The Adderall Shortage: Why It’s Still Happening and What to Do if You Can’t Get Your Meds (2024)

Proposed Rule Changes Could Limit Virtual Adderall Prescribing

This easier access could soon be curtailed. The DEA, which regulates the supply of ADHD drugs like Adderall or Ritalin that are considered controlled substances, recently announced a proposed change in the rules for telehealth prescribing of the drugs.

The proposed rules are intended to improve the safety of online prescribing as telemedicine grows in popularity. “DEA is committed to the expansion of telemedicine with guardrails that prevent the online overprescribing of controlled medications that can cause harm,” Anne Milgram, the DEA administrator, said in a press release.

According to the DEA's proposed rules, doctors will need to evaluate a patient in person before prescribing controlled substances like Adderall and Ritalin by telemedicine for the first time, or the patient must be referred by another physician who has seen them in person. Doctors who have been prescribing controlled drugs via telehealth must now have an in-person evaluation of the patient within six months after the DEA implements its final rule in order to continue prescribing the medications.

The proposed rules also require the doctor to have DEA registration in both the state they practice in and the state where the patient lives. “That might limit access to doctors for patients who have few prescribing doctors in their state and can’t easily travel for the in-person evaluation,” says Dr. McWilliams.

Although the rules aren’t as restrictive as they were before the pandemic, they may still make it more difficult for some people with ADHD to get the medications even when supply bounces back.

The proposed rules were open for public comment until March 31. The DEA originally planned for the new rules to go into effect by May 11, 2023, when the public health emergency ends. But after receiving a record 38,000 comments on the proposed rules, the DEA instead extended its timeline.

“We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards,” said Milgram in a press release issued May 3, 2023.

ADHD Drug Prices Are Also Increasing Amid Short Supply

Another factor that could make ADHD drug shortages even more complicated is that some patients are now facing steeper price tags for Adderall and other medications to treat ADHD.

There’s an “upward trend” in the prices retail community pharmacies are paying for popular ADHD drugs, according to a USA Today analysisof Medicaid National Average Drug Acquisition Cost data. These prices are outpacing inflation and, in some cases, have doubled or tripled in price since the Adderall shortage began in October 2022, the analysis states.

These price hikes are especially putting financial pressure on families who aren’t adequately insured. It’s a trend experts say occurs when demand spikes.

“Some people have been forced to switch to nongeneric meds, which are more expensive, and for this reason they remain available when other generic ones are not,” says Alex Dimitriu, MD, a psychiatrist in private practice in Menlo Park, California, and a medical reviewer for Everyday Health, who prescribes stimulants for some of his patients with ADHD.

“In the end, unfortunately even with medication, the laws of economics — supply and demand — still apply. As expected, during a shortage of medication, the price surges upward as demand continues, or even increases,” he says.

Ryan Sultan, MD, a psychiatrist at Columbia University in New York City who studies medical interventions for ADHD, says he’s heard from a handful of his patients that they’ve found it difficult to pay for their prescriptions amid inflated prices and inadequate health insurance.

“It’s the new problem on top of our ongoing problem of getting the medication to the people who need it,” Dr. Sultan says. “I can’t tell you the amount of time we spend on the phone with pharmacies trying to figure out if they have enough of the medication, and there’s an added layer of price now.”

What to Do if You’re Having Trouble Getting Your ADHD Meds

The ADHD drug shortages have shown some signs of waning, according to the FDA.

“Manufacturers are working to meet the demand and the FDA is helping with anything we can do to increase supply. Supply is increasing, and the FDA is continuing to offer assistance,” says James McKinney, a spokesperson for the FDA.

Establish a Relationship With Your Local Pharmacy

If you were taking a stimulant medication like Adderall that was working well for you, it’s worth calling several pharmacies in your area to see if any of them have that medication in stock, says Jack Turban, MD, an assistant professor of child and adolescent psychiatry at the University of California in San Francisco.

Your local pharmacy may also be able to help you with this, says Sultan. “At large chain pharmacies, pharmacists can call around to other branches to see if they can fill your prescription. And at smaller pharmacies, the pharmacist may be able to contact distributors to see what they have on hand or are getting in,” says Sultan.

Ask About Alternative Doses of Your Usual Medication

If your usual medication is unavailable, ask your prescriber about the availability of smaller doses, or if larger doses can be divided into smaller ones, such as splitting a 10 milligram (mg) tablet into 5 mg ones, says Dr. Dimitriu.

There may also be an extended-release version of certain medications such as Adderall XR, which may work for you, Dimitriu adds. They don’t need to be taken as frequently as other ADHD medications.

If you find yourself responding differently to an alternative medication dose — or if you notice new or worsening side effects — talk to your doctor, says Dimitriu.

See if Your Doctor Could Temporarily Switch You to Another Medication

If you’re not able to find the medication anywhere, despite your best efforts, there are other similar stimulant formulations you can talk with your prescriber about taking on a temporary or longer-term basis, says Sultan.

Each formulation may work differently for different people, so it could take some trial and error to find a suitable alternative, he adds.

Potential alternative drugs could include modafinil (Provigil), armodafinil (Nuvigil), and bupropion (Wellbutrin), all of which may have some benefit for ADHD, says Dimitriu.

Alternative drugs could be covered by your insurance at a lower or higher rate than your current drug, notes Childress. For more expensive drugs, Childress recommends asking your pharmacist about discount coupons and programs to help you afford alternative medications if you need them.

Talk to Your Doctor About Whether Adderall Is Really the Right Drug for You

While stimulants are generally safe and very effective for ADHD when prescribed appropriately, they can come with side effects including decreased appetite, sleep problems, and increases in heart rate and blood pressure, says Dr. Turban. “That’s why it’s so important for patients to have appropriate medical and mental health screenings prior to starting them and regular medical follow-up while taking them,” Turban says.

If you’ve benefited from stimulants for ADHD, but have had bothersome side effects, the shortage might prompt you and your doctor to consider nonstimulant medications such as guanfacine (Intuniv), clonidine (Catapres), and atomoxetine (Strattera), he says.

Ask Your Doctor About Nondrug Treatments and Lifestyle Management Strategies

People with ADHD who take medication often also work on behavioral management strategies such as time management, organization, and task prioritization to help them manage their symptoms. If you’re having trouble getting your medication, consider talking to your doctor about whether you might be able to bolster your condition management with more of these nondrug approaches.

These types of strategies could be very helpful for you as an alternative to medication or while you’re waiting for a drug to come back in stock or for a new drug to begin working, Dimitriu explains.

Although these strategies may not replace some of the effects of medication, evidence shows that certain nondrug treatments are still very effective. For instance, one study published in the September 2019 issue of Psychiatry Research showed that cognitive behavioral therapy (CBT) on its own was no less effective than a combination of medication and CBT.

Find Ways to Save Money on the Meds You Need

If escalating prices are deterring you from buying your medication, you have a few options to consider, says Dimitriu.

If you’re insured, your best bet is to thoroughly read and understand your policy, Sultan says. Check which ADHD medications your insurance provider covers and which of your insurance company’s preferred pharmacies are near you. Both of these strategies can help you find a better price and coverage for the medication you need.

“It’s about looking at your insurer first rather than these other routes, which won’t be as fruitful,” Sultan explains. “You’re going with the system and what it wants you to do as opposed to going around it.”

It could also help to try GoodRx.com for savings on medication where possible, but keep in mind that savings offers can be limited when it comes to stimulants, Dimitriu notes. You can also check for savings plans and coupons for newer, nongeneric medications, which are provided by each drug manufacturer and featured on their website, he adds.

Additional reporting by Lisa Rapaport, Christina Vogt, and Carmen Chai.