral has not disclosed their financials publicly, it's widely believed that the company has suffered a significant loss in value from its $5 billion value a few years ago.

Investing Lens

From an investment standpoint, it’s tough to gauge just how profitable prescription drugs are to pharmaceutical companies. The profitability of prescription drugs can vary widely for pharmaceutical companies. Some prescription drugs can have very high-profit margins, particularly if they are protected by patents and there is little competition in the market. 

However, drugs that treat ADHD and anxiety may have lower profit margins due to competition from generic versions of the drug or regulatory pressures to keep prices low. It’s difficult to find concrete financials on specific drug brands. 

If you want to invest in pharmaceutical companies, we’d recommend doing so for reasons other than specific drug brands. Xanax doesn’t even crack Pfizer’s top ten products based on revenue. Some figures suggest that Pfizer sold around $200 million of Xanax in 2019 yet the company’s total revenue was over $40 billion.


For pharmaceutical companies, specific prescription drugs compose a small fraction of a company’s portfolio. Pfizer markets more than 350 different products, and Xanax only makes a small imprint on its $234 billion market cap.

That said, other companies in the ecosystem have tried to profit from prescription meds in recent years, especially telehealth companies like Cerebral. We expect more companies to disrupt the traditional healthcare landscape, though Cerebral may have set progress back.

Whether we like to admit it or not, prescription drugs have become big business in the United States, with pharmaceutical companies and intermediaries eager to profit from the perceived value they add.

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