A few weeks ago, Sheletta Brundidge got a call from her son Andrew’s high school informing her that his daily medication had run out. The 16-year-old has attention deficit hyperactivity disorder (ADHD) and takes Adderall to control it. But when Brundidge went to refill it, her pharmacy was out of the drug. “The closest one that was available was over in St. Paul, Minn.,” she tells Yahoo Life. “That’s a whole other city!”
Thanks to a continuing nationwide Adderall shortage, there are many families like Sheletta’s who have been scrambling to get their prescriptions filled. So, what can you do if you or a loved one’s medication suddenly becomes unavailable? Here’s what medical experts say you need to know.
First, why is there a shortage?
The U.S. Food and Drug Administration (FDA) tracks all drug shortages on its website. In October, the FDA announced a shortage of the immediate-release form of amphetamine mixed salts, which includes the brand-name drug Adderall. These are stimulants used to treat ADHD as well as certain sleep disorders, including narcolepsy.
One major reason for the FDA’s announcement was a labor shortage at Teva Pharmaceuticals, one of the largest manufacturers of Adderall. Other companies make Adderall, but the supply is simply not high enough to keep up with the growing demand in the U.S. market. This increase in demand is due in part to the U.S. government relaxing the rules during the pandemic, which allowed Adderall to be prescribed at telehealth appointments.
At the same time, the Drug Enforcement Administration (DEA) reduced the amount of permissible raw materials for making Adderall, in order to avoid patient abuse of the controlled substance. “Two things can happen: Either you can’t make it, which they had problems with, or there is increased demand,” Dr. Max Wiznitzer, a pediatric neurologist and co-chair of the professional advisory board for the ADHD advocacy group CHADD, tells Yahoo Life. “In other words, they underestimated what the demand would be. And we got hit by both of those issues.”
For Brundidge, the shortage of Adderall meant that she had to drive an hour and a half through snow and ice to fill her son’s prescription. Knowing that she would not make it home in time for an important work meeting, she stayed in the pharmacy parking lot, hopped into the back seat of her car and conducted the call on her laptop. “It’s really an inconvenience for people right now,” she says. “We’re all scraping over the last few pills here and there.”
But beyond being an inconvenience, there are bigger concerns for those who rely on these medications.
What does the shortage mean for patients?
An estimated 6 million children ages 3 to 17 have been diagnosed with ADHD, and 62% of those kids take medication for it, according to the Centers for Disease Control and Prevention (CDC). “For many people, putting on eyeglasses helps them focus their eyes. In the same way, ADHD medication helps people focus their thoughts,” Dr. Irene Koolwijk, a developmental-behavioral pediatrician at UCLA Health, tells Yahoo Life. “The medications help them ignore distractions, pay attention and control their behavior.”
The medications work by increasing the levels of neurotransmitters such as dopamine and norepinephrine within the brain, which helps people focus and pay attention. Or in the case of a sleep disorder, the drugs help them feel more awake and alert.
Brundidge says the thought of her son Andrew going without his medication is nerve-racking. “Is he going to be able to keep his composure and stay maintained if he gets upset about something?” she says. “I really have to go to the worst-case scenario and prepare him: ‘Listen, you don't have your medicine. We’ve got to wait until this doctor calls it in. If you feel upset, just walk away.’”
The mother of four also worries about the long-term implications. “This is bigger than just a shortage of medication. My child's educational future is at stake. He’s in 11th grade, he’s going to 12th grade, he’s going to college, and this could impact college for him.”
The impacts can be devastating for adult ADHD patients, too. One Twitter user said it was “absolute hell” not being able to get a prescription refill, while one mom tweeted that she had to call six different pharmacies to find one that could fill her son’s Adderall prescription.
Wiznitzer says that without proper medication, adult patients may have problems at work, due to a lack of time management, trouble with relationships or making poor and impulsive financial decisions. “ADHD makes you inefficient,” he says. “No matter what task that you’re supposed to do. There are ramifications for a negative impact on your daily functioning, whether you’re a kid or an adult.”
How to navigate the shortage
The good news is that there are some actions that adults and parents of children who need the medication can take if they suddenly have to deal with a drug shortage. Koolwijk suggests starting with a visit to your local pharmacy. “Pharmacies don’t release information over the phone about their stimulant stock generally, as it’s a controlled substance,” she says. “But pharmacies of a large chain might be able to see if other related pharmacies have the medication available.”
To help track down available medications, Wiznitzer says connecting with local parent or patient groups in your area can also be useful. “Let’s say you’re a member of CHADD, you might then post an inquiry: ‘I’m having problems getting this medication at pharmacy x, who has had success?’” he says. “So, there's lots of ways to do it. Networking with both the physicians, as well as with support groups can be very helpful.”
Another option is to try a different form or dosage of your medication. For example, Wiznitzer says he has successfully switched many of his short-release Adderall patients to an extended-release tablet, because it is more readily available. He also recommends asking your doctor if you can try a methylphenidate ADHD drug such as Ritalin or Concerta.
However, because the Adderall shortage has caused many patients to go this route, Koolwijk says a domino effect is happening. “Because patients who were prescribed short-acting Adderall are now prescribed other stimulant medication, this has led to intermittent shortages of other stimulant medications as well,” she says. But no matter which option you explore with your doctor, also check in with your insurance company, to make sure the new drugs are covered and what they will cost.
For parents, Koolwijk recommends revisiting your child’s behavioral and educational support systems at school and at home to ensure they are fully optimized in case there is a gap in their treatment. “If they notice learning or behavioral challenges, they can request an evaluation at school to see if more supports can be put in place,” she says. “Or families can connect with a therapist to work on challenges at home.”
There is hope on the horizon. Wiznitzer says for the drug shortages that stem from a lack of raw materials, the DEA has now released new supplies of those ingredients. Although manufacturing issues persist, Koolwijk also says she is starting to see a slight improvement in the availability of ADHD medications as compared to December 2022.
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