ADHD Med Shortage & Alternatives

If you’re one of the many US adults who take stimulant medication to treat adult ADHD, you know the kind of stigma we already face. The lack of understanding, and sometimes downright refusal to believe that the struggles we face are real, and not a symptom of some character flaw. The side-eyes, or even blatant accusations of addiction and drug abuse.

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Many of us struggle daily to function in a world not built for our brains. Compounding that struggle is a shortage of the medication we need in order to perform daily tasks - and the fear of ‘looking like an addict’ if we complain.

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So, what gives? Why has this gone on for so long, and what can we do to change it? I wanted to know - so I recruited a freelancer, reached out to some pharmacist contacts, and we did some digging. Here’s what we found out.

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What’s Causing the ADHD Medication Shortage?

Government regulations, unsteady production lines, a rising demand and pricing are some of the causes of the shortage of ADHD medications. For example:

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Government Policies

The production of stimulants like Adderall, which are used in treating ADHD, are regulated by government policies. The control over their production is a precautionary measure against the risk of abuse and overdose. To address this concern, there is a predetermined quota for manufacturing these drugs - the DEA places industry-wide limits on manufacturing certain ingredients. Unfortunately, until very recently, they haven’t been adjusting those limits to meet demand. Consequently, these stimulants often experience shortages during the periods between when production halts and then resumes.

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📢 Make Your Voice Heard!The Federal Trade Commission (FTC), and the U.S. Department of Health and Human Services (HHS), are seeking public input on the shortage. You can comment here until April 15, 2024. You can also submit letters to your congressional representatives, or to the DEA and FDA. ADDitude Magazine even has a sample letter you can copy to make it easier!

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Increased Demand for ADHD Medication

More people getting diagnosed with ADHD means more need for ADHD medication. When the demand exceeds the current production capacity, shortage of ADHD medication can occur. This challenge makes it difficult to ensure a consistent and sufficient supply of these crucial medications.

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The increased demand is real - and it became especially difficult during the pandemic shutdown. As the routine of ‘normal’ life came to a halt, many people lost the structures that they relied on to manage (in some cases, perhaps very tenuously) their symptoms. ADHD diagnoses boomed during the pandemic, adding to already-increasing numbers as (finally) physicians are learning more and more about the prevalence of ADHD in adulthood, especially in underdiagnosed populations like women, BIPOC, and the gender-diverse.

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Manufacturers weren’t prepared for the increased demand - and there isn’t, unfortunately, a simple way for them to request an increase in their production capacity from the DEA once it’s been set.

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Supply Chain Issues

Many of the major ADHD medication manufacturers use a global supply chain; for instance, a company called Teva Pharmaceuticals, based in Israel, is the largest supplier of US drugs. While supply chain challenges have eased somewhat since, the lockdown and labor shortages in 2020 and beyond had a detrimental effect on supply.

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Increased Pricing

ADHD medications may also be short in supply as prices have gone up. It’s an unfortunate part of basic supply and demand. Drug companies may also focus more on making drugs that make more money - drugs that are still under patent, with no generics - and less on ADHD meds, most of which do have generic versions.

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This may create an unfortunate cycle perpetuating the shortage. Even if people have insurance, they might not take their meds, or use less, because they can’t afford exorbitant copays. (For example, when I was first diagnosed, I was prescribed Vyvanse - and even AFTER insurance, I was expected to pay almost $300 for a 30-day supply). As you’ll recall, manufacturers base their estimated yearly production capacity on past numbers. So, if less people are able to afford medications, they end up manufacturing less than what is actually needed.

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How To Deal With the ADHD Medication Shortage

If you’re struggling to obtain your medication, you can try out some of these strategies and alternatives to help you cushion the effect of the shortage:

• Try Smaller Pharmacies: Smaller, local ‘mom & pop’ type pharmacies may be more likely to have your medication in stock. Larger, chain-brand pharmacies have higher volumes of customers, and may only order more of a medication when stock runs out. A smaller, mom & pop store might be more proactive in ordering ahead, because they know how many of their customers will need a given medication, and can order in advance to keep from running out. (This strategy worked great for me!) You might also try pharmacies in more rural or lower population-dense areas, where demand may not be as high.
• Try Alternate Doses and Drug Versions: If you can't get the usual dose of your medication, your doctor may be able to order a different dose. For example, if you take 15mg, but that dosage is consistently out, your doctor might order 30mg, which you could break in half (in tablet form). You might also ask your doctor to try different forms of certain drugs, like extended-release vs instant release.
• Switch Temporarily to Other Medications: While waiting for your usual medication to be available, you could ask your doctor to switch you to different medications. For example, my pharmacist contact said that there’s not really any shortage of drugs like Ritalin and Concerta, which have a different active ingredient than the one in Adderall (which is the most likely to be out of stock).
• Try Different Treatment Options: Aside from medication, you could try out other treatment options such as therapy or virtual ADHD coaching. Therapy is really useful when you're dealing with tough emotions. It can help you shift negative thinking and find positive ways to make your ADHD work better for you. ADHD coaching helps you learn skills to handle your symptoms. An ADHD coach can assist you in managing your day-to-day tasks effectively. You can try affordable adult ADHD coaching at Shimmer.
• Community Networking: Join or form a group of local ADHDers, where people can share which pharmacy locations they were able to fill their medications at. (This has worked for me, as well). Especially when your pharmacy has been out, and receives a restock, it could be helpful to let others know so that they can have their prescription changed to that location.
• Build Relationships: If you are able to spend a few extra minutes getting to know the nurses at your doctor’s office, or the pharmacy staff, they’re probably going to be more willing to go out of their way to help you find a pharmacy that has medication in stock. For example, a nurse at the doctor’s office may be willing to call around to a few different pharmacies to see which of them has your meds in stock before sending the prescription out, which could minimize the legwork on your end.

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Final Words

Dealing with an ADHD medication shortage can be tough. The process is definitely not built for our brains. But you’re not alone. Make your voice heard by reaching out to government officials and departments. Reach out to your doctor to discuss adjusting your dosage or trying a temporary switch. Find and build community where you can. Consider exploring ADHD therapy, or find an adult ADHD coach for tailored support and accountability.