“Handle with extreme caution if Aaron doesn't have his medication,” said his mom, Robin Richeson. “Seriously,” she said, “without his medication [Concerta], he can be very hyperactive, impulsive, stubborn, and not able to focus on anything at all.”
Unfortunately, there have been occasions when Richeson has been turned away from her pharmacy because her son’s needed medication was out of stock. The problem of not enough supply to meet the demand is becoming more and more common. According to a White House statement, prescription drug shortages are becoming more frequent and increasing in severity each year. The overall number of medication shortages almost tripled between 2005 and 2010.
Why Are ADHD Medication Shortages Happening?
Depending on whom you ask, ADHD medication shortages are the result of drug companies trying to maximize profits, or the Drug Enforcement Administration (DEA) trying to minimize access to people who will abuse the drug.
“The active ingredients in most ADHD drugs are controlled substances,” explained Troy Rebert, PharmD, manager of the soon to open University Pharmacy at the University of Tennessee Medical Center. “The DEA sets annual quotas limiting the amount of controlled substances that can be produced or purchased by manufacturers. Due to outdated DEA regulations, supply is unable to keep up with the growing demand and pharmacies are running out of ADHD medications.”
The White House identified the main reasons for reported shortages as issues at the point of manufacture (43 percent), delays in production or shipping (15 percent), and lack of enough active pharmaceutical ingredients (10 percent).
Questioning the Decision to Medicate
Whatever the underlying reason, being turned away from the pharmacy because a prescribed medication was out of stock caused Richeson to worry about her decision to accept her son’s diagnosis. Were too many people being diagnosed? “As a mother I worried, and still do, over his diagnosis, even after having gone through weeks of testing,” she said.
But she also acknowledged the benefits the medication has provided. Beforehand, she tried changing his diet, increasing his activity, and every other option she could think of, but nothing worked until he took ADHD medication. “Aaron recently finished his second year in kindergarten because of my decision to hold him back — not because of his failed grades and social anxiety, but because I knew he could do better the second time around. He spent his second year fully medicated, unlike the first year, and grew academically and socially by leaps and bounds. It was amazing to see the changes in him. He could think clearly and concentrate easily,” she explained proudly. Whatever it takes, she knows she has to find a way to continue filling her son’s prescriptions for the drug that is helping him to succeed — even if it means driving to other cities when she can’t fill it locally.
Being Proactive About ADHD Prescriptions
The best way to assure a refill is available is to call ahead for it, recommended Richeson. “Once Aaron has only a week's supply left, I call in for a refill,” she said, adding that she calls again when he is down to three or four pills to see if the refill is ready to be picked up.
Rebert recommended using a single pharmacy for all prescriptions. “Pharmacies typically order medications based on current customer need, and if they know you will be coming back month after month, the medicine you need will be in stock.”
When a drug shortage occurs, the ADHD advocacy group CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) recommends asking your pharmacist to call other locations to see if they have the medication in stock or contacting the manufacturer yourself to ask for help locating a nearby source. If the medication simply cannot be found, ask your pharmacist for information about other possible medications and then discussing those options with your doctor. You might also check with the pharmacist to see if they have the required medication in a smaller dose — then your child can take additional pills to reach the required dose. Discuss this option with your doctor.
Mail-Order Prescriptions: A Warning
Mail-order prescription coverage is offered by some insurance plans, and this option works well for many families. However, Rebert recommended using caution if you order medication from random online websites claiming to have medications you haven’t been able to locate anywhere else. “The Food and Drug Administration warns consumers about counterfeit drugs during shortages,” he said. According to the FDA, a counterfeit version of an Adderall tablet was being sold on the Internet. “We recommend using only reputable pharmacies that you are familiar with.”