A rising demand for and restricted supply of varying dosages of the medication Adderall has caused patients diagnosed with ADHD to miss out on their treatment, according to psychiatry experts.
The medication has been in short supply since around October 2022, according to the Food and Drug Administration. Patients are having to call several pharmacies every month to find one that can fill their prescription since the prescriptions cannot be transferred between pharmacies and a new prescription has to be written by a doctor each time a new pharmacy is used by the patient, Dr. Tim Spedoske said.
Spedoske, who works at Olin Health Center, said this shortage is especially challenging because the dosages of what is short on supply change every week and run out fast.
“I’ve sent the exact same prescription to three or four different pharmacies before they actually were able to get it filled,” Spedoske said.
Kinesiology and exercise science freshman Valencia Morris is prescribed Adderall for her ADHD. Throughout this school year, however, she said she has struggled to maintain a consistent supply.
Morris would go into pharmacies and ask for half of her prescription, even if she couldn’t get the rest until a week later. She called the Walgreens in East Lansing to see if any medication was available, even willing to drive to other locations in Michigan if necessary. At one point, she took a trip to her hometown in Minnesota to pick up her prescription.
“It was so extremely complicated and hard and long,” Morris said.
Since Adderall is a Schedule II stimulant, the Drug Enforcement Administration imposed a regulation to only allow 30 days' worth of the prescription to be given at a time, meaning that the patient has to navigate new obstacles each month to refill it.
“When the Adderall shortage came, ... I had to trick myself into thinking I didn’t really need the Adderall,” Morris said. “That did not go well. I just remember struggling a lot just to get out of bed and get to class, plus it was cold too, and people with ADHD, a lot of their emotions rely heavily on their surroundings and the weather.”
Psychiatrist Dr. Swapna Hingwe said when patients aren’t able to receive their prescribed medication, their symptoms flare up, causing brain fog, anxiety, restlessness, behavioral health issues and impacts on academic performance. Hingwe is the director of psychiatry services at Michigan State University’s Counseling and Psychiatric Services.
Patients struggling to access stimulant medications often face challenges in their personal relationships, such as communication, being easily distracted or forgetful, Hingwe said.
“Some people might assume that you’re not interested or you’re not paying attention because you don’t care,” Hingwe said. “There’s so many behavioral effects from ADHD if it’s untreated.”
Hingwe said that she hears about patients skipping their medication for an entire month or rationing the pills for instances when they really need them if they can’t get their consistent dosage of Adderall when they need it.
“People will try to ration whatever they have of their medication, but then they’re getting suboptimal treatment,” Hingwe said.
After being prescribed an alternative medication that made her tired as a side effect, Morris said she started giving up.
“I just had to learn to adjust,” Morris said. “I now have trouble speaking, I can fully talk, I don’t have trouble pronouncing my words, ... but I did form a little bit of a stutter and I completely slur my words sometimes.”
This effect and others worsen for Morris when she is off of her prescription, but she also experiences negative effects upon starting it again.
“The first day I took it (again) I had to leave class early because it sent me into a panic attack, and I was shaking so hard. I didn’t know why I was shaking, I was just shaking — I could not stop," Morris said. "After hours of that you crash, ... but it could also be very short and you’re back to being jittery again, or it can last a whole 24 hours. And it sucks.”
Spedoske and Hingwe both encourage patients struggling with a shortage of their medication to stay in contact with their health providers to get the medication they need.
Hingwe said that the FDA is predicting that the shortages should resolve sometime around May or June of this year. Until then, CAPS suggests the following:
- Talk to your healthcare provider right away. It can be frustrating to navigate this process alone and your health care provider and/or their office can help you.
- You may be able to find a pharmacy that has your medication in stock if you work together to contact pharmacies.
- Your healthcare provider can recommend alternative medications for ADHD that may be helpful in the short term. There are a variety of stimulant and non-stimulant medications available for the treatment of ADHD symptoms.
- Avoid self-medicating with substances.
- Try to prioritize getting plenty of sleep, eating nourishing foods, and keeping your body moving every day.
- Do your best to keep an up-to-date calendar for yourself in a very visible place and try to prioritize tasks.
- Be as kind and patient with yourself as you can. Managing your symptoms and studying/working/being in relationships is a lot to balance.