@@ ADHD Med shortage - NYTimes article

[redheadbaker]

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The Collateral Damage of A.D.H.D. Drug Shortages
As a new school year begins, parents and doctors find medication shortages are leading to declines in learning and self-esteem.

"Parents and caregivers across the country are spending hours each month hunting down pharmacies with A.D.H.D. medication in stock and asking their doctors to either transfer or rewrite prescriptions, a process many equate to having a second job. Others pay hundreds of dollars out of pocket for name-brand drugs that are sometimes more readily available but, unlike generics, are not covered by their insurance. Some children end up taking similar but less effective medications or go without medication for months at a time because their families do not have the extra time or cash." 

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"One of the cruelest aspects of the A.D.H.D. medication shortage, some parents have said, has been the collateral damage to their children’s self-esteem.

Kari Debbink, who lives in Bowie, Md., said her daughter, who is about to enter her senior year of high school, would lose motivation to do her school work when her A.D.H.D. medication, Concerta, was not available in either the brand name or the generic version. Her grades, which had typically been B’s, plummeted — and so did her confidence.

“Once she got behind, she couldn’t catch up,” Ms. Debbink said. “By the end of the year, we were just trying to prevent her from failing classes.”" 

[twilightmv]

It sucks. DS hasn't been on anything since around March, since we haven't been able to find adderall. We tried to switch to Concerta but couldn't find that. I switched to Vyvanse for myself, but it made my son anxious. I struggled to get my Vyvanse this month as there's now a shortage of that. My psych said a generic is coming next month which should help for me, but I know DS misses the Adderall.

[Velar Fricative]

I did not realize this was happening, the stories in the article are heartbreaking.

The article did mention some possible causes but it seems more frustrating because there really isn't a clear cause or causes per my reading, like there was during the baby formula shortage.

Also, don't read the comments unless you sort it by Readers' Picks.

[wanderingback]

Aug 16, 2023 12:09:57 GMT -5 Velar Fricative said:

I did not realize this was happening, the stories in the article are heartbreaking.

The article did mention some possible causes but it seems more frustrating because there really isn't a clear cause or causes per my reading, like there was during the baby formula shortage.

Also, don't read the comments unless you sort it by Readers' Picks.

I believe it was the perfect storm of manufacturing delays (shortages of supplies) along with more prescription demand.

It’s always a reminder that nothing, especially when it comes to healthcare, has an infinite supply.

I really try hard not to police certain things my patients ask for, like if they ask for blood work that is not indicated/needed. But at the same time I remind myself that the chain of things that need to happen, the supplies, the transport of the blood, the people running the labs, the results getting entered, etc, are not an infinite resource so saying no is ok sometimes.

Sorry a bit of a tangent, and hopefully a solution is found, but many things are not simple when it comes to supply chains which I think people have a hard time grasping these days since the advent of 2 day shipping being expected.

[pixy0stix]

The increase in diagnosis between 2020 and now is interesting. The article ties it to telehealth being more widely available. Just conjecture, but I also wonder if the forced closeness of being around family 24/7 during the pandemic really highlighted to people their kids, and their own, brain chemistry makeup.

[somersault72]

This is timely as I am currently calling multiple pharmacies to try and find Adderall for my son.

[penguingrrl]

This is really interesting. All three of my kids have ADHD diagnoses, but none are on stimulant meds due to adverse reactions, which has honestly had me questioning if their proper diagnosis is ADHD or something else. But one of the doctors in their neuropsych practice swore to me in July that it’s only chain pharmacies experiencing the shortage and he claimed it was “not really a shortage, just an issue with their contracted warehouses and local pharmacies that can use any warehouse don’t have an issue.” That didn’t make sense to me, and this article confirms he really wasn’t correct.

[pugz]

They have GOT to get production up. So many adults and kids are suffering due to the shortage. I know parents skipping theirs so their kid can take them instead.

[wildrice]

I can't believe this is still happening. It's been an issue for my H for months, and I know it's harder to feel sorry for a man in his 40s than for kids, but he has a highly intellectually demanding job with lots of details, and it's incredibly hard for him to do it without his meds. It absolutely impacts his self esteem and overall wellbeing. So far he has always been able to find something, but it isn't always the right formula or dose and it takes a lot of extra back and forth that he really can't easily do.

I hope they get this figured out. I don't think demand is going down anytime soon.

[Jalapeñomel]

Aug 16, 2023 13:22:22 GMT -5 penguingrrl said:

This is really interesting. All three of my kids have ADHD diagnoses, but none are on stimulant meds due to adverse reactions, which has honestly had me questioning if their proper diagnosis is ADHD or something else. But one of the doctors in their neuropsych practice swore to me in July that it’s only chain pharmacies experiencing the shortage and he claimed it was “not really a shortage, just an issue with their contracted warehouses and local pharmacies that can use any warehouse don’t have an issue.” That didn’t make sense to me, and this article confirms he really wasn’t correct.

We were told this at CVS on Friday!

[penguingrrl]

Aug 16, 2023 13:44:57 GMT -5 Jalapeñomel said:

Aug 16, 2023 13:22:22 GMT -5 penguingrrl said:

This is really interesting. All three of my kids have ADHD diagnoses, but none are on stimulant meds due to adverse reactions, which has honestly had me questioning if their proper diagnosis is ADHD or something else. But one of the doctors in their neuropsych practice swore to me in July that it’s only chain pharmacies experiencing the shortage and he claimed it was “not really a shortage, just an issue with their contracted warehouses and local pharmacies that can use any warehouse don’t have an issue.” That didn’t make sense to me, and this article confirms he really wasn’t correct.

We were told this at CVS on Friday!

Really? So that’s going around still! Doesn’t sound like it makes sense given that this article cites more diagnoses and a supply chain issue!

I could definitely see how a non chain isn’t bound to particular warehouses so it’s easier for them to source, but it sounds like that won’t overcome there being less medication made than there is need for.

[lilac05]

Aug 16, 2023 12:59:43 GMT -5 pixy0stix said:

The increase in diagnosis between 2020 and now is interesting. The article ties it to telehealth being more widely available. Just conjecture, but I also wonder if the forced closeness of being around family 24/7 during the pandemic really highlighted to people their kids, and their own, brain chemistry makeup.

I think there are a lot of factors at play, and definitely time increased together and increased awareness of it thanks to social media have had an impact. We’re actually just in the midst of this right now. Waiting for my son’s first Rx to be filled. We were discussing testing with our psychiatrist earlier this week, and he said his biggest frustration with current testing is that it does not take technology into consideration. As a society, he believes (and I agree) that our reliance on so much technology (including things like being able to switch to a million different shows on TV and not needing to wait through commercials to return to a show) is having a significant impact on the brains of almost everyone. He said it has been several YEARS since he referred someone for testing for ADHD and it came back negative, which is a change from earlier in his practice (he’s in his mid 40s). He & I agreed that many, many years from now, we’re going to look back and see that the way we’re living now just isn’t good for our brains.

We asked for him to prescribe was he felt would be best while also keeping the shortage in mind. We still had to wait. We could have called the doctor and had it sent to a different pharmacy, but that was too many steps on that day for my ADHD brain, so we decided to just wait. That’s the other thing…having someone who has ADHD have to jump through a million hoops just to get access to the thing that will hopefully help them jump through those hoops really sucks.

[lessel]

We're struggling with this with DS1 (8.5y). He's on Vyvanse now, but we've tried Ritalin and Focalin. We're in that phase of trying to see what works for him (have had various not-great side effects on all so far)... which is already a struggle because he doesn't want to take anything in the first place and had very adult and legit arguments. Plus the med shortage on top of that struggle. It honestly makes me want to throw in the towel on meds. It's so frustrating.

[sillygoosegirl]

Aug 16, 2023 14:01:34 GMT -5 penguingrrl said:

Aug 16, 2023 13:44:57 GMT -5 Jalapeñomel said:

We were told this at CVS on Friday!

Really? So that’s going around still! Doesn’t sound like it makes sense given that this article cites more diagnoses and a supply chain issue!

I could definitely see how a non chain isn’t bound to particular warehouses so it’s easier for them to source, but it sounds like that won’t overcome there being less medication made than there is need for.

The non-chain pharmacies near me all seem be out of business...

[lilac05]

Aug 16, 2023 15:13:36 GMT -5 lessel said:

We're struggling with this with DS1 (8.5y). He's on Vyvanse now, but we've tried Ritalin and Focalin. We're in that phase of trying to see what works for him (have had various not-great side effects on all so far)... which is already a struggle because he doesn't want to take anything in the first place and had very adult and legit arguments. Plus the med shortage on top of that struggle. It honestly makes me want to throw in the towel on meds. It's so frustrating.

I totally understand this. We’ve gone back and forth for DS1. Our psychiatrist also recommends what he calls “The Big 5.” Diet, sleep, exercise, therapy, and meditation. Meditation (free app Insight Timer) and exercise have been the most beneficial for him. My own struggles make diet difficult.

[cattledogkisses]

Aug 16, 2023 13:42:56 GMT -5 wildrice said:

I can't believe this is still happening. It's been an issue for my H for months, and I know it's harder to feel sorry for a man in his 40s than for kids, but he has a highly intellectually demanding job with lots of details, and it's incredibly hard for him to do it without his meds. It absolutely impacts his self esteem and overall wellbeing. So far he has always been able to find something, but it isn't always the right formula or dose and it takes a lot of extra back and forth that he really can't easily do.

I hope they get this figured out. I don't think demand is going down anytime soon.

Liking in solidarity.  Adderall has been life changing for H, and in a roundabout way has been beneficial for me too, because as the neurotypical partner in the relationship I felt like I often ended up in a "caretaker" role, which was exhausting and stressful sometimes.  I can tell immediately now if he forgets to take his meds. 

At this point this shortage has been going on since the early spring... they really need to get a handle on this somehow.  Sometimes I feel like people don't view ADHD medications as being essential the way that they do for other drugs, but for people who take these medications they really do have such a large impact on well-being. 

[Susie]

Aug 16, 2023 13:42:56 GMT -5 wildrice said:

he has a highly intellectually demanding job with lots of details, and it's incredibly hard for him to do it without his meds. It absolutely impacts his self esteem and overall wellbeing. 

I have an employee in this situation.  He shared with me about 6 months ago that he was struggling to find the Rx that he needed at pharmacies, and did I have any recs on where else to try.  (I guess I give mom vibes at the office more than I realized, lol)  He's a 20-something relatively recent grad, no kids, but even so, he doesn't have time with a full time job to run and call around to a million different pharmacies only to come up empty handed.  I did recommend trying a couple of independent pharmacies that I knew of that might be different from your average Walgreen's, CVS, etc. but it's a tough situation.  I can 100% tell in his work quality when he isn't able to get his Rx.  It goes from fantastic to poor really quickly, with nothing in between.  I'm sure it's miserable for him, it's challenging for me as a manager, it's just an overall really tough situation.  And that's with all adults involved.

[penguingrrl]

Aug 16, 2023 15:28:34 GMT -5 sillygoosegirl said:

Aug 16, 2023 14:01:34 GMT -5 penguingrrl said:

Really? So that’s going around still! Doesn’t sound like it makes sense given that this article cites more diagnoses and a supply chain issue!

I could definitely see how a non chain isn’t bound to particular warehouses so it’s easier for them to source, but it sounds like that won’t overcome there being less medication made than there is need for.

The non-chain pharmacies near me all seem be out of business...

That stinks. I’m lucky that we still have one that’s thriving and where I always go.

[mcsangel2]

It isn't just ADHD meds. Several cancer drugs have had shortages for months (meaning there are patients dying sooner than they would have otherwise), and some veterinary meds as well. Clearly it's some kind of lagging effect left over from the pandemic, bottlenecks and/or labor shortages.

[redheadbaker]

DS used to be on Focalin, but the effectiveness wore off, so his doctor wanted to switch him to Adderall. We couldn't find it anywhere. So, he's on Vyvanse instead but it's SO DAMN expensive. Luckily, a friend told me about gettiing him Medicaid, and that helped.

We haven't run into being unable to fill his Rx -- yet. We use an independent pharmacy since we kept running into them being out of his meds and not telling us, AND they screwed up my antidepressant medication putting me in withdrawal for a week.

[wesleycrusher]

penguingrrl Jalapeñomel

As a nurse who works in psychiatry and has dealt with this daily for the past year, it is absolutely every pharmacy and not just chains. Chains were impacted first before local pharmacies, but it has been all pharmacies for months.

[ssmjlm]

Aug 16, 2023 12:59:43 GMT -5 pixy0stix said:

The increase in diagnosis between 2020 and now is interesting. The article ties it to telehealth being more widely available. Just conjecture, but I also wonder if the forced closeness of being around family 24/7 during the pandemic really highlighted to people their kids, and their own, brain chemistry makeup.

This is where I am. I'm having flashbacks to the 90s when every kid was on ritalin if they couldn't sit still. Obviously that's a generalization, but I do wonder where the spike has come from. 

There's a thread on ML about getting a ADHD diagnosis and the hoops/testing the parents are going through. So I guess I'm surprised that people are being diagnosed via telehealth?

[AdaraMarie]

It really sucks but it isn't new news. The article said it's been going on since last fall and I couldn't get a prescription filled in December or March. Thankfully I just had a 90 day mail order one come in so dd should be good for a while. The part about it being controlled sucks too because you can't order a refill until you're almost out - it's not like you can just get on a list early and have it filled when it is available.

[redheadbaker]

Aug 16, 2023 16:26:39 GMT -5 AdaraMarie said:

It really sucks but it isn't new news. The article said it's been going on since last fall and I couldn't get a prescription filled in December or March. Thankfully I just had a 90 day mail order one come in so dd should be good for a while. The part about it being controlled sucks too because you can't order a refill until you're almost out - it's not like you can just get on a list early and have it filled when it is available.

I'm jealous you can get a 90-day supply! 

[raleighnc]

Our insurance decided to stop covering the med that my girls have been on for four years (Jornay) in July, with spectacularly bad timing. Jornay must not be in as much demand because we almost never had trouble getting it (you take it at night and it's working when you wake up, which is amazing). So they have to fail three alternatives before we can appeal (so basically generic focalin, generic concerta, and a new one called Azstarys that they must have gotten a sweetheart deal on). Trying to find supplies of these alternatives has been awful, and the meds themselves have been awful. So much stress trying to get them out of the house in the morning when they were self-sufficient for years, so much sniping in the afternoon when DD1's impulse control is gone and so much crying on DD2's part. It sucks so much.

[spindle92]

I didn't read the full article but I am in this boat for myself.
Since last fall, every month has been a struggle to see if my rx is in stock (which it never is) and then the waiting game as to when the pharmacy will get a shipment.

Luckily my job has not been effected by my ADHD and lack of rx but my schoolwork most definitely has.

[whattheheck]

What am I finding particularly frustrating with the shortage is that the pharmacies in my area won’t tell you if they have the medication in stock bc it’s a controlled substance. And you can’t transfer the prescription once it’s sent to a pharmacy - even one in the same chain. So my doctor sends the Rx over to the CVS I usually use. They don’t have it which I don’t get notified of - I have to obsessively check the app until it’s rejected. So I have to take a guess and ask the doctor to send it to another one. And so on and so forth with varying pharmacies (not just CVS). If my doctor were to call they could find out if the pharmacy has it in stock but the doctors office doesn’t have time for that. Understandably. And since you can only refill it two days in advance by the time you finally find a pharmacy that can fill it those two days have passed and your kid is off their meds. And I don’t know WTF I’m going to do after he leaves for college and doesn’t have a car to drive to a pharmacy to pick it up himself and I can’t stick a controlled substance in the mail. It all sucks in so many ways.

[vamoose]

Aug 16, 2023 21:52:07 GMT -5 whattheheck said:

What am I finding particularly frustrating with the shortage is that the pharmacies in my area won’t tell you if they have the medication in stock bc it’s a controlled substance. And you can’t transfer the prescription once it’s sent to a pharmacy - even one and the same chain. So my doctor sends the Rx over to the CVS I usually use. They don’t have it which I don’t get notified of - I have to obsessively check the app until it’s rejected. So I have to take a guess and ask the doctor to send it to another one. And so on and so forth with varying pharmacies (not just CVS). If my doctor were to call they could find out if the pharmacy has it in stock but the doctors office doesn’t have time for that. Understandably. And since you can only refill it two days in advance by the time you finally find a pharmacy that can fill it those two days have passed and your kid is off their meds. And I don’t know WTF I’m going to do after he leaves for college and doesn’t have a car to drive to a pharmacy to pick it up himself and I can’t stick a controlled substance in the mail. It all sucks in so many ways.

Ugh. Dealing with this for my son’s Vyvanse. Pharmacies treat you like a drug seeker and many have told me that my doctor needs to send in the RX to see if they have stock. But getting the doctor to send in the script takes a day or two because they are short staffed and currently you have to go through their online system. Ughhhh. We have tried so many meds in the past with bad results and we can’t just switch around without bad side effects.

[shauni27]

Aug 16, 2023 15:42:40 GMT -5 cattledogkisses said:

Aug 16, 2023 13:42:56 GMT -5 wildrice said:

I can't believe this is still happening. It's been an issue for my H for months, and I know it's harder to feel sorry for a man in his 40s than for kids, but he has a highly intellectually demanding job with lots of details, and it's incredibly hard for him to do it without his meds. It absolutely impacts his self esteem and overall wellbeing. So far he has always been able to find something, but it isn't always the right formula or dose and it takes a lot of extra back and forth that he really can't easily do.

I hope they get this figured out. I don't think demand is going down anytime soon.

Liking in solidarity.  Adderall has been life changing for H, and in a roundabout way has been beneficial for me too, because as the neurotypical partner in the relationship I felt like I often ended up in a "caretaker" role, which was exhausting and stressful sometimes.  I can tell immediately now if he forgets to take his meds. 

At this point this shortage has been going on since the early spring... they really need to get a handle on this somehow.  Sometimes I feel like people don't view ADHD medications as being essential the way that they do for other drugs, but for people who take these medications they really do have such a large impact on well-being. 

I am in this boat as well with my H. He was diagnosed last Christmas with ADHD and anxiety/depression. Fortunately he has his anxiety meds, but since his diagnosis and prescription was written for his ADHD meds, he has not been able to get them yet. 

[Captain Catnip]

Just fyi in case this helps anyone else - - my local pharmacy was not filling brand name unless requested, so while my generic was on back order they had the pricier brand name on hand, I just had to request it and have a note added to my account.