ADHD Medication Shortages

The shortage of ADHD medications like Adderall, Ritalin, and Vyvanse over the past two year is, to an extent, an ongoing crisis in the United States. Some patients who rely on these drugs to manage attention deficit hyperactivity disorder (ADHD) are still facing some challenges in accessing their prescriptions, a problem that began as early as late 2022. As psychiatrist Dr. Royce Lee of UChicago medicine shared in a recent NBC News article, around a third of his patients are still experiencing the impacts of this shortage3. Many patients have encountered barriers, which is especially concerning given the importance of consistency and continuity in taking any psychotropic medication. The reasons for this shortage are multifaceted, with no single reason entirely driving the recent trend. Regulatory hurdles, manufacturing delays, supply chain issues, and unprecedented spikes in demand are all pieces within this. 

Rise in Demand and Telehealth Expansion

One of the key contributors to the shortage is the sharp increase in the number of ADHD diagnoses. This spike has been attributed to greater public awareness about ADHD in adults, the accessibility of telehealth during the COVID-19 pandemic, and the expansion of remote medical consultations. These are all generally positive forces that have allowed many to finally get the care that they need for symptoms they may have been living with for years. Telehealth made it much easier for patients to access ADHD treatment, but it also led to an increase in prescriptions4. Many of these prescriptions were given by providers who had no prior relationship with patients or without in person consultations. While overprescription is one concern, many are also worried about starting a medication only to have to switch to another as a result of shortages. 

Data from 2021 shows that stimulant prescriptions increased by 10% from 2020, often driven by adults who were struggling to manage the challenges of working from home or handling children during the pandemic4. As demand skyrocketed and the pandemic exarcerbated existing mental health concerns, pharmaceutical companies were not equipped to produce enough supply to meet this new volume. 

Regulatory Constraints and DEA Production Limits

Adding to the problem is the fact that ADHD medications like Adderall and Vyvanse are classified as Schedule II controlled substances. This classification means that the U.S. Drug Enforcement Administration (DEA) places strict limits on how much of these drugs manufacturers can produce each year, to prevent abuse2. These caps are meant to balance legitimate medical needs with concerns over substance misuse. Across both of these drugs, there is a high potential for developing physical dependence, but Adderall is considered higher-risk for addiction than Vyvanse, since the latter takes longer to be metabolized. As a result, the supply of these drugs on the market is a point of regulation for the DEA. 

However, this regulatory framework has made it difficult for manufacturers to respond quickly to the surge in demand. For example, after Adderall faced significant manufacturing delays in late

2022, many patients turned to Vyvanse, a similar stimulant medication. This sudden spike in demand for Vyvanse quickly led to shortages of that drug as well. In September 2024, the DEA granted permission for Vyvanse’s manufacturer, Takeda Pharmaceuticals, to increase production by 24%, a move aimed at mitigating the lingering shortage2. 

Despite these efforts, manufacturers are still struggling to meet demand due to shortages of active pharmaceutical ingredients (APIs), global shipping delays, and bottlenecks in the supply chain that were common across industries during the pandemic. 

These issues have been compounded by the fact that ADHD medications must be produced under tightly controlled conditions, adding another layer of complexity to the process of replenishing supplies of the drug4. Because amphetamine is an active ingredient in these drugs, it is especially important for manufacturer’s to take additional care in synthesizing ADHD medications. 

The Role of Supply Chain Disruptions

Supply chain disruptions are another major factor contributing to the ADHD medication shortage. Many pharmaceutical companies have reported difficulties in sourcing the active ingredients needed to make these stimulant drugs. For example, ingredients for Adderall are often imported from overseas, where logistic delays and shipping constraints have made it harder to keep up with production schedules4. 

Additionally, some companies are facing logistical challenges when actually distributing medications once they have been produced. Delays in shipping and transporting these controlled substances have added to the problem, with many pharmacies unable to restock medications quickly enough to meet patient needs. Even as production levels rise, uneven distribution of the drug may lead to it taking months before the supply chain stabilizes, leaving patients to face ongoing uncertainty on whether their local pharmacy holds stock of the drug1. 

Impact on Patients

The impact of this shortage on patients has been profound. Many individuals rely on ADHD medications on a daily basis to manage symptoms like difficulty concentrating, impulsivity, and hyperactivity. Without access to these drugs, patients can experience mood swings, irritability, and a return of ADHD symptoms, making it harder to function in daily life. In some cases, patients may also experience withdrawal symptoms if they are forced to abruptly stop their medication rather than slowly tapering down a dose. These symptoms can range from sleep problems to panic attacks, depending on the individual5. 

Compounding this issue is the fact that the shortage is affecting not just Adderall, but most stimulant medications. It is also important to note the these medications are not exclusively used to treat ADHD, so patients may be prescribed these drugs for conditions from narcolepsy to Tourette syndrome6. Patients who are unable to get their usual prescription often have to

switch to alternative medications, if they are even available, a process that can be disruptive and unpredictable. This is especially the case in patients with multiple drug allergies or intolerances. Different medications may have varying side effects or effectiveness, and finding the right replacement can be a frustrating and time-consuming process, both for the patient and the prescriber. 

Pharmacies are struggling to keep up, and patients often find themselves having to call multiple pharmacies to locate available stock. In some states, laws that limit how much of a controlled substance can be dispensed at one time (typically 30 or 90 days’ worth) add another layer of difficulty1. If a patient’s usual medication is out of stock, they must go back to their doctor to get a new prescription, further delaying treatment 

Looking Forward: What’s Being Done?

While the DEA has increased production quotas for some ADHD medications, the situation is far from resolved7. Manufacturers are still working to address the shortage of active ingredients and logistical delays, and it is likely that the shortage will persist into late 2024. Experts warn that unless there are significant changes in how these medications are regulated and produced, shortages may continue to plague the system in the coming years as pharmaceutical companies work to meet demands4. 

In the meantime, patients are encouraged to stay in close contact with their healthcare providers and pharmacists. In some cases, adjusting dosages or switching medications may be necessary to ensure continued treatment2. However, given the unpredictability of the supply chain, there is no one-size-fits-all solution to the problem. 

For more information on the shortage and potential alternatives to discuss with your physician, you can read further details from our sources below. 

This article by Dr. Jennifer Poon of the Medical College of Georgia in Augusta describes the steps that parents of kids diagnosed with ADHD can take in dealing with the medication shortage.