Workforce problems, federal regulations and an increase in demand are creating a shortage of ADD and ADHD medications. Oklahomans are feeling the strain.
When stories started coming out about an Adderall shortage, Lydia didn’t have a major concern. Immediately, anyway. Her pharmacy app said her refill was on its way.
“At first it just said we should have it filled in the next two days,” she said. “So I wasn’t worried at all, was like, ‘OK’ And then that message saying it should be filled in two days just went away. And then it just said, ‘This prescription is currently unavailable. We will notify you once it’s ready to be picked up.'”
She is one of millions across the country who have an attention deficit disorder like ADHD. One treatment for the condition is a stimulant like adderall or its generics.
Here’s the basic idea: people with these conditions have brains that produce too little of certain chemicals, called neurotransmitters. Those chemicals help us focus, and they help us carry out plans.
These medications help brains produce more of those chemicals. If someone with a neurotypical brain takes them, they will experience a high — hyperactivity, euphoria. But for someone with ADHD, they simply mean leading a more productive life.
“I functioned for 25 years without taking this medicine,” she said. “But when I did start, I was like, oh, this is what normal people feel like.”
But then her pharmacy was out. And so was every pharmacy she called across the city.
“This happened at the exact same time that I had huge work deadlines, for major projects,” she said. “And so trying to, you know, stay awake and focus and get things done was just a nightmare.”
The US Food and Drug Administrationformally announced a shortage of Adderall and its generics last month. The lag started at one of the drug’s largest manufacturers: Teva. It’s a familiar story in COVID times — worker shortages led to production delays. The main issue was in its packaging facility. That company produces most of the ADHD stimulant medications in the U.S.
Other companies make the drugs too. But they’re also having workforce problems. And there’s another issue: these stimulants are controlled substances. The US Drug Enforcement Agencyhas tight regulations on how much of the chemical can be produced annually, so companies can’t spontaneously ramp up production.
Local medical providers started seeing an issue this summer. Here is Dr. Tim Barrick, who owns and is a pharmacist at Clinic Pharmacy in Shawnee.
“I’ve talked to my pharmacists and we all kind of agree that it seemed to start in July,” he said. “It looks like it could last into as late as March of this coming year. So it’s not going to go away overnight, for sure. So that’s problematic.”He and other patients say there are ways around the shortage, but they involve jumping through hoops with doctor’s offices, insurers and regulations.
The medications come in quick-release forms and extended release forms. They also come in varying doses — measured in milligrams.
“So you may end up in a situation where you may not have the thirties, but you might be able to do two fifteens,” he said.
But pharmacists can’t just dispense whatever they have. It has to match the prescription, which means getting a hold of the doctor, who has to write a new script and get that to the pharmacy.
“Most of the physicians are aware of this,” Barrick said. “We work with them. The problem is … a lot of times insurance may not pay for two tablets at a time.”
Another Oklahoman, Sarah, says there have been shortages of these medications in the past, so there are some backup plans she already had in place.
“And when you have controlled substances that you have to take, you just kind of got to roll with the punches and accept that things are going to change,” she said.
One of the methods: rationing.
“My mom and I were preparing because she was like, ‘Hey, there’s meds, shortages happening, you need to start stockpiling on ADHD meds,’ which means I don’t take them one day on the weekend, or I don’t take them on two days on the weekend, ” she said. “Right? Because you need them to function.”
She says she used to request her meds more than a week out to ensure she could get them in time, but the ever-changing regulations on the stimulants now prohibit that.
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