Since earlier this year, the nationwide shortage of medication used to treat Attention Deficit /Hyperactivity Disorder (ADHD), a common neurodevelopmental disorder, has impacted patients and their families across the country. Pharmacies in Oregon, including Samaritan’s five outpatient pharmacies, have been hindered by limited supply.
“The shortage has been problematic for our patients, and while it is getting better, I foresee a shortage continuing through the end of the year,” said Megan Jones, director of Outpatient Pharmacies for Samaritan Health Services.
Affected drugs include both generic and name-brand versions of medications, such as Adderall, Concerta and Ritalin. While these drugs can be prescribed to treat other health conditions, such as narcolepsy, they are primarily used for ADHD. Each drug works differently in the individual and medications may not be interchangeable, meaning a person who is prescribed one, may not experience the same results from another similar drug.
How These Drugs Are Unique
ADHD medications are stimulants and contain ingredients that are Schedule II controlled substances with a high potential for abuse, so these drugs are tightly controlled federally. The U.S. Drug Enforcement Administration (DEA) sets quantity quotas with drug manufacturers on how much of these medications can be produced nationally, which in turn affects the quantity of drugs pharmacies can order.
“Because of the restrictions set on the quantity we are allowed to order from our wholesaler per day, per month and per quarter, if we have a larger number of patients filling prescriptions for these medications, we will hit our threshold and are unable to order more until the next timeframe,” Jones explained. “When this happens, we work with the patient to locate the nearest pharmacy that has the medication in stock.”
A “Perfect Storm” for Shortages
In August, the U.S. Food and Drug Administration (FDA) and the DEA released a joint letter stating that the shortage is due to manufacturing delays combined with a record-high prescription rate for these medications.
According to the Centers for Disease Control and Prevention (CDC), the percentage of prescriptions for these drugs to treat children and adults, who have issues with focus, disorganization and hyperactivity, doubled from 2006 to 2016 and then rose by more than 10% between 2020 and 2021.
Jones noted that the increase is similar locally.
“Samaritan pharmacies are seeing a rise of 10 to 15% in the number of prescriptions for these medications in the last few years,” she said.
This “perfect storm” has prompted manufacturers to push back on government regulations while governmental agencies say that manufacturers have been allowed to produce more but have chosen not to. This has left pharmacists and the patients they serve caught in the middle.
Pharmacists Work to Find Alternatives
“Our pharmacists are doing their best to find alternatives, like having a patient take two 10 mg tablets rather than one 20 mg tablet, or finding another pharmacy with the medication in stock, but sometimes there are no easy alternatives, and patients and their doctors have to make decisions on therapy changes,” Jones said.
Patients should not make treatment adjustments without consulting their medical provider, Jones stressed.
“Don’t just stop taking a medication without talking with your provider or pharmacist. Stopping a medication can sometimes lead to worsening symptoms or withdrawals,” she explained.
Patients Should Plan Ahead
Also, she urges patients to plan further ahead than normal when seeking a refill on these medications.
“Don’t wait until you are out of a medication to request your next fill because, with the shortages, supply is inconsistent. I suggest working with your pharmacy team when you still have five to seven days’ worth of medication remaining,” said Jones.
Learn more about Samaritan Pharmacies at samhealth.org/Pharmacy.