How the Adderall Shortage Is Casting a Long Shadow on ADHD Treatment
In a recent ADDitude survey, ADHD clinicians and other professionals reported that nearly all of their patients currently prescribed Adderall are experiencing treatment disruptions, anxiety around finding medication, and symptom flare-ups with serious professional and mental-health ramifications.
The Adderall shortage first reported this summer and confirmed by the U.S. Food and Drug Administration (FDA) in October is dragging on — and dragging down many patients’ mental health in the process. A significant population of patients cannot reliably procure the ADHD medication from local pharmacies, and many prescribers are trying to find alternatives to the immediate and extended-release formulations of Adderall for their patients, according to a recent ADDitude survey. All of this is causing anxiety, treatment disruption, and symptom flare-ups.
In September, 80% of ADDitude poll respondents said they were having trouble getting their ADHD medication. Earlier this month, we asked clinicians, counselors, and other ADHD professionals to assess the percentage of their patients impacted by the Adderall shortage. Their estimates ranged from 1% to 75%. For patients prescribed Adderall, however, there was near universal agreement that new hurdles and headaches exist today.
Severity and Prevalence of the Adderall Shortage
“90% of my clients who are treated for ADHD with Adderall are having issues filling their extended-release prescriptions,” wrote one psychiatric-mental health nurse practitioner. “In our area, short-acting Adderall is more easily available. Today, I sent in an Adderall prescription for a client who had to call seven different pharmacies to find one that could fill her generic Adderall XL 30 mg. She was lucky to find it at all.”
“They are entirely unable to access supplies,” wrote a prescribing physician in private practice. “I have attempted to move some patients over to Zenzedi, but it is not without great opposition ranging from a pharmacy’s refusal to stock Zenzedi, the inability to identify pharmacies that stock it, or insurance’s denial of Zenzedi.”
“My patients have told me they are blocked from fulfilling their prescriptions,” wrote one licensed social worker specializing in ADHD. “Doctors I have consulted told me that it is not just the shortage that is the barrier, but it is also becoming more difficult to access Adderall due to restrictions on its use. They tell me that they are resorting to prescribing Wellbutrin or other alternatives. This is additionally challenging because ADHD medications are designed in a way that fits the disorder. Adderall often works instantly and does not require perfect daily adherence to be effective.”
“The current Adderall shortage and restrictions negatively impact 75% of my patients,” wrote a licensed social worker specializing in ADHD. I have a homeless adult client with ADHD who is also depressed and anxious. He experienced a barrier to getting Adderall, which demotivated him even further, and he missed his therapy appointment.”
Even when patients do successfully access Adderall with some persistence and good luck, they often do so after missing some number of doses. Many are tempted to skip doses or otherwise alter their treatment plans in order to build a stockpile “just in case.”
“Most of the time, my clients can get their prescription moved to a different pharmacy with Adderall in stock, but that is certainly a hassle and not ideal for clients or doctors,” wrote a licensed professional counselor. “Many patients skip doses or are forced to go without medication for a few days before it is available.”
“All of my clients have been able to get Adderall, though some have had to call multiple pharmacies to find their dose,” said another survey respondent. “Others have asked for different strengths if the dose they take is unavailable.”