When the US Food and Drug Administration confirmed a shortage of the drug Adderall last month, many people who rely on the medication weren't surprised: They've been struggling to fill their prescriptions for months.
The FDA says the shortage is expected to last another 30 to 60 days. It's happening in part due to surging demand for Adderall and intermittent manufacturing delays at Teva Pharmaceuticals, one of the leading makers of the drug, which is primarily used to treat attention-deficit/hyperactivity disorder.
Amid this increased demand, other manufactures are also experiencing shortages.
It's a problem that affects a growing number of Americans.
A report from data analytics firm Trilliant Health found that nationally, prescriptions for Adderall among people ages 22 to 44 increased 15% between 2020 and 2021. There was also a slight uptick in prescriptions among people 45 and older.
Dr. David Goodman, an assistant professor in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins School of Medicine, said that for the past several months, his patients have had to wait several days to fill their prescriptions. Lately, they're having to wait up to a week or two. Some were even told that pharmacies might not see new supplies for months.
A lack of access to Adderall, which must be taken daily, can have implications for careers, home lives and even safety, Goodman said.
"This can come down to the difference between stopping at the red light or running the red light because you got distracted," he said.
At home, it can mean being a less attentive member of the family, being unable to regulate your emotions and feeling more irritable, increasing conflicts. At work, it may mean increased impulsivity and tardiness, making the person seem like an unreliable worker.
"I've had patients call 10,15, 20 pharmacies in order to get their medication," Goodman said. "Now imagine you're sitting on the phone, desperate to get needed medication, and pharmacy after pharmacy after pharmacy is telling you either they can't tell you or they don't have any, and 'we can't tell you when we're going to get it,' and that's where the panic sets in."
Over time, these incidents can take a serious toll on a patient's mental health.
'You can't get this anywhere'
Clara Pitts is what her mom describes as an overachiever. The 17-year-old from Taylorsville, Utah, is a National Merit Scholar and is constantly busy with studying and schoolwork.
Without medication, Clara experiences something known as ADHD paralysis: She might have a long list of things to accomplish and knows she needs to get through it, but she struggles to stop whatever other activity she is doing.
"She's constantly trying to accommodate," Rebekah Pitts said. "She has a really detailed spreadsheet online where she puts everything she needs to do to try to help herself to compensate, but the difference between being on [Adderall] and not on it is more of a scale -- that it's easier for her to stay focused."
Rebekah has called eight local pharmacies on behalf of her daughter since the FDA announced the shortage, and each one turned up empty. She was told Clara could have to wait up to two months to get the medication.
"As a parent, I was surprised at how upset I felt," Rebekah said. "I was crying, and it caused me to be just exhausted. By the end of the day, I just crashed. I was like, 'Wow, this has really taken a toll on me,' and I think I've realized I'm accustomed to being able to get medication when I have a prescription. I have never in my life tried to fill a prescription and been told 'you can't get this anywhere.' "
When CNN talked to Clara in late October, her prescription bottle had eight pills left, enough to last four days. But with college applications looming and the stress of senior year, Clara was rationing the pills for the moments when she needs absolute focus.
"Sometimes, my resting heart rate is elevated when I'm just sitting down thinking about my applications," Clara said.
Clara is headed to her doctor to seek an alternative medication until Adderall is back in stock.
Ashley Jordan, 24, of Colorado said she is also having to save her pills for when she needs them most.
She has been taking Teva's version of Adderall for over seven years for ADHD and was surprised to find in August that her pharmacy had given her a different brand without telling her, because it was all they had.
However, the new brand was not a good fit. "I was getting sick and throwing up every day I took it," she said.
Now, she's rationing the few Teva pills she has left.
"I've pretty much had to try to get as much done as possible when taking the pills to avoid struggling without them," she said, "so I've pretty much just been in overdrive since it happened."
Mikey DeDona, 22, of Boston takes Adderall for type 1 narcolepsy. This condition makes it hard for him to regulate his sleep. It can look like lots of low-quality sleep or even insomnia.
It took five days for his pharmacy to fill his prescription in late October, and those days took a toll.
"It's just knowing that I'm not going to be even 50% throughout the day," DeDona said.
Without Adderall, it was much more difficult for DeDona to get out of bed, and he needed several naps throughout the day. Suddenly going without the medication also caused headaches and confusion.
"It sucks to not be able to do anything, against your own will," DeDona said, "You immediately have to be reminded of how bad it is without medication."
He was finally able to fill his prescription last month but worries about availability in the months ahead, as he doesn't want to try an alternative medication.
Goodman says there are pros and cons to trying different meds. "The plus is, here's an opportunity to change medicine and see if there's a subjective improvement in the experience of the medication. ... The downside to this is that the stimulants are not equally substitutable."
Goodman said new medications could also bring new side effects such as sleep issues, mood changes and headaches.
Searching for safe alternatives
Many people who have trouble finding Adderall in stock are looking for alternatives. Hundreds of social media accounts claim to have the medication available, and some people are turning to friends who no longer use the pills they were prescribed.
Goodman strongly warns against this, offering a reminder that not only is selling your own prescription medication a felony, so is sharing it with others.
He also emphasized that buying pills from social media or dealers is incredibly dangerous.
In October, the US Department of Justice charged 23 people with trafficking counterfeit pills after seizing over 74,000 counterfeit pills -- including counterfeit Adderall laced with methamphetamine.
"Remember, if you're not getting your pills by a medical prescriber and they're not dispensed to you by an authorized pharmacy, you're taking literally your life into your hands," Goodman said.
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