Startups are pushing ADHD meds via TikTok ads targeting doctors

A wave of startups are using slick TikTok ads and relaxed drug regulations to sell prescription drugs for ADHD like Adderall and Vyvanse, raising ethical and legal questions from doctors.

In a typical San Francisco Done spot, a young woman swallows a pill from an orange prescription bottle, while a caption reads, “What it’s like to take ADHD medication.”

The ad then switches to a shot of the woman typing on a computer while the phrases “Better focus,” “Better time management,” and “Less anxiety” appear above her head. Another shot then encourages users to “get affordable ADHD treatment” through Done’s website.

dr Ravi Shah, a psychiatrist at Columbia University, says the ad “blurs the line between a clinical indication drug and a dietary supplement for performance enhancement” because drugs like Adderall and Vyvanse are often abused on college campuses and in offices.

“The ad makes it seem like this happens if you take ADHD medication, but whether you actually have ADHD isn’t necessarily relevant,” he said.

Combined with other social media posts and patchy Google search results, the proliferation of drug ads on TikTok may convince children to self-diagnose with diseases they may not have, according to psychiatrist Dr. C. Neill Epperson of the University of Colorado.

TikTok promotion for Done
This Done ad “blurs the line” between clinical and illegal use, said Dr. Ravi Shah.

“I hear parents say, you know, my kid comes up to me and says, ‘I think I have ADHD, PTSD, bipolar disorder, etc.’ …they say where is my kid getting this from?” Epperson told the Post. “‘Where do these diagnoses come from if I haven’t taken my child to a mental health provider? We haven’t even spoken to her pediatrician.’”

“Advertisement” versus “bait”

Psychiatrists say the startups not only potentially attract users who will self-diagnose with ADHD, but also risk attracting people who want to get high or flip the pills for profit.

A TikTok ad for another San Francisco startup, Ahead, promises users “a simplified treatment” for ADHD in just three steps: “1. Fill out an online form. 2. Prescriptions Delivered. 3. Appointments are online.”

Until recently, users browsing Ahead’s website were greeted with a list of drugs: Ritalin, Adderall, Concerta, and Vyvnase — all prescription stimulants restricted by the US government due to their potential for addiction and abuse.

A TikTok ad for Ahead’s “simplified treatment.”

dr Yamalis Diaz, a specialist in child and adolescent psychology at New York University’s Grossman School of Medicine, says exposing drug names online risks encouraging potential patients to use certain drugs.

“It’s a very, very fine line between advertising and hate speech,” Diaz told the Post. “Especially with younger patients, they have certain names in their heads.”

Legal Questions

Aside from being ethically questionable, Shah added that Ahead’s practice of naming specific drugs rather than just promoting a general treatment for ADHD could violate the law.

“In my capacity of running clinics and advising companies, I would not suggest listing controlled substance names as part of marketing,” Shah said.

The Post asked the Food and Drug Administration for comment Wednesday on Ahead’s listing of specific ADHD medications. The following day, Ahead removed the list of drugs from its website, replacing it with a shorter line instead, stating that the website offers “stimulants (e.g. Adderall)”.

Some patients can diagnose themselves with ADHD from online ads, psychiatrists say.
Andrei Popov

FDA spokeswoman Kimberly DiFonzo declined to say whether the agency had contacted Ahead about the issue, saying, “FDA is not commenting on individual services or websites.”

Ahead and Done, which does not appear to list specific drug names on its website but does offer controlled substances, did not respond to requests for comment.

Medication or therapy?

Diaz, the NYU psychologist who works with children, also criticizes what she calls Ahead and Done’s “drug advertising.”

“This could mislead people into thinking that treating ADHD is drug treatment,” she said. “Indeed, the first line of treatment for ADHD should be behavioral therapy before trying medication or behavioral therapy in combination with medication.”

TikTok promotion for Done
Another TikTok ad for Done.

A third startup, Cerebral, offers both therapies and prescription drugs for ADHD and other conditions like anxiety and depression. Previously, TikTok ads flaunted ADHD meds but appeared to have removed many of them in front of you Bloomberg Exposé published on Friday. Current and former employees told the outlet that Cerebral pushed pills too hard, advertised too aggressively, and failed to adequately track patents, potentially sparking “a new addiction crisis.” Cerebral did not respond to a request for comment from The Post.

Diaz said doctors responsible for evaluating patients through sites like Done and Ahead may feel pressure to write ADHD drug prescriptions for patients who actually have other conditions, such as anxiety or depression.

“Inattention, difficulty concentrating – it’s like fever. You can’t assume it’s related to a specific thing,” she said. “I also hate it when these providers feel pressured to ‘treat’ ADHD and completely overlook or overlook that that person is struggling with another disorder.”

DEA Rules

Every doctor interviewed by The Post for this story said online health services can help increase access to much-needed treatments for many people – but also warned that so-called “telemedicine” can be dangerous without restrictions can.

In 2008, Congress passed legislation called the Ryan Haight Act, named after an 18-year-old who died of an opiate overdose using Vicodin pills prescribed to him online. The law made it illegal in most situations for doctors to prescribe “scheduled” drugs like opiates and amphetamines without first seeing patients in person.

However, the DEA changed its implementation of the law in 2020 due to the coronavirus, allowing doctors to prescribe “Schedule II through V” drugs — a category that includes narcotics like Adderall and Vicodin but excludes marijuana — over the internet. The measure will remain in effect until the coronavirus health emergency is over, according to DEA.

It’s unclear how startups like Done and Ahead, which use the convenience and speed of the internet as a key element of their pitches, will adapt if the DEA reverses the rule.

ADHD letters
“For my part, I would feel pretty uncomfortable offering someone controlled substances that I’ve literally never seen and nobody in my practice has ever seen,” said Yale Professor of Child Psychiatry Yann Poncin. “It’s very worrying.”

But Yann Poncin, a professor of clinical child psychiatry at the Yale School of Medicine, says seeing patients in person before potentially dangerous and addictive ADHD medications are prescribed is an important part of the process.

“For my part, I would feel pretty uncomfortable offering someone controlled substances that I’ve literally never seen and nobody in my practice has ever seen,” he told the Post. “It’s very worrying.”

Poncin also said the intimate nature of drug ads on TikTok — compared to traditional advertising techniques like television or magazines — can make it difficult for parents or doctors to monitor what drugs children are told to take.

“When it comes to that level of targeted marketing, the rest of us don’t necessarily know,” he said. “There is no way for people to know what other people are experiencing.” Startups are pushing ADHD meds via TikTok ads targeting doctors


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