Patients across Northeast Ohio continue to face shortages of ADHD medications, a problem pharmacists say is tied to federal production limits and rising national demand.
Chris Peshek, director of pharmacy at Discount Drug Mart, said shortages of medications like Focalin, Adderall and Ritalin have been occurring on and off for about three years. Because the drugs are classified as controlled substances, they are subject to stricter manufacturing rules than most prescriptions.
“Not all manufacturers can absorb the administrative burden that those drugs carry because they’re more regulated,” Peshek said. “And then not only are there less manufacturers, but there are federally established quotas on controlled substances.”
Those quotas are set by the U.S. Drug Enforcement Administration and are based largely on past usage. Peshek said that becomes a problem when demand rises faster than the quotas can be adjusted.
“The quotas assume that the habits and usage of the drug tomorrow is going to be the same as what it was yesterday,” he said. “When usage spikes for one reason or another, that’s where we run into problems because now the quota is not updated as fast as demand is updated.”
Nationally, the scope of drug shortages has grown. The American Society of Health-System Pharmacists reports the number of active drug shortages in the U.S. topped 323 medications in the first quarter of 2024, the highest level since tracking began in 2001. The list included ADHD drugs such as Adderall, along with cancer, allergy and diabetes medications.
Pharmacy chains say availability can vary by location. Walgreens and CVS say Focalin is generally available, though some dosage strengths may be in short supply at certain stores.
When one ADHD medication becomes scarce, patients are often switched to another, which can trigger a yo-yo effect of alternating shortages.
“All the patients on Focalin switch over to Adderall, and that causes a demand spike for Adderall,” Peshek said. “And then one or two months later, now all of a sudden we see a supply issue for Adderall.”
The impact on patients is widespread. Based on data from a 2023 Centers for Disease Control and Prevention survey, about 6% of U.S. adults have ADHD, and more than 71% of adults taking stimulant medications reported difficulty filling a prescription in the past year because their medication wasn’t available.
Pharmacists work with doctors and patients to find alternatives, such as switching drugs or adjusting doses.
“While not a perfect solution, it’s better than going cold turkey or going without the medication at all,” Peshek said.
Peshek said it's not a good idea to stop ADHD medication without tapering off if a prescription can’t be filled.
“Stopping suddenly after you’ve been on it regularly can cause withdrawal symptoms,” he said, including tiredness and sleep disturbances.
He said patients should call their pharmacy ahead of time and coordinate closely with their provider if a medication is unavailable.
