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About 1 in 10 adults are affected by the ADHD drug shortage in the United States. The shortage began in 2022 when the FDA announced the insufficient production of Adderall, Ritalin, and other ADHD medication brands. Although both psychiatrists and pharmacies agree there are signs the shortage is lessening, it does not seem it will come to a close any time soon. Patients throughout the U.S. are still struggling to get a hold of their medications, contributing to an increasingly negative influence on the daily lives of children and adults with ADHD.
Attention-Deficit Hyper-Activity Disorder (ADHD) is a neurological disorder and is most common in children. From 2016 to 2019, about 6 million children were diagnosed with ADHD. Symptoms of ADHD include inattention, hyperactivity, and impulsivity. It is known to adversely influence one’s personal relationships, academics, and daily functioning. If ADHD is left untreated, children can experience poor self-esteem, behavioral problems, and increased self-criticism. Sharon Saline, a psychologist and expert on ADHD, describes that due to behavioral problems children with ADHD experience, they may have negative thoughts about themselves and internalize these messages. This can undermine the self-image of many children with the disorder and lead to anxiety and depression. These problems often continue into adulthood and make it challenging for adults with ADHD to complete certain tasks like executive functions, affecting work performance and professional life.
One way to improve executive functioning skills is to take medication such as Methylphenidate (Ritalin), Mixed amphetamine salts (Adderall), or Extended-release methylphenidate (Concerta). These medications help to increase the neurotransmitters that are associated with attention: norepinephrine and dopamine. Although these medications do not “cure” ADHD, they certainly can alleviate the symptoms and help diagnosed patients manage better executive functions, plan activities and have fulfilling lives.
However, with the ADHD drug shortage in the United States, it is becoming increasingly harder for patients to access their medication. One reason for the drug shortage is the increased demand for the medication due to a surging number of diagnosed patients. During the pandemic, there was an increase in individuals diagnosed with ADHD in the United States, especially among young adults and women. This increase in ADHD diagnoses may be a contributor to the shortage due to the increased number of prescriptions demanded. Another reason for the shortage is because of a short supply. Drug makers report that they do not have permission from the Drug Enforcement Administration (DEA) to have a supply of the active ingredients found in ADHD drugs, so they are unable to supply more medication. However, the DEA has not indicated this is an issue and is “insisting that drugmakers have not met their quota for production and could make more of the drugs if they wanted.” ADHD drugs have been proven to be extremely addictive for young adults, so the DEA has set regulations on the quantity of active ingredients used in the production of ADHD drugs that drugmakers are allowed to obtain. Consequently, this affects the production of the drugs themselves and limits access to medication for those with ADHD.
Although drugmakers are trying to compensate for the shortages, Dr. David Goodman, the director of the Adult Attention Deficit Disorder Center of Maryland, said he noticed that brand-name versions of ADHD medication seem to be more available than their generic versions. He explained that this may be because many insurance companies only cover generic versions of ADHD drugs, limiting their supply as patients are more likely to purchase them instead of brand-name drugs. This leads to an increased demand and short supply of generic versions of ADHD medication.
However, production shortages are slowly declining for many drug companies. Teva Pharmaceuticals, a popular manufacturer of ADHD medications, resolved all of its shortages, according to the agency’s database. Dr. Royce Lee, a psychiatrist at the University of Chicago Medicine, recommends that patients develop close connections with their pharmacists to know when their medication will be in stock. Along with this solution, many psychiatrists have tried other methods to ease ADHD symptoms besides the use of medication, such as therapy which can help build their executive functioning skills.
Nevertheless, each person with ADHD faces a different experience with the disorder, and medication may be the most effective strategy for a patient. With the shortage, many are still not getting the treatment they need. Further, many patients who have been unable to access medication have had their education severely compromised. Elizabeth (Elle) Sharrard, a writer for the ADDitude Magazine and ADHD patient who has used medication for a decade, explained her frustration with trying to reach multiple pharmacies for her medication. Without medication, it can be frustrating as she feels helpless in caring for her own physical and mental health. Likewise, the inability to access medication has led to many patients fearing that this will negatively affect their job performance. Employees with ADHD who do not have access to their medication may experience behavioral symptoms such as a short temper or trouble focusing. However, managers may not be accommodating and decide to fire workers who are not performing well under these circumstances. Some politicians have responded to the agitation of those affected by the shortage. A legislative draft written by Senate Finance Committee Ranking Member Mike Crapo (R-ID) and Chair Ron Wyden (D-OR) is currently being sent to the FDA, expressing concerns and arguing for the on-time arrival of medications. The American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and the Children’s Hospital Association (CHA) have also sent a letter to the U.S. Department of Health and Human Services and the FDA about their concerns for the shortages. Furthermore, many patients are signing petitions and writing stories about the personal struggles this shortage has caused them.
Although the shortage of ADHD medication is seeing some improvement, patients feel it continues to be unpredictable whether they are able to access their medication on time. Many are experiencing difficulty in their daily personal and professional lives. Those with ADHD who have been let go from their jobs due to work performance impacted by the drug shortage may see lifelong consequences. A solution for the shortage will be essential to help patients who are struggling, and time will tell if the demands of policymakers, psychiatric associations, and patients themselves will produce one.