Can You Stock Up on ADHD Medications During a Crisis?

As cases of the novel respiratory disease increase across the United States, throwing life into bedlam and patients out of their dorm rooms, many wonder if it is necessary — and possible — to stock up on their prescription medications just in case.

The Center for Disease Control and Prevention recommends that individuals and families have access to several weeks of medications and supplies in case they have to stay home as a result of the pandemic.¹ Several of the country’s largest medical insurers are also waiving prescription refill limits (typically set at 30 days) on maintenance medications.² In addition, big-name pharmacies like Walgreens³ and CVS⁴ are now waiving prescription delivery fees.

But what about individuals who take medication to treat attention deficit hyperactivity disorder (ADHD)? Most ADHD stimulant medications are considered controlled substances that come in 30-day supplies. Can anything be done about that? In short, yes, if the patient has prescription drug coverage by an insurance company.

“They ought to get their physician to write a 90-day, mail-order prescription,” said Dr. William Dodson, a retired psychiatrist who has spent decades working with adults with ADHD. “It’s a lot easier through the mail.”

Dodson, who was seeing patients until last year, said a 90-day supply is the largest a patient can get at any one time of any one medication, whether a stimulant or a nonstimulant (many in the latter group appear on some health insurer’s maintenance medicine lists^{5 6 7}). That restriction does not, Dodson says, stem from concerns over abuse of controlled substances.

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“Insurance companies know that about a third of people they insure will not have a policy with them next year,” he said. “They don’t want to give a year’s worth of medication to someone who may leave.”

A patient should have no issues approaching their physician with the request, though authorization for the length of prescription supply may vary according to state law. Still, a 90-day supply is widely accepted, and the process can even be expedited if the physician has an electronic submission setup.

Mail-order prescriptions offer patients increased convenience and in-person delivery — even in another state. The trade-off is that an adult must be present to sign for the package. Dodson, who is based in Colorado, said that about 20 percent of his patients lived in other states. He frequently sent mail-order prescriptions to patients with addresses in Florida and California.

Some states, like New York and Texas, do not honor prescriptions from other states, but a mail-order prescription is a legal way to circumvent those state laws. Again, someone has to sign for the package when it arrives. Many prefer to have their prescriptions sent to their workplace or college dorms for this very reason.

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Patients may also secure an extended supply with what’s known as a travel override. This is issued by an individual’s insurance, and is done when a patients is traveling for a long period and needs steady access to their medication. Proof of travel is not necessary to obtain this override, according to Dodson.

While the great majority of prescribers should accommodate requests for a 90-day supply, some doctors, Dodson said, may overestimate the risk of ADHD medication abuse and refuse to increase a patient’s prescription. A patient’s choices are limited in this situation, but mail-order prescriptions — even if only for 30-day supplies — are still a good way to ensure a steady supply of medicine while practicing social distancing.

A 90-day supply of medication is associated with decreased cost in the long run, but it may be more expensive up front, given prescription co-pays and other factors (one study by the University of Southern California found that insurance co-pays can sometimes be higher than the price of the drug itself ⁸). For those who are who are insured, but may not be able to take advantage of the 90-day option due to cost concerns, or for those that are uninsured and therefore can’t get medication in 90-day batches, options like Good RX can be useful for getting medication at discounted prices.

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