A nationwide shortage of Adderall is making it harder for some parents to help their children manage symptoms of attention deficit/hyperactivity disorder (ADHD).
Kandi and Lion Fludd had no reason to believe they would have any trouble filling their 8-year-old son’s Adderall prescription when they were out shopping in their hometown of Las Vegas, Nevada two weeks ago. “We had no notice,” Kandi, 44, told TODAY Parents. “When we went to the pharmacy, they told us it was nationwide, they didn’t know when they would get (another shipment) and we had to call our doctor’s office.”
Kandi says it was difficult to contact her son’s doctor, largely due to an influx of calls from other parents who could no longer fill their children’s prescriptions.
“I spoke to a nurse and she told me that she had had three other calls before me with parents who were crying because there was no Adderall at the pharmacy and they did not know not what to do,” Kandi added.
The couple’s son went seven days without his medication before a pharmacist could fill his prescription.
“I called the pharmacy every day. After four days, his teacher walked up to my vehicle as I was picking him up from school and said, ‘I can’t take it anymore, you gotta do something,'” Lion, 45, explained.
“She said he was rolling on the floor, unfocused and getting in the faces of other kids,” Kandi added. “When he’s not on medication… there are no boundaries.”
“Not having access to this medicine for our son affects our lives tremendously,” Lion said.
What is causing the national Adderall shortage?
Dr. Max Wiznitzer, a pediatric neurologist and co-chair of the Professional Advisory Board of CHADD, an ADHD advocacy organization, says Adderall shortages are not uncommon.
“Raw materials for stimulant drugs are regulated and supervised by the government,” Wiznitzer told TODAY Parents. “Pharmaceutical companies have to request certain amounts of raw materials every year and that has to be approved by the DEA. We’ve had other years in the past where as we approach that time of year – late October, November, December — the companies no longer have the raw material and cannot supply the product.”
On Wednesday, October 12, the Federal Drug Administration (FDA) confirmed a nationwide shortage of the immediate-release form of Adderall, a stimulant drug that can help people manage symptoms of ADHD, including anger, anxiety , forgetfulness and difficulty concentrating.
The FDA cites “continued intermittent manufacturing delays” and a lack of “sufficient supply to continue to meet US market demand through these producers” as the cause of this year’s shortage.
In August, Teva Pharmaceuticals – the nation’s largest maker of Adderall – reported order delays, citing labor shortages. On August 5, nearly 64% of 360 independent pharmacies had problems acquiring Adderall, according to a survey conducted by the National Community Pharmacists Association.
The Adderall shortage could last until January 2023, according to the FDA’s website.
Wiznitzer says a better understanding of ADHD means more Adderall prescriptions, which can also lead to supply shortages.
“We now recognize that ADHD doesn’t stop when you’re 16,” Wiznitzer said. “We are better able to recognize the presence of ADHD in adults and therefore treatment is instituted, and stimulant medications are still one of the main treatments.”
ADHD diagnoses in children and adults have also increased during the ongoing COVID-19 pandemic, according to a survey of 2,365 adults by ADDitude, a quarterly consumer ADHD publication.
“More children were having trouble maintaining their attention and focus, especially during remote school,” Dr. Brittany Webber, a child and adolescent psychologist practicing in New York City, said today. “It becomes a heightened presentation that we see – a fair combination of anxiety and ADHD and often the two are linked.”
As ADHD diagnoses and Adderall prescriptions have increased, the DEA has decreased the allowable quota for raw materials used to make the drug, citing cases of recreational use and abuse.
What parents need to know
Wiznitzer pointed out that supply issues are nothing new for doctors, pharmacists or clinicians.
“This is more of a setback than a ‘sky is falling’ scenario,” he said. “My big advice is to work with the prescribing healthcare professional to make sure you can access a treatment that works best for you or your child’s ADHD.”
Wiznitzer added that while some prescription strengths may not be available, others are in stock and, in consultation with a doctor, parents could obtain a different strength of the same medication to circumvent the issue.
Webber agreed, adding that there are many other medication options, prescription dosages and alternative treatments parents can explore. She noted that not all alternatives will be appropriate or successful.
“Not all drugs are right for all children,” Webber said. “Sometimes parents have to try several different things until they find something that both works and has minimal side effects for the child. So yes, there are other medications, but fit- they exactly to Adderall? No.”
Parents could also run into health insurance issues even if they are able to switch manufacturers or drugs.
“If it’s a brand name drug, you have to play ‘pre-authorization games’ with the insurance company,” Wiznitzer explained.
For the Kandi and Leo parents, insurance issues were a problem.
“It took us a long time to even get references from insurance,” Kandi explained. “Insurance can only go to certain places and those places need so many documents and forms and they can only see certain patients with certain insurance and it costs out of pocket…a lot of parents are lost and don’t know nowhere to even go for help.”
The Role of ADHD Medication Shame and Stigma
In response to the shortage, some people on social media have criticized parents for giving their children Adderall.
A 2008 study found that “stigmatizing views about stimulants” can “negatively affect” patients seeking pharmaceutical options, and parents are “less likely to turn to close relatives, friends, hospitals community and psychiatrists than to teachers, doctors and mental health professionals” when their child is diagnosed with ADHD.
“We would never say the same to someone with diabetes who needs insulin because their body can’t produce it on its own,” Webber said. “It’s similar – their child’s body isn’t producing the necessary neurotransmitters for him to be able to maintain control of his body.”
Webber added that parents are “damned if they do and damned if they don’t.”
“They either face the stigma of having a child that another person sees as out of control, or the stigma of giving their child something that could be used as a tool to learn self-regulation,” she said.
Kandi and Lion said that amid judgment from some people, they remain focused on their son and his well-being. Fearing further supply problems in the future, the child’s doctor offered to prescribe another drug. The couple have yet to come to terms with the change, as they worry about the physical and emotional impact it will have on their son.
“Adderall is an absolute necessity right now,” Lion said. “We joke that we would sell our house before we leave without giving him medicine. Without it, he says his brain is shaking.”
To protect their child from shame, the parents taught that ADHD is their son’s “super power.”
“We don’t want him to be ashamed,” Lion explained. “It’s not his fault. It’s just what it is and we have to learn to work with it and shine with it.”