The essay’s central argument rendered as geometry: the DEA production quota flatlined while prescriptions climbed 24%. The widening space between the two lines is the structural crack the essay traces from telehealth waivers through the 2022 shortage.
Adults drove the prescription surge. Pediatric fills actually fell. Meanwhile, two telehealth companies industrialized the diagnostic encounter — and were prosecuted for it.
| Metric | Done Global | Cerebral |
|---|---|---|
| Patients | 67,000 | — |
| Pills Prescribed | 40M+ | — |
| Revenue | $100M+ | — |
| Rx Rate Target | — | 95% (100% ADHD) |
| Peak Valuation | — | $4.8B |
| Ad Spend | $40M | — |
| Outcome | Convicted (Nov 2025) | $6.57M penalty |
The first federal telehealth drug distribution prosecution did not retract the demand. The 90.2M fills recorded in 2023 include patients who entered the system through telehealth doors that have since been shut. The demand is baked into the DEA’s quota baseline.
The commodity chain reimagined as a data flow. Each node carries a stat from the essay. The prescription node is the hinge point — the gatekeeping layer that COVID digitized.
The same chain I traced at twenty-two. China sources the raw chemicals. India processes them. The United States consumes the finished product. The generic market is fragmented — no single manufacturer serves as backstop.
| Node | Location | Role | Risk |
|---|---|---|---|
| KSMs | China | Key starting materials | Cost advantage, single-source concentration |
| APIs | India | Active pharmaceutical ingredients | Manufacturing concentration, regulatory variation |
| Finished Forms | United States | Generic manufacturing & distribution | Quota cap: 21.2M g (frozen 2021–2024) |
| Prescribing | Digital | Telehealth (post-COVID) | Gatekeeping layer removed |
If Adderall was the rehearsal, GLP-1 agonists are the performance at scale. Same structural pattern, compressed timeline, larger addressable market, higher price point.
Rising & Califf (JAMA Psychiatry, 2025) drew the parallel explicitly: the pattern of stimulant overprescribing through telehealth platforms resembles the pattern of opioid overprescribing through pain clinics in the 2000s. The structural mechanics are identical. A legitimate medical need exists. A prescribing infrastructure develops to serve it. The infrastructure is captured by commercial interests that widen the definition of “legitimate need” until it encompasses anyone willing to book an appointment.
| Statistic | Value | Source |
|---|---|---|
| Total Stimulant Fills (2023) | 90.2 million | DEA / IQVIA, 2024 |
| Total Stimulant Fills (2019) | 72.8 million | DEA / IQVIA, 2024 |
| Prescription Growth (2019–2023) | +24% | DEA / IQVIA, 2024 |
| Pediatric Fill Change | −6.5% | DEA / IQVIA, 2024 |
| DEA d-Amphetamine Quota (2021–2024) | 21.2M grams (frozen) | DEA Diversion Control |
| DEA Quota Adjustment (Oct 2025) | 26.5M grams | DEA, first mid-year adjustment |
| Adults Reporting Fill Difficulty | 71.5% | CDC MMWR, Oct 2024 |
| Adults with Current ADHD Diagnosis | 15.5 million | CDC / NCHS, 2024 |
| Diagnosed at Age 18+ | 55.9% | CDC / NCHS, 2024 |
| College Stimulant Misuse (past year) | 8% | Wong et al., 2022 |
| College Stimulant Misuse (lifetime) | 17% | Wilens et al., 2020 |
| TikTok #ADHD Views | 39.7 billion | PLOS ONE, 2025 |
| TikTok ADHD Content Classified Misleading | 52% | PLOS ONE, 2025 |
| Done Global — Pills Prescribed | 40 million+ | DOJ, Nov 2025 |
| Done Global — Revenue | $100 million+ | DOJ, Nov 2025 |
| Cerebral — Rx Rate Target | 95% (100% for ADHD) | Nonprosecution agreement, 2024 |
| Ozempic Rx Growth (YoY) | +152% | Wojtara et al., 2023 |
| GLP-1 Prescriptions (Q4 2022) | 9 million | Wojtara et al., 2023 |
| GLP-1 Users from Unregulated Sources | 23% | Hendrix et al., 2025 |