For those with visual impairments, language models can summarize visual content and reformat information. Tools like ChatGPT’s voice mode with video and Be My Eyes allow a machine to describe real-world visual scenes in ways that were impossible just a few years ago.
AI language tools may be providing unofficial stealth accommodations for students—support that doesn’t require formal diagnosis, workplace disclosure, or special equipment. Yet this informal support system comes with its own risks. Language models do confabulate—the UK Department for Business and Trade study found 22 percent of users identified false information in AI outputs—which could be particularly harmful for users relying on them for essential support.
When AI assistance becomes dependence
Beyond the workplace, the drawbacks may have a particular impact on students who use the technology. The authors of a 2025 study on students with disabilities using generative AI cautioned, “Key concerns students with disabilities had included the inaccuracy of AI answers, risks to academic integrity, and subscription cost barriers,” they wrote. Students in that study had ADHD, dyslexia, dyspraxia, and autism, with ChatGPT being the most commonly used tool.
Mistakes in AI outputs are especially pernicious because, due to grandiose visions of near-term AI technology, some people think today’s AI assistants can perform tasks that are actually far outside their scope. As research on blind users’ experiences suggested, people develop complex (sometimes flawed) mental models of how these tools work, showing the need for higher awareness of AI language model drawbacks among the general public.
For the UK government employees who participated in the initial study, these questions moved from theoretical to immediate when the pilot ended in December 2024. After that time, many participants reported difficulty readjusting to work without AI assistance—particularly those with disabilities who had come to rely on the accessibility benefits. The department hasn’t announced the next steps, leaving users in limbo. When participants report difficulty readjusting to work without AI while productivity gains remain marginal, accessibility emerges as potentially the first AI application with irreplaceable value.
While supplies of Adderall and its generic versions are finally recovering after a yearslong shortage, the Drug Enforcement Administration is now working to curb the short supply of another drug for attention-deficit/hyperactivity disorder: Vyvanse (lisdexamfetamine) and its generic versions.
“These adjustments are necessary to ensure that the United States has an adequate and uninterrupted supply of lisdexamfetamine to meet legitimate patient needs both domestically and globally,” the DEA said.
Quotas
Just like Adderall (amphetamine/dextroamphetamine salts), Vyvanse (lisdexamfetamine) is an amphetamine-class stimulant classified by the DEA as a Schedule II drug. As such, the DEA controls its production levels to ensure demand is met while preventing excess supply that could find its way to the black market. The administration does this by setting an “aggregate production quota”—which is what the DEA adjusted for lisdexamfetamine this week—and doling out undisclosed allotments to drug manufacturers.
While various factors have contributed to the shortages of ADHD medications, some medical and industry groups have placed blame on the DEA’s quota system for underestimating demand and choking supply. For instance, the Adderall shortage began in 2022 following a labor shortage on the product’s production line at Teva, Adderall’s maker. But, while that production snag was resolved, prescription rates increased significantly, in part due to increased awareness of ADHD, broadening diagnosis criteria, and an increase in access with the rise of telehealth services, which boomed during the COVID-19 pandemic. In a report earlier this year, the American Society of Health-System Pharmacists pointed to the DEA’s quotas, saying they’re “exacerbating” shortages.
In an August 2023 joint letter, the DEA and the FDA responded to such criticism, suggesting that the quotas aren’t to blame. Rather, it’s that some manufacturers are not using up their allotment of controlled drugs.
“Based on DEA’s internal analysis of inventory, manufacturing, and sales data submitted by manufacturers of amphetamine products [which include the two ADHD drugs], 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. Data for 2023 so far show a similar trend,” the FDA and DEA wrote.
The FDA and DEA said they would work with manufacturers to ensure they would ramp up production of drugs in short supply or relinquish their remaining allotments.
Vyvanse shortage
A similarly complicated situation is seen with the current shortfall of Vyvanse and its generics. The DEA raised the quota after prodding from the Food and Drug Administration. In July, the FDA sent the DEA a letter requesting a quota increase. However, the shortage had actually begun in June 2023. At that time, Vyvanse’s maker, Takeda, said that a “manufacturing delay compounded by increased demand” had led to low inventory.
In August 2023, the FDA approved multiple generic versions of Vyvanse after Takeda’s patent exclusivity expired, raising hopes that the shortage would ease with the injection of new generics. But supply problems have persisted. In November, the Association for Accessible Medicines, which represents generic drugmakers, sent a letter to the DEA saying that generic manufacturers weren’t able to obtain enough raw material to “launch their products at full commercial scale,” because the quotas were standing in the way, according to reporting by Bloomberg.
FiercePharma reported another potential factor raised by lawmakers and industry watchers. Those onlookers took note of the timing of Takeda’s “manufacturing delays” just months before generics entered the market. With the significantly thinner profit margin of generic and off-patent drugs, there’s concern that manufacturers may de-prioritize production.
Last, the DEA flagged yet another factor in the supply chain: exports to foreign markets. While the FDA estimated a 6 percent increase in the domestic need for lisdexamfetamine between 2023 and 2024, the DEA’s export data showed a 34 percent increase in exports of lisdexamfetamine between 2022 and 2023, with expectations that exports would continue to increase this year and beyond. As such, the current 23.5 percent quota increase for lisdexamfetamine is only partly for domestic production. In fact, only a quarter of the 6,236 kg is intended for the US. Of the increased allotment, 1,558 kg is for domestic drug production, while the other 4,678 kg addresses increases in foreign demand, the DEA said.
Enlarge/ Ten milligram tablets of the hyperactivity drug, Adderall, made by Shire Plc, is shown in a Cambridge, Massachusetts pharmacy Thursday, January 19, 2006.
The Centers for Disease Control and Prevention on Thursday warned that a federal indictment of an allegedly fraudulent telehealth company may lead to a massive, nationwide disruption in access to ADHD medications—namely Adderall, but also other stimulants—and could possibly increase the risk of injuries and overdoses.
“A disruption involving this large telehealth company could impact as many as 30,000 to 50,000 patients ages 18 years and older across all 50 US states,” the CDC wrote in its health alert.
The CDC warning came on the heels of an announcement from the Justice Department Thursday that federal agents had arrested two people in connection with an alleged scheme to illegally distribute Adderall and other stimulants through a subscription-based online telehealth company called Done Global. The company’s CEO and founder, Ruthia He, was arrested in Los Angeles, and its clinical president, David Brody, was arrested in San Rafael, California.
“As alleged, these defendants exploited the COVID-19 pandemic to develop and carry out a $100 million scheme to defraud taxpayers and provide easy access to Adderall and other stimulants for no legitimate medical purpose,” Attorney General Merrick Garland said in a statement. “Those seeking to profit from addiction by illegally distributing controlled substances over the Internet should know that they cannot hide their crimes and that the Justice Department will hold them accountable.”
Deadly consequences
According to the Justice Department, Done Global generated $100 million in revenue by arranging for the prescription of over 40 million pills of Adderall and other stimulants, which are addictive medications used to treat ADHD (attention-deficit/hyperactivity disorder). Done Global allegedly eased access to the drugs by limiting the information available to prescribers, instructing prescribers to prescribe Adderall and other stimulants even if the patient didn’t qualify, and mandating that the prescribing appointments last no longer than 30 minutes. The company also discouraged prescriber follow-up appointments and added an “auto-refill” feature.
Prosecutors further allege that He and Brody continued with their scheme after becoming aware that patients had overdosed and died.
The CDC cautioned that the disruption from lost access to Done Global prescriptions comes amid a long-standing, nationwide shortage of Adderall and other stimulant medications. For patients with ADHD, the disruption could be harmful. “Untreated ADHD is associated with adverse outcomes, including social and emotional impairment, increased risk of drug or alcohol use disorder, unintentional injuries, such as motor vehicle crashes, and suicide,” the CDC warns. Further, a loss of access could drive some to seek illicit sources of the drugs, which could turn deadly.
“Patients whose care or access to prescription stimulant medications is disrupted, and who seek medication outside of the regulated healthcare system, might significantly increase their risk of overdose due to the prevalence of counterfeit pills in the illegal drug market that could contain unexpected substances, including fentanyl,” the CDC said. Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.
The Drug Enforcement Administration recently reported that seven out of every 10 pills seized from the illegal drug market contain a potentially lethal dose of illegally made fentanyl, the CDC noted.
This post was updated to clarify that the DEA’s data indicated that 70 percent of illicit pills seized contained “potentially” lethal doses, which was not included in the CDC’s warning.
