Update on the ADHD Medication Shortages

Imageby Ruth Hughes, PhD

BY THE TIME YOU READ THIS ARTICLE, I fervently hope that none of you are continuing to have difficulties getting your ADHD medication. CHADD has been working hard to ensure that significant efforts are made to alleviate the shortage.

CHADD and the American Academy of Child and Adolescent Psychiatry have joined forces and created a coalition of other patient and clinical advocacy groups to highlight the seriousness of the problem and to influence the policies of the two federal agencies with oversight responsibilities—the DEA and the FDA. We have been talking with many of the pharmaceutical companies to understand the scope of the problem. And CHADD has been underscoring the importance of this issue for the media. More than 4500 people responded to CHADD’s survey and gave us incredibly important information on the depth and range of the shortages. For the very latest update, go to the homepage of chadd.org and click through the ADHD Medication Shortages box.

What caused the shortage?

Each year the Drug Enforcement Agency and the many pharmaceutical companies manufacturing stimulant medications do a complicated dance. DEA’s mission is to ensure that only the amount of stimulant medications necessary for medical treatment is manufactured and that diversion of these medications for nonmedical purposes is strongly discouraged. To that end, DEA approves each pharmaceutical company for a limited amount of the active pharmaceutical ingredient (API). Once a company has used its entire quota of the API, it either has to apply for more—a lengthy process—or wait until the next year to receive a new allotment. Problems at the manufacturing level, problems with distribution, or an incorrect guess about the amount legitimately needed, can all result in a shortage. The other unknown is the growth in the diversion of stimulant medications for use by college and high school students for studying. Once a shortage occurs, it is very difficult to address, unless the DEA authorizes more of the active ingredient. The 2011-12 shortage began with the short-acting generic versions of amphetamine mixed salts but then spread to most generic medications for ADHD.

The good news

The DEA has announced new quotas for 2012 with the first increases since 2007. Amphetamine mixed salts (generic for Adderall) total allotment has been increased by 36%, and methylphenidate (generic for Ritalin) has been increased by 11%. This should make a huge difference in the availability of these medications. But it takes eight to twelve weeks for the pharmaceutical companies to actually make the medications and get them to your local pharmacy. It should begin to become easier to find your medication in late February with an alleviation of the shortages by the end of March.

CHADD will continue to advocate for policies that prevent such a shortage from happening again.

The problem of diversion and misuse

Diversion of stimulant medications is one of the culprits in this saga. The demand among students for stimulant medications to help with studying has grown substantially. In 2008, Timothy Wilens, MD, and his colleagues examined twenty-one studies in this area and concluded that five percent to thirty-five percent of college students report nonmedical use of stimulant medications in a year. High school student usage was five percent to nine percent. That has the potential for a huge impact on the marketplace.

It is imperative that we address the misuse and diversion of these medications if we are to prevent another shortage from happening in the future. At an individual level, that means never, ever sharing any medication with others, and keeping medication in a secure place that does not allow others to help themselves. At the physician level, that means screening carefully to ensure that ADHD is present, before prescribing any stimulant medication. And at the cultural level, it means encouraging good study habits and strongly discouraging last minute cramming for exams with the illegal use of stimulants.

Because of the time lag between writing and publication, I encourage you to visit chadd.org and link to the latest information by clicking through the ADHD Medication Shortages box on the CHADD homepage.

Ruth Hughes, PhD, is CEO of CHADD.

This article originally appeared in the February 2012 issue of Attention magazine. Copyright © 2012 by Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD). All rights reserved. No portion of this article may be reproduced without written permission from CHADD.
Posted in: 2012, February