“A Daily Nightmare:” One Year into the ADHD Stimulant Shortage
One year into the ADHD stimulant shortage, patients still struggle to fill their prescriptions for Adderall XR and other stimulants like Vyvanse, Concerta, and Focalin. Amid increased demand this back-to-school season, children and adults with ADHD are feeling exhausted by the persistent treatment strain.
September 26, 2023
Thirteen months have passed since ADDitude first forecast a disruptive American shortage of the ADHD medication Adderall, and today more than one-fifth of ADDitude readers continue to experience problems accessing their stimulant prescriptions. According to an ADDitude survey of 10,936 caregivers and adults with ADHD, roughly 38% of all patients have had trouble finding and filling their prescription medication over the last year and 21% continue to suffer treatment disruptions today.
“I was on Adderall XR for 15 years, but discontinued it this spring due to the shortage,” wrote a survey respondent, one of many who has switched or stopped taking medication over the last year.
“I’m struggling to get Adderall XR and I am forced to take regular Adderall, which I dislike,” wrote another survey respondent. “The shortage is affecting me horribly.”
One year of medication shortfalls finds patients, parents, and doctors across the country devoting huge resources of time and money each month to repeat-dialing dozens of pharmacies in the hopes of securing scarce supply, and driving 30, 40, sometimes 50 miles to get it. As the school year kicks into high gear, children and adults tell ADDitude they have been forced to forgo medications, make do with substitutes that aren’t as effective or cause bothersome side effects, and ration out a dwindling supply, oftentimes dividing it between multiple family members with ADHD. Their work, grades, relationships, self-esteem, and overall well-being has suffered. And there is no hopeful end in sight.
According to the American Society of Health-System Pharmacists, at least 38 different doses or formulations of stimulant ADHD medications remain in short supply today.
ADHD Medication Shortage Trajectory
When the Food and Drug Administration (FDA) first announced a shortage of Adderall last October, it confirmed what thousands of people with ADHD who’d struggled to fill prescriptions already knew. While the shortage was initially caused by a manufacturing delay at one pharmaceutical company, a complex combination of factors — including increased demand, restrictions on pharmacists related to the opioid crisis, and quota issues — has caused the shortage to persist.
In the ensuing months, doctors have switched many patients to other stimulants, triggering a domino effect that has led to a reported Vyvanse shortage, as well as difficulty filling scripts for other ADHD medications like Concerta and Focalin.
In December 2022, a large American opioid settlement put new restrictions on Schedule II controlled substances, making a bad situation worse for patients trying to fill stimulant medication prescriptions. By spring, the academic fallout of the Adderall shortage was clear and educators told ADDitude, “The interruptions, resets, and resumption of new medications is noticeable in the classroom.” Meanwhile, the FDA commissioner appeared to blame patients and prescribers by saying, “If only the people that needed these drugs got them, there probably wouldn’t be a [stimulant medication] shortage.” As the Drug Enforcement Agency (DEA) maintained low production quotas despite rising demand, patients throughout the U.S. were left without vital medication or answers from government agencies.
In March, a group of lawmakers wrote a letter urging the DEA to take action to mitigate the stimulant shortage, including adjusting quotas to meet increased demand, helping with supply chain issues, and crafting new prescription and telehealth rules. Five months later, the DEA and FDA issued a letter of their own, encouraging manufacturers to collaborate with distributors, pharmacies, and payors to bring an end to the stimulant shortage. The letter mentioned a re-evaluation of drug quota allotment, an important lynchpin to opening up more supply, but it also placed blame on manufacturers, who they said produced just 70% of the stimulants they were allowed to make.
In the meantime, though the recent FDA approval of Vyvanse generics stands to improve the treatment landscape, many children and adults continue to suffer at the start of this new school year, and here is how they describe the experience:
“A Daily Nightmare”
“I am still dealing with the Adderall shortage and calling anywhere from 3 to 16 pharmacies each month to find the strengths I need — and driving anywhere from 3 to 25 miles to pick it up. It’s usually 25 miles.” — Ellyn, Florida
“It feels ridiculous that the only solution is to sit and call pharmacy after pharmacy in a 50-mile radius, hoping someone has it in stock and that they will still have it when your doctor calls in the script. As usual, government agencies turn a blind eye to anything that treats psychiatric issues or neurodiversity.” — Jane, Connecticut
“Absolutely a daily nightmare for a physician like me with a neurodivergent clinic. It is very frustrating.” — Pippi, Oregon
Scrounging, Switching, Rationing
“Both my daughter and I take 25 mg Adderall for our ADHD. I also have 5 mg tablets for when I need a boost at the end of the day. When the Adderall shortage hit, we used some of our previously tried ADHD medications, neither of which were preferred. In addition, we had the 5 mg Adderall that we use in a pinch. There were some days where we just kept taking the 5mg tablets throughout the day.” — Claire, Washington
“I have been scrounging for Focalin for a month. My daughter and I both take it, in the same strength and a few days ago, I was finally able to get a prescription filled for me. Now I’m rationing it out between my daughter and I.” — Jane, Connecticut
“I have not been able to get my Adderall 30 mg EX medication for three weeks going on four. I am getting ready to ask my doctor for something else, even though that is the most effective. Several of my students have needed help to get theirs. Their behavior was terrible, but I tried to be patient.” — Runell, North Carolina
“My pharmacy was never able to fulfill my Vyvanse or Adderall prescriptions, so I had to switch to a different medication entirely.” — Emily, Colorado
“Generic Concerta (methylphenidate XR) 36 mg is almost impossible to find right now — and my insurance won’t cover the name brand.” — Bridgette, Arkansas
“Months Without Medication Had a Devastating Effect”
“I dropped out of graduate school because I couldn’t concentrate and was so anxious when the pharmacist said they didn’t know when they could get my prescription. Day after day I called to check. I can’t do that over and over.” — Jen, Oregon
“The doctor prescribed Vyvanse when Concerta was unavailable, but we could not get this either. My son went three months without medication which had a devastating effect on his college grades.” — Kerry, Florida
“My son is an adult now and struggles to find his medications. He’s a rebel and I wouldn’t put it past him to cross the border for his medication. He has been cautioned about the possibility of getting fake medication that could be laced with fentanyl.” — Karen, Washington
ADHD Medication Shortage: Next Steps
- Read: How the Adderall Shortage Is Casting a Long Shadow on ADHD Treatment
- Watch: Stimulants vs. Nonstimulants – Understanding ADHD Medications
- Read: ADHD Medication Options – Stimulants, Non-stimulants & More
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