In other words, it’s critical for college students and others who recently moved out on their own to develop reliable medication management routines without parental scaffolding — and to advocate for their own health care needs at the doctor’s office.

[Free Resource: 2024 Scorecard of ADHD Treatments]

Here is the advice I give to my young adult patients:

• Incorporate medication administration into your daily routine. Use alarms or reminders on your phone, or associate medication with specific daily activities (e.g., breakfast or brushing teeth). Use a pill organizer to keep track of doses.
• Understand the expected effects and potential side effects of ADHD medication, and the likelihood that ADHD symptoms will return if doses are skipped. Also know that ADHD medication reduces the risk of substance use and improves productivity at work and in school.
• With your provider, brainstorm ways to adjust your routine to better support medication maintenance. Discuss different medication options, such as long-acting versus short-acting formulations.
• Regularly monitor medication effectiveness and side effects. Keep track of changes in symptoms or adverse reactions. Talk to your doctor about these and any other challenges with your medication regimen, concerns about mixing your ADHD medication with other medications or substances, difficulties adhering to the prescribed schedule, or struggles with getting timely refills from your pharmacy.
• If you experience significant side effects, worsening symptoms, or recognize a change or deterioration in your work performance, relationships, sleep, exercise routines, task management, or overall executive functioning skills, it’s important to tell your health care provider.

ADHD Medication Management: Next Steps

• Download: Get Control of Your Life and Schedule
• Q&A: ADHD Medication — Side Effects, Dosages, Precautions & More
• Read: How to Treat a Teen Self-Medicating ADHD

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Health Insurance Plans: High-Deductible vs. Low-Deductible

Employer-sponsored health plans generally include high-deductible plans and low-deductible plans. With the former, you pay less in premiums but more out-of-pocket for medical care and prescriptions before your insurance kicks in to cover eligible costs.

In traditional low-deductible plans, you pay higher premiums, but the carrier covers a copay or coinsurance on your office visits and certain prescriptions. Your deductible is tapped only for services like surgery, emergency room visits, MRIs, and so on. Under these plans, you typically copay for medication and therapy sessions.

[Free Download: What to Ask Before Starting ADHD Medication]

Drawbacks of High-Deductible Plans for ADHD Patients

The higher your deductible, the lower your premiums. For people with ADHD, this is usually not the best option. (However, if you have a Health Savings Account (HSA) or a Flexible Spending Account (FSA), a high-deductible plan may be worthwhile because it will let you set aside pre-tax dollars for certain health care costs. More on that below.) Generally, high-deductible plans are not advised for these reasons:

• You’re unlikely to put the money saved from lower premiums toward your health care. Also, many folks with ADHD are reluctant to seek routine health care. If they must pay out-of-pocket to see a provider, their motivation won’t improve.
• You may avoid preventive care and end up spending more in the long run. A copay-based system generally helps you to spend less on medical care and keeps you healthier.

HSA vs. FSA

Many employer-based insurance plans offer these options. HSAs are attached to high-deductible plans. If you contribute more than you spend on health care costs in a year, you can roll those funds over year after year and build a sizable nest egg.

FSAs, on the other hand, do not typically roll over to the next year; you must spend the funds during the policy year or lose them. But if you have a sudden expense early in the year, you can typically pay for it with an FSA because these accounts are usually fully funded at the beginning of the policy year (then paid back over the next 12 months through an employee’s pre-tax payroll deduction). By contrast, the HSA can pay only what has been saved.

[Free Resource: Treatment Strategies You Haven’t Tried]

Prescription Discount Programs and Medication Discount Cards

Before you start any brand name medication for ADHD (or anything else), go to the manufacturer’s website and see if they offer a discount program (find a list at additu.de/medsavings). This is not the same as an after-market coupon, like GoodRx. Those can be helpful too, but typically only for generics.

How Does Health Insurance Work: Next Steps

• Free Webinar: How to Get, Afford, and Refill Your Prescriptions With Minimum Hassle
• <Read: Doing Battle with Your Insurance Company
• Read: Can Insurance Companies Discriminate Because of ADHD?
• Find: ADDitude Directory — Affordable Care Near You

Wes Crenshaw, Ph.D., is a licensed psychologist in Kansas and co-author of ADD and Zombies: Fearless Medication Management for ADD and ADHD.

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The ongoing shortages of generic ADHD medications and chemotherapy drugs are addressed in new draft legislative proposal released on May 3 by Senate Finance Committee Ranking Member Mike Crapo (R-Idaho) and Chair Ron Wyden (D-Oregon), who said the proposed legislation would “tear down regulatory barriers that are preventing families from accessing critical drugs like those needed to combat ADHD.”

The draft legislation was announced on the same day the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP), and Children’s Hospital Association (CHA) sent a letter to the U.S. Department of Health and Human Services and Drug Enforcement Administration expressing their continued concern about the ongoing stimulant medication shortages.

“Families that rely on generic stimulant medications have been disproportionately affected by the ongoing stimulant shortages,” the letter said. “This situation only exacerbates existing health disparities among economically disadvantaged families who are enrolled in Medicaid and CHIP.”

The proposed legislation establishes a Medicare Drug Shortage Prevention and Mitigation Program, wherein hospitals, healthcare providers, group purchasing organizations, drug manufacturers, and others could earn payment incentives for improving their purchasing and contracting practices across the supply chain for generic drugs, including generic versions of ADHD medications such as Adderall and Vyvanse. The proposed legislation would also limit inflationary rebates under the Medicaid Drug Rebate Program (MDRP) for certain generic drugs susceptible to shortages.

“It is unacceptable that America is consistently running out of affordable and essential generic medicines,” Wyden said in a press release. “Once again, monopolistic middlemen have put market power and profit over families’ healthcare.”

Associations Urge Government to Address ADHD Medication Shortage

In their letter on ADHD medication shortages, the AAP, AACAP, and CHA call on the federal government to “convene all relevant stakeholders for a forum to discuss the impact these shortages are having on patients, families, and their providers and identify actionable solutions that will alleviate these shortages.”

“Pediatric providers, including child and adolescent psychiatrists, pediatricians, and children’s hospitals, along with the patients and families they serve, face an insurmountable struggle with stimulant medication shortages,” the letter said. “Untreated ADHD can contribute to worsening mental and behavioral health disorders, including mood and substance-use disorders, unintended injuries resulting from ADHD-related impulsivity and long-term impacts on relationships-building, educational achievement, and professional success. Parents and families may also be negatively impacted by the disruption that untreated ADHD can cause in the home, school, and work environments.”

According to the American Society of Health-System Pharmacists (ASHP), 323 medicines are currently in short supply, the highest number of ongoing and active drug shortages since the organization began tracking data in 2021.

ASHP reported that “new DEA quota changes, along with allocation practices established after opioid legal settlements, are exacerbating shortages of controlled substances (12% of all active shortages).” The Drug Enforcement Agency (DEA) classifies stimulant ADHD medications, such as Adderall and Vyvanse, as “Schedule I,” which indicates drugs with a high potential for abuse.

FTC, HHS Seeks Public Input on ADHD Medication Shortage

The Federal Trade Commission (FTC) and U.S. Department of Health and Human Services (HHS) are seeking public input to understand how the practices of pharmaceutical middlemen contribute to drug shortages and impact patients, hospitals, healthcare providers (including small healthcare providers and rural hospitals), pharmacies, generic manufacturers, and other suppliers.

Sixty-three percent of the more than 6,200 public comments already submitted mention ADHD.

The deadline to submit public comments is May 30, 2024. Add your testimony at Regulations.gov.

The public can also demand an end to the ADHD medication shortage by writing letters to representatives, the DEA, and the FDA using templates provided by ADDitude.

When administered at carefully selected dosages in clinical settings, and combined with therapy before and after treatment, psychedelics have been found to provide rapid relief from some of the most painful and difficult-to-treat mental health conditions. Ketamine is being used for depression and suicidality in clinical trials. MDMA is treating severe post-traumatic stress disorder (PTSD), and psilocybin is being used for treatment-resistant depression, alcohol use disorder, and more.

However, important questions remain about the long-term efficacy and safety of psychedelics, as well as patient suitability. Several large-scale studies are now under way to address these concerns, including the first-ever phase 3 clinical trial on psilocybin-assisted therapy — the largest randomized, controlled, double-blind study on the drug, with more than 800 participants. Initial results are expected this summer.

How Do Psychedelics Work?

Research shows that psychedelics improve many neuropsychiatric disorders, but the way they work is less clear. Functional MRIs and laboratory studies offer possible explanations:

• Ketamine binds to NMDA receptors in the brain, increasing levels of a mood-regulating neurotransmitter called glutamate.¹
• MDMA increases oxytocin, dopamine, and other chemical messengers related to positive emotions.²
• Psilocybin stimulates the brain’s serotonin 2A receptors, appearing to decrease activity across the default mode network.³

But these biochemical explanations don’t tell the full story, says Gül Dölen, M.D., Ph.D., professor of psychology and researcher at University of California Berkeley’s Center for the Science of Psychedelics. Psychedelics only reliably improve psychiatric conditions when administered with therapy. “Therapy is the context to get the cure,” Dölen explains. “You can’t take MDMA and go to a rave and expect it to cure your PTSD.”

Indeed, when taken on their own, psychedelics aren’t hugely effective, according to studies; therapy unlocks the drugs’ enduring benefits. Also, there are serious risks to taking the drugs without medical supervision.

[Read: The Truth About Lion’s Mane, Psychedelics & Caffeine]

A Brand-New Framework

Most psychiatric medications must be taken daily, often for a lifetime. By contrast, a single dose of certain psychedelics paired with therapy can result in full-blown remission. This claim appears too good to be true when viewed through the traditional “biochemical imbalance” model of neuropsychological disease that has dominated the field for the past 50 years. “The idea is that depression, for example, is a biochemical imbalance in serotonin,” Dölen says. “So, we’ll restore serotonin levels with a pill, and you’ll get better.”

But what if there were an approach that treated depression by restoring the fundamental ability to learn (and unlearn) behaviors and ways of thinking, and not by raising serotonin levels? It’s an entirely different framework for understanding neuropsychiatric disorders — the learning model — and Dölen says it’s the best way to comprehend how psychedelics work.

Psychedelics act like master keys unlocking what scientists call “critical periods” of learning—specific times when individuals have a heightened ability to soak in new information. During brain development, these are the critical windows in which we acquire vision, language, motor development, and more. And after these critical windows close, they remain locked.

Or so we thought.

Psychedelics Restore Child-Like Learning

In a study that involved giving mice MDMA, Dölen found that the drug unlocks a critical period for social reward learning, restoring adult mice to child-like levels of openness for social development.⁴ Dölen’s next study uncovered the potential of all psychedelics—including LSD, psilocybin, ketamine, and ibogaine—to open these critical periods.⁵

[Watch: “Psychedelic Therapy for Mood Disorders: Research & Potential”]

“This is a big deal,” says Dölen. “And if it’s true, it’s going to revolutionize things, but only if we understand what a critical period is. It’s not that you take a pill and you speak Japanese. It’s that you take a pill and you restore the ability to learn Japanese.”

The drugs open the mind to learning. The therapy provides the learning itself.

“Patients talk about how they had an epiphany, how the trip enabled them to see how they’d built their lives around a foundational myth that wasn’t true, whether about their relationship to other people, their personality, their deserving to be in the world,” Dölen says. The post-trip therapy, in turn, allowed them to identify how that myth led to maladaptive ways of interacting with the world, and understand how to integrate that knowledge into their daily lives.

The potential of psychedelics to re-open critical periods has far-reaching implications. Dölen’s lab is exploring the possibilities of treating conditions like stroke and blindness with psychedelics through a project called PHATHOM (Psychedelic Healing: Adjunct Therapy Harnessing Opened Malleability).

“Psychedelics are not going to be the magic bullet that fixes everything, but we’re excited about the possibilities,” Dölen says. “Being able to restore child-like learning is a major therapeutic opportunity.”

Psychedelics Therapy and Mental Health: Next Steps

• Self-Test: Symptoms of Depression in Adults
• Free Download: Signs of Depression That May Surprise You
• Read: Real Stories of Using Ketamine for Depression, Anxiety, PTSD

Nicole C. Kear is Consumer Health Editor at ADDitude.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Matveychuk D, Thomas RK, Swainson J, Khullar A, MacKay MA, Baker GB, Dursun SM. Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers. Ther Adv Psychopharmacol. 2020 May 11;10:2045125320916657. doi: 10.1177/2045125320916657. PMID: 32440333; PMCID: PMC7225830.

² Mitchell, J.M., Bogenschutz, M., Lilienstein, A. et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med 27, 1025–1033 (2021). https://doi.org/10.1038/s41591-021-01336-

³ Smausz R, Neill J, Gigg J. Neural mechanisms underlying psilocybin’s therapeutic potential – the need for preclinical in vivo electrophysiology. J Psychopharmacol. 2022 Jul;36(7):781-793. doi: 10.1177/02698811221092508. Epub 2022 May 30. PMID: 35638159; PMCID: PMC9247433.

⁴ Nardou, R., Lewis, E.M., Rothhaas, R. et al. Oxytocin-dependent reopening of a social reward learning critical period with MDMA. Nature 569, 116–120 (2019). https://doi.org/10.1038/s41586-019-1075-9

⁵ Nardou, R., Sawyer, E., Song, Y.J. et al. Psychedelics reopen the social reward learning critical period. Nature 618, 790–798 (2023). https://doi.org/10.1038/s41586-023-06204-3

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A cluttered, disorganized living environment is as common as it is unsettling for many people who have ADHD. Overwhelm often prevents them from even getting started on decluttering. For some people, the clutter reaches a level that compromises their ability to live safely in their homes. This is usually the result of hoarding disorder. Sometimes, it’s difficult to discern what constitutes clutter versus hoarding.

Michael Tompkins, Ph.D., will explain why the traits in ADHD contribute to excessive clutter and hoarding. He will also walk viewers through the process of managing these often-debilitating situations and employing strategies for success.

In this webinar, you will learn:

• About the ADHD traits and underlying causes that contribute to clutter and hoarding
• About signs of clutter and hoarding, and red flags for when clutter turns into hoarding
• How clutter is different from hoarding, and the characteristics that define each
• About practical strategies to help decrease clutter and disorganization
• How to deal with hoarding in your own living situation or with a loved one
• How cognitive behavior therapy for ADHD and hoarding can help people manage better

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Meet the Expert Speaker

Michael A. Tompkins, Ph.D., ABPP, is a licensed psychologist and board certified in Behavioral and Cognitive Psychology. He is co-director of the San Francisco Bay Area Center for Cognitive Therapy, and a faculty member of the Beck Institute for Cognitive and Behavior Therapy. He is the author or co-author of numerous articles and chapters on cognitive-behavior therapy and related topics, as well as 16 books, including Digging Out: Helping Your Loved One Manage Cutter, Hoarding, and Compulsive Acquiring (with Tamara L. Hartl) (New Harbinger, 2009) and Clinician’s Guide to Severe Hoarding: A Harm Reduction Approach (Springer, 2014). (#CommissionsEarned) The Mental Health Association of San Francisco awarded him the 2013 Lifetime Achievement Award for his contribution to the understanding of hoarding and cluttering. Dr. Tompkins has presented to national and international audiences on the topic hoarding, particularly managing hoarding behaviors through a harm reduction approach.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Hoarding vs. ADHD Clutter: More Resources

• Download: Clean Up and Get Organized in One Weekend
• Get: Declutter Your Life (and Home! and Office!)
• Read: What Does Hoarding Disorder Look Like?
• Read: How to Motivate for Cleaning House When You Really Don’t Want To

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Despite highly esteemed and plentiful literature on the use of stimulant and nonstimulant medication to treat ADHD, relatively little information is available on the treatment of complex ADHD — that is, attention deficit disorder plus at least one comorbid condition like anxiety, depression, or an eating disorder. Few studies address the treatment of comorbid conditions, the order of treatment, or the treatment of cognitive deficits and/or hard-to-treat ADHD symptoms.

This presentation will integrate data from controlled and open trials to highlight strategies for illustrative cases of complex ADHD. Participants will learn:

• About new medications approved for ADHD and their use for complex and hard-to-treat ADHD
• About strategies to manage ADHD comorbidities
• About approaches for treating cognitive executive function deficits in ADHD

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Meet the Expert Speaker

Timothy E. Wilens, M.D., is the Chief of Child and Adolescent Psychiatry, and (Co) Director of the Center for Addiction Medicine at the Massachusetts General Hospital. He is a Professor of Psychiatry at Harvard Medical School. Dr. Wilens specializes in the diagnosis and treatment of ADHD, substance use disorders, and bipolar disorder. Widely published, Dr. Wilens has more than 350 original articles, reviews, chapters, books and editorials to his credit. Dr. Wilens is a consultant to the National Football League, Major/Minor League Baseball, Bay Cove Human Services and Phoenix/Gavin House and is consistently named one of the Best Doctors in Boston and in America for psychiatry.

Treating Complex ADHD: More Resources

• Download: 2024 Scorecard of ADHD Treatments
• Sign Up: The Clinicians’ Guide to Treating Complex ADHD
• Read: Treatment Troubleshooting Guide for Patients
• Replay: Substance Use Disorder and ADHD: Safe, Effective Treatment Options with Dr. Timothy Wilens

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ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

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It began with an Adderall shortage in 2022. Today, prescriptions for many stimulant medications used as the first-line treatment of ADHD are consistently and frustratingly difficult to fill. So it’s unsurprising that ADHD features prominently in the majority of public comments submitted to the Federal Trade Commission (FTC) by stakeholders impacted by long-term medication shortages involved in the treatment of many conditions, including cancer. ADHD patients demand attention on their suffering.

But, by inviting public testimony on the stimulant shortage and pharmaceutical practices, I believe the FTC is only trying to find cover for the Drug Enforcement Administration (DEA). The DEA is the only governmental agency that sets production and distribution quotas for every drug company manufacturing controlled medication. The DEA decides how much of each medication can be released to pharmacies in any given month. Therefore, this problem traces its roots and long tendrils back to the DEA alone. No other agency has the authority to create and prolong it.

The DEA meets with every company that markets a controlled substance each March and April to determine how much of that company’s product can be released each month in the following calendar year. This process tries to predict in March of 2024 how much medication will be needed 21 months later in December of 2025. It is a crude and inadequate system that the DEA is too inflexible to relinquish.

For as long as the United States government has wrestled with combatting the distribution and use of illicit drugs, the DEA has used only one tactic — restricting the amount of drugs available to be sold legally. Now, the DEA is using the same playbook for ADHD stimulants.

Roots of the Adderall Shortage

Two years ago, the DEA decided that ADHD stimulants were being diverted and abused on a large scale, though there was virtually no evidence to support this belief. Studies have shown that a number of people (statistics vary) try stimulants but do not continue to take them without a prescription. About 90% of the diverted immediate-release stimulants are used by a narrow demographic: white male college students who use the drugs so they can stay awake. The medications are not being abused by people with ADHD, many of whom consider the drugs a lifeline for daily functioning.

[Read: Call to Action! Speak Up to End the ADHD Drug Shortage]

The DEA’s skepticism also came on the heels of increased rates of ADHD diagnosis and as a response to online providers who were sloppy about prescribing ADHD stimulants during the pandemic. The online clinics, however, never accounted for more than 1% of all prescriptions issued. And that problem was solved more than two years ago.

The DEA also observed that the number of people taking ADHD medications had been growing by 10% a year for 15 years. The growth rose largely from adults being diagnosed in later life. The relative number of children and adolescents taking stimulants has not changed in 20 years.

The DEA’s apparent logic behind its sweeping decisions was that these adults were abusing prescription stimulants, disregarding the well-documented evidence that ADHD persists after childhood. The rate of diagnosis and medication treatment is rising faster in every European country as well.  In the last year for which I had access to the drug company marketing studies (2014), the average age of diagnosis of ADHD was 31.

The DEA does not bother with facts. Its answer to this increased level of prescriptions: Decrease the amount of drug available regardless of consequences. Even when it became abundantly clear that placing quotas on drug companies had been a disastrous decision, the DEA did not reverse course. Even if the DEA decided in April to raise the allotments of drugs released to pharmacies, its current flawed and inflexible distribution mechanism would not allow for an increase until January 2025.

[Download: The Ultimate Guide to ADHD Medication]

I strongly suspect that the FTC is looking for an agency other than the DEA to blame. First, it said the drug companies were not making enough medication. But the drug companies were making and distributing as much as the DEA allowed them to. The idea that the drug companies were forgoing billions of dollars of profit was always unbelievable. Then the blame was laid on raw material shortages, but after two years, that explanation became hard to believe as well.

Then the FTC, FDA, and DEA blamed the telemedicine-only clinics that sprang up during the pandemic. However, the bad actors in this area have all closed down. Still, there has been no improvement in the shortage.

The time has long since passed for the DEA to admit its fault and fix its broken quota system. There has already been too much needless suffering by innocent people who did nothing to cause the DEA’s restrictions.

Give Your Input on the Drug Shortage

The deadline to submit public RFI comments to the FTC and U.S. Department of Health and Human Services (HHS) is May 30, 2024. Add your testimony at www.regulations.gov. (Direct link to the comment section)

The public can also demand an end to the ADHD medication shortage by writing letters to representatives, the DEA, and the FDA using templates provided by ADDitude.

Adderall Shortage & DEA: Next Steps

• News: ADHD Medication Shortage Comments Top Government Inquiry
• Download: ADHD Treatment Scorecard from ADDitude Readers
• Blog: “This Cannot Be the Price We Pay to Function.”
• Hub: Stimulant Shortage

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Women with ADHD can continue using the stimulant medication dexamphetamine and the painkiller acetaminophen (brand name: Tylenol) during pregnancy, according to two recent studies that refute a long-standing medical consensus.

An observational study published in the Archives of Women’s Health found that use of dexamphetamine (DEX), the main ingredient in brand-name ADHD medications such as Adderall, Dexedrine, Zenzedi, and ProCentra, does not put women or their babies at increased health risks. However, women who ceased using DEX during pregnancy were more than twice as likely to have a threatened abortion (mild to moderate bleeding during the first trimester) compared to those who continued DEX or who did not use the stimulant during pregnancy.¹

“This could indicate a possible association with DEX withdrawal,” the study’s authors wrote. “However, this is something that requires further investigation due to the small sample size, difficulties examining timing, and the inability to examine spontaneous abortion.”

The researchers analyzed a cohort of 1,688 women diagnosed with ADHD who gave birth in Western Australia between 2003 and 2018. Of the participants, 65% (547) ‘continuers’ took dexamphetamine throughout their pregnancy; 35% (297) ‘ceasers’ stopped using DEX before the end of the second trimester. A matched ‘unexposed’ group of 844 women had prescriptions for dexamphetamine before but not during pregnancy.

The three groups shared similar maternal health and labor and delivery characteristics, such as the onset of labor and delivery method. Complications during pregnancy, such as threatened pre-term labor, premature rupture of membranes, and bleeding in the second trimester, did not differ between the ‘ceasers’ and the ‘unexposed.’

Compared to the ‘continuers’ and ‘ceasers,’ the ‘unexposed’ group had a lower risk of:

• preeclampsia
• hypertension
• postpartum hemorrhage
• neonatal special care unit admittance
• fetal distress

While the findings illustrate the possible benefits of ceasing DEX before conception, the study’s authors noted that discontinuing ADHD medication puts pregnant people with ADHD at a higher risk for depression, anxiety, feelings of isolation, and family conflict. ²

“The results indicated that continuing to take dexamphetamine did not put women or their babies at increased health risks,” said Dani Russell, the study’s lead author, and a Ph.D. student from the University of Western Australia School of Population and Global Health. “Pregnancy can be a really stressful period for women with ADHD, so it is good to know that stopping their medication during pregnancy may not always be necessary.”

This research is part of a larger body of work investigating different ADHD treatments during pregnancy. The study’s authors said that more investigations are needed on the topic.

Acetaminophen Use in Pregnancy Not Linked With ADHD

A new study published in JAMA found that acetaminophen exposure during pregnancy does not increase the risk of autism, ADHD, or intellectual disability in children; however, factors such as genetics and the environment do. ³ This is the largest nationwide cohort study to date on acetaminophen usage during pregnancy. The study challenges prior research claiming that acetaminophen exposure during pregnancy may increase the risk of neurodevelopmental disorders in children. ⁴, ⁵

Scientists from the Karolinska Institute of Sweden and Drexel University’s Dornsife School of Public Health analyzed the prenatal and medical records of nearly 2.5 million children born in Sweden from 1995 to 2019, with follow-up through 2021. Of the 185,909 children exposed to acetaminophen in pregnancy, nearly 9% were diagnosed with autism, ADHD, or an intellectual disability, compared to about 7.5% of children whose mothers did not use the medication while pregnant. Children exposed to acetaminophen had marginally higher rates of diagnoses compared to those not exposed (1.53% vs. 1.33% for autism, 2.87% vs. 2.46% for ADHD, and 0.82% vs. 0.70% for intellectual disability).

The research team used the same database to conduct a second study focused on pairs of siblings whose mothers used acetaminophen during one pregnancy but not the other. This sibling control analysis found no evidence of increased risk of autism, ADHD, or intellectual disability associated with acetaminophen use during pregnancy.

“Associations observed in models without sibling control may have been attributable to confounding,” they wrote. “Results suggested that there was not one single ‘smoking gun’ confounder, but rather that multiple birthing parents’ health and sociodemographic characteristics each explained at least part of the apparent association.”

The study found acetaminophen had similar risks for neurodevelopmental disorders as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and anti-migraine medicines. (The FDA recommends against using NSAIDs, such as Aspirin and Ibuprofen, in the third trimester of pregnancy because they may cause a blood vessel in the fetus to close prematurely.)

The researchers said that, despite the study’s large sample size and long duration, their reliance on self-reported and prescription dispensing data introduced several limitations. Still, these findings coincide with the American College of Obstetricians and Gynecologists, which maintains that acetaminophen is safe for pregnant women to use.

The Archives of Women’s Health and JAMA studies highlight the importance of pre-conception or early pregnancy counseling, individualized treatment plans, and medication management and recommend that patients discuss all medication decisions with their doctor.

Sources

¹ Russell, D.J., Wyrwoll, C.S., Preen, D.B. et al. (2024). Investigating Maternal and Neonatal Health Outcomes Associated with Continuing or Ceasing Dexamphetamine Treatment for Women with Attention-Deficit Hyperactivity Disorder During Pregnancy: A Retrospective Cohort Study. Arch Womens Ment Health. https://doi.org/10.1007/s00737-024-01450-4

²Damer, E.A., Edens, M.A., van der Loos, M.L.M., van Esenkbrink, J., Bunkers, I., van Roon, E.N., Ter Horst, P.G.J. (2021). Fifteen Years’ Experience with Methylphenidate for Attention-Deficit Disorder During Pregnancy: Effects on Birth Weight, Apgar Score and Congenital Malformation Rates. Gen Hosp Psychiatry. https://doi.org/10.1016/j.genhosppsych.2021.09.003

³Lee, B.K., et al. (2024). Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability. JAMA. https://doi.org/10.1001/jama.2024.3172

⁴Ji, Y., et al. (2019). Association of Cord Plasma Biomarkers of In Utero Acetaminophen Exposure with Risk of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in Childhood. JAMA Psychiatry. https://doi.org/10.1001/jamapsychiatry.2019.3259

⁵Bauer, A.Z., Swan, S.H., Kriebel, D. et al. (2021) Paracetamol Use During Pregnancy — A Call for Precautionary Action. Nat Rev Endocrinol. https://doi.org/10.1038/s41574-021-00553-7

Adults and caregivers harmed by the ongoing ADHD medication shortage have contributed thousands of impassioned, irate impact statements to a joint Request for Information (RFI) issued by the Federal Trade Commission (FTC) and U.S. Department of Health and Human Services (HHS) seeking public comment on drug prices and availability. Of the more than 5,600 public comments submitted so far, 62% (nearly 3,500) have mentioned ADHD and/or the stimulant shortage ongoing since October 2022.

Open through May 30, the RFI asks patients to submit comments, documents, and data regarding how the practices of two types of pharmaceutical drug intermediaries — group purchasing organizations (GPOs) and drug wholesalers — may contribute to generic drug shortages, including how both entities may influence the pricing and availability of pharmaceutical drugs. The RFI does not specifically ask about ADHD medications.

More than 300 medications, including chemotherapy drugs, medic drugs, antibiotics, and psychostimulants, are in short supply, according to David W. Goodman, M.D., LFAPA, an assistant professor in psychiatry and behavioral sciences at the Johns Hopkins School of Medicine. The RFI comments are overwhelmed with ADHD patients, in part, because “the shortage of ADHD medications has extended so long that there are more people actively engaged ‘in the conversation,’” he says.

“The ADHD drug shortage is now over a year old and continues to be problematic,” says Timothy Wilens, M.D., an associate professor of psychiatry at Harvard Medical School. “It is tiring to patients and clinicians, and it puts individuals at risk for academic and occupational difficulties and a myriad of other issues. In my practice, people are totally fed up with tracking down medications every month.”

Stimulant shortages continue to be a problem for many of the patients Ann Childress, M.D., treats at her private practice in Las Vegas. Childress, who is the current president of the American Professional Society of ADHD and Related Disorders (APSARD) says, “Each week, I have to rewrite several prescriptions to send to an alternative pharmacy because the patient’s regular pharmacy does not have the medication needed in stock. Many insurances will not cover brand-name medication in stock even when the generic is not available. I don’t think the shortage is going away any time soon.”

ADHD Patients Express Anger, Fear, Frustration in RFI

Harrowing personal stories of treatment disruptions and anxiety around finding — and paying for — ADHD medications were found easily in the comments submitted to the RFI.

“I get it: the FDA and DEA are looking to avoid Opioid Crisis II: The Stimulant Years. But attempting to absolve yourselves of your past failures at the expense of current patients is not the answer,” wrote Tiffany from Texas. “Especially considering ADHD patients are the least well-equipped to navigate complicated, multi-step tasks like calling multiple pharmacies — who often refuse to divulge inventory information without a valid script — and doctors who want us to verify a pharmacy has the drug in stock before they’ll send the script; finding and completing the necessary forms with insurance companies to beg for brand name coverage exceptions. And if, by some stroke of luck, we successfully amble through this Byzantine process with a filled prescription, we have exactly 29 days before we get to start it all over again, and all the while, our federal government is trying to gaslight us into believing there’s sufficient supply to meet demand.”

“When I try to fill my prescription, I’m made to feel like some kind of drug-seeker or addict,” wrote Susan from Washington. “People treat my diagnosis as spurious. People assume that I’m simply unwilling to tolerate the normal challenges of life and expect medication to make things easier. It’s hard not to wonder if people in power are deliberately creating this situation because they dislike people with my diagnosis, or if they don’t care enough about our needs to make a real effort.”

“This ADHD drug shortage has severely affected me,” wrote one anonymous commenter. “There have been many times I have been unable to fill my prescription. I work in a hospital with critically ill patients. Without medication, my inattention puts people’s lives at risk.”

“The shortage of necessary medication for ADHD is a huge problem for my family,” wrote Julia from New York. “Both my spouse and child take different medications to manage their ADHD symptoms. They choose not to medicate on days it would help but isn’t ‘necessary’ so that they can save medication for the most ‘necessary’ days. This kind of self-denial and hoarding is a ridiculous solution to a problem they did not create. My 18-year-old child is trying their best in school but feels they are not living up to their potential because they cannot participate appropriately. My child does not deserve to have their self-esteem eroded because a necessary medication that they deserve is not available to them.”

“My day-to-day living is unmanageable without Adderall,” wrote Sara from Florida. “I tried to go without medication for a few months because it was such a challenge to find… and I hated being treated like a drug addict at pharmacies. After a few months without meds, my impulsive spending led to an inability to pay my bills. I lost my home and endangered my job. All I did was think about the things I had to do and not do any of them.”

“I have had to leave one of my two jobs because I could not function at the level I needed to without my medication, and I suffered from a severe mental health crisis,” wrote Jennifer from Oregon. “My current insurance no longer covers the copay for Vyvanse, which costs upward of $400 for 28 pills. I have been relying on and thriving on this medication for half of my life, and it now costs more than my monthly car payment. Because of the astronomical costs, I have been unable to afford the medication that I need to function.”

“The ADHD medication shortage has negatively impacted every single part of my life and my child’s,” wrote Kelly from Iowa. “Attempting to fill prescriptions in the past two years or so has been an absolute nightmare. I have been forced to bundle my child up and drive up to 45 minutes away (one way) from our city to acquire our ADHD medication on many occasions. We have gone without or with a fraction of our prescribed dose for many days. I have spent time I could not spare searching for our ADHD medication. I have constant anxiety when one of our ADHD medications starts getting low each month. We have missed healthcare appointments, events, and social gatherings. We have lost friendships. My small business has suffered.”

According to an ADDitude survey of 11,013 adults and caregivers, at least 20% of ADHD patients were still impacted by the stimulant shortage in the summer of 2023. (Learn more about how the ADHD medication shortage has impacted ADDitude readers “Stop Treating Us Like We’re Addicts!” and “A Daily Nightmare:” One Year into the ADHD Stimulant Shortage.)

The deadline to submit public RFI comments is May 30, 2024. Add your testimony at Regulations.gov.

The public can also demand an end to the ADHD medication shortage by writing letters to representatives, the DEA, and the FDA using templates provided by ADDitude.

But if you’ve tried some of these ADHD interventions with limited success and ended up feeling like you “failed” at treatment, rest assured that you did not -— and you’re not alone in feeling this way.

In ADDitude’s recent treatment survey, we asked 11,000 readers about their experiences with 10 different kinds of treatments for ADHD, from medication to meditation. Readers shared what worked and what didn’t, plus stories of how painful the process of finding effective treatment can be, especially for those with rejection sensitive dysphoria (RSD), perfectionism, or feelings of shame.

“I felt as though I flunked mindfulness because I couldn’t pay attention for that long!” said one ADDitude reader. Another shared: “I felt like I was failing in talk therapy when I couldn’t talk in straight lines or remember what I had just said.”

Robyn, an ADDitude reader in Canada, simply said, “I always feel like I’m failing.”

[Read: ADHD and the Epidemic of Shame]

Feelings of Failure, Easily Triggered and Intense

Many people are quick to blame themselves when supplemental therapies don’t work as rapidly or as well as they’d hoped. This instinct has everything to do with the wiring of the ADHD brain, explains Tamar Rosier, Ph.D., in the ADDitude article, “Silence Your Harshest Critic — Yourself.”

“Neurotypical people have prefrontal cortexes that act like a butler. ‘Sir,’ the butler calmly says, ‘your keys are on the table.’ Or ‘Madam, you must leave now if you want to be on time,’” Rosier explains. “Instead of a tranquil butler, individuals with ADHD have an angry neighbor threatening them with his shoe. ‘If you lose your keys again,’ he yells, ‘I’ll throw this at you!’”

Zak, an ADDitude reader in Florida has experienced this first-hand: “My doctor is still working with me to get the meds correct and I feel at times it’s my fault; that I am the one whose body is not adjusting.”

[Download: 2024 Scorecard of ADHD Treatments]

For many, these feelings of falling short or failing to meet expectations are amplified by RSD, which triggers intense emotional sensitivity and pain, explains William Dodson, M.D., LF-APA in “How ADHD Ignites Rejection Sensitive Dysphoria.” “For people with RSD, these universal life experiences are much more severe than for neurotypical individuals. They are unbearable, restricting, and highly impairing.”

This description resonates with ADDitude reader Calvin in Florida. “When I have tried things like mindfulness, exercise, or therapy, I have not had success and I just felt awful,” Calvin says. “I thought mindfulness might help to end the snow-piercer-like train that lives in my head, but instead I felt like a child unable to do a simple concept.”

In addition to the neuroscientific factors that play a role in triggering feelings of failure, a long history of negative experiences exerts a powerful force, says J. Russell Ramsay, Ph.D., ABPP, clinical psychologist.

“Adults with ADHD are often more susceptible to feelings of failure and defeatism when undertaking new endeavors,” Ramsay explains. “This is likely due to past experiences with setbacks, which often result in criticisms. This, in turn, makes adults with ADHD sensitive to the first signs that something seems to not be going well.”

Clinical psychologist Sharon Saline, Psy.D., agrees, adding: “These past struggles resemble a thousand paper cuts per day and accumulate over time into larger wounds which leave sensitive scars. Feelings of shame and not measuring up haunt folks and make it tougher to try new things.”

How to Reframe Feelings of Failure

Experts agree that to optimize treatment for ADHD, trial-and-error is essential. The “error” part of that process can be demoralizing, but it is critical. To discover interventions that work, you’ll have to try ones that don’t — and knowing that from the get-go can be helpful.

“It is important to normalize setbacks as a part of the process of establishing new habits. It is rarely, if ever, a straight line,” Ramsay says. “Reframing a new habit as a challenge or as an experiment is important, as is setting up realistic expectations.”

“I have a hard time planning and sticking to a good regular habit, like exercise and mindfulness meditation. I used to get so aggravated with myself, and feel helpless,” says an ADDitude reader. “My therapist has taught me to not make a big deal of it and simply get back on track.”

Fine-tuning the therapies, lifestyle changes, and medications that best address your particular constellation of symptoms — and dealing with the emotional fallout of that process — is hard work, make no mistake. You can make that hard work a little easier by being kind to yourself, says Saline.

“Treat yourself with compassion, understanding that change usually involves forward motion along with some backsliding,” Saline urges. “Stumbling, regrouping and trying again is part of living for everybody—ADHD or not.”

 Fear of Failure & Treatment: Next Steps

• Read: You Are Worthy of Self-Compassion – How to Break the Habit of Internalized Criticism
• Read: “My Fear of Failure Becomes Paralyzing Perfectionism”
• Free Resource: Understanding Rejection Sensitive Dysphoria

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Treating ADHD with medication can lower overall risk of mortality and of hospitalizations, both psychiatric and non-psychiatric, according to two new Swedish studies.^{1, 2} These findings highlight the importance of ADHD medication use for long-term health and longevity, underscoring the urgent need to end the stimulant shortage that has prevented U.S. patients with ADHD from consistently accessing medication since the Fall of 2022.

Lower Risk of Death from All Causes

An observational study from Sweden, published in JAMA, followed nearly 150,000 adults and adolescents with a diagnosis of ADHD, tracking participants for two years following diagnosis.

The researchers found that use of ADHD medication:

• Reduced overall risk of death by 19%: Among people with ADHD who did not receive medication, there were 48 deaths for every 10,000 people, contrasted with 39 deaths per 10,000 people within the medicated cohort.

• Reduced risk of overdose by 50%: Medication use also reduced the risk of death from other unnatural causes, including accidental injuries, accidental poisoning such as drug overdoses, and suicide. This trend was particularly pronounced among men and significant in the category of accidental poisoning, where risk of death was lowered by almost 50%.

• Reduced risk of death from natural causes for women: ADHD medication use reduced the risk of death from natural causes, such as medical conditions, for women. Though it did not reduce this risk for men, medication use did not increase risk either. This is an important finding that may alleviate long-standing worries about the impact of stimulant use on cardiovascular health, among other concerns.

While the authors of the study caution that these findings show correlation, not causation, the results are encouraging for patients and clinicians with reservations about ADHD medication use, especially later in life.

Fewer Hospitalizations

A second Swedish study sought to investigate the effect of a variety of ADHD medications on rates of hospitalizations. Published in JAMA Network Open, the cohort study used nationwide medical and administrative databases to identify 221,000 people with ADHD, 56% of whom had a psychiatric comorbidity including anxiety or stress-related disorder (24%), and depression or bipolar disorder (20%). These individuals were then followed for up to 15 years.

The study found that a patient’s use of amphetamine, lisdexamphetamine, dexamphetamine, and/or methylphenidate significantly lowered the risk of:

• Suicidal behavior
• Psychiatric hospitalization
• Non-psychiatric hospitalization

Untreated ADHD in Adults Leads to “Dire Consequences”

The authors of the study featured in JAMA Network Open believe that the decrease in hospitalizations reflects the fact that ADHD medication use is associated with decreased risk for suicide attempts,³ substance use disorder,⁴ depression,⁵ car accidents,⁶ and unintentional injuries.⁷

“Impulsivity in adults can lead to dire consequences. The idea is that by improving impulsiveness and executive functioning, people are able to make better decisions,” explains Frances Levin, M.D., author of the JAMA editorial “Treating Attention-Deficit/Hyperactivity Disorder Matters,” ⁸ in a recent interview. “If you’re dealing with a substance use disorder (SUD) population, treating the ADHD allows them to better utilize clinical treatment for their SUD, and therefore reduce their risk of substance use and reduce accidental poisoning or overdose.”

“A Significant Public Health Problem”

The mortality risk study emphasizes the importance of treating ADHD, Levin explains: “Unlike other conditions, there’s often a sense that ADHD is over-hyped or it’s not a big deal, but this article demonstrates that this group is at higher risk of having both substantial morbidity as well as mortality.”

ADHD expert Russell A. Barkley, Ph.D., echoes this sentiment, stressing that ADHD is the number one factor affecting mortality for people with the condition. In other words, ADHD is not just a mental health issue; it’s a significant public health problem.

Barkley published a study in the Journal of Attention Disorders that found adults with ADHD could expect an 11- to 13-year reduction in life expectancy compared to neurotypical peers of a similar age and health profile.⁹

However, most of the ADHD-related factors impacting life expectancy — impulsivity, risky behavior, and inattention, to name a few — can be improved with interventions. Behavioral programs designed to improve overall health will also improve life expectancy, but only if ADHD symptoms are under control first, Barkley says. That requires more accurate diagnosis and more thoughtful treatment.

“When adults ask me questions about why they should try medication to manage their ADHD, my answer always comes down to two words: Medication works,” Barkley says in the ADDitude article, “Adult ADHD Treatment Options.” “When you find the right medicine, you can experience substantial improvements in your ADHD symptoms.”

Sources

¹ Li L, Zhu N, Zhang L, et al. (2024). ADHD Pharmacotherapy and Mortality in Individuals With ADHD. <em>JAMA.<em>doi:10.1001/jama.2024.0851

² Taipale H, Bergström J, Gèmes K, et al. Attention-Deficit/Hyperactivity Disorder Medications and Work Disability and Mental Health Outcomes. JAMA Netw Open. 2024;7(3):e242859. doi:10.1001/jamanetworkopen.2024.2859

³ Chang  Z, Quinn  PD, O’Reilly  L,  et al.  Medication for attention-deficit/hyperactivity disorder and risk for suicide attempts. Biol Psychiatry. 2020;88(6):452-458. doi:10.1016/j.biopsych.2019.12.003PubMedGoogle ScholarCrossref

⁴ Chang  Z, Lichtenstein  P, Halldner  L,  et al.  Stimulant ADHD medication and risk for substance abuse.  J Child Psychol Psychiatry. 2014;55(8):878-885. doi:10.1111/jcpp.12164PubMedGoogle ScholarCrossref

⁵ Chang  Z, D’Onofrio  BM, Quinn  PD, Lichtenstein  P, Larsson  H.  Medication for attention-deficit/hyperactivity disorder and risk for depression: a nationwide longitudinal cohort study. Biol Psychiatry. 2016;80(12):916-922. doi:10.1016/j.biopsych.2016.02.018PubMedGoogle ScholarCrossref

⁶ Chang  Z, Quinn  PD, Hur  K,  et al.  Association between medication use for attention-deficit/hyperactivity disorder and risk of motor vehicle crashes.  JAMA Psychiatry. 2017;74(6):597-603. doi:10.1001/jamapsychiatry.2017.0659ArticlePubMedGoogle ScholarCrossref

⁷ Ghirardi  L, Chen  Q, Chang  Z,  et al.  Use of medication for attention-deficit/hyperactivity disorder and risk of unintentional injuries in children and adolescents with co-occurring neurodevelopmental disorders. J Child Psychol Psychiatry. 2020;61(2):140-147. doi:10.1111/jcpp.13136PubMedGoogle ScholarCrossref

⁸ Levin FR, Hernandez M, Mariani JJ. Treating Attention-Deficit/Hyperactivity Disorder Matters. JAMA. 2024;331(10):831–833. doi:10.1001/jama.2024.1755

⁹Barkley, R. A., & Fischer, M. (2019). Hyperactive Child Syndrome and Estimated Life Expectancy at Young Adult Follow-Up: The Role of ADHD Persistence and Other Potential Predictors. Journal of Attention Disorders, 23(9), 907-923. https://doi.org/10.1177/1087054718816164

Even after an ADHD diagnosis, many clinicians are reluctant or refuse to prescribe stimulant medications due to conflicting or outdated information, leaving many older adults with ADHD without proper treatment.

It’s never too late to seek a diagnosis and symptom relief. Use this Patient Resource to begin conversations about and pursue an evaluation for ADHD as an older adult.

In this download, you will learn

• Why it’s never too late for an ADHD diagnosis
• Why older adults with ADHD symptoms go undiagnosed or misdiagnosed
• Why stimulants do not increase cardiovascular risk
• Why ADHD treatment gets tougher with age
• And much more

In addition to draining limited reservoirs of stamina, time, and patience, the monthly ordeal of searching for stimulants often includes upsetting encounters with pharmacy staff. Among ADDitude readers who use ADHD medication, 38% report that they’ve been made to feel like a “criminal” or “addict” when trying to obtain their prescribed medication. They share stories of encountering wariness, annoyance, and even downright hostility at the pharmacy, all of which exacerbates an already exhausting ordeal. In some cases, this refill process is so fraught with negative emotion that readers report re-thinking their decision to take medication at all.

You’re not alone if you have been made to feel judged, embarrassed, or interrogated. Here, readers vent about experiences they’ve had while trying to locate prescribed stimulants in the middle of an unprecedented shortage.

“For the love of all that is holy and all that is not, the pharmacies need to stop treating us like we are addicts. Yes, I am desperate to get my ADHD medication. But it is not so I can abuse it or sell it! It is because I desperately need the medication that makes my brain work well enough so that I can keep my job, so that I don’t make mistakes that might be dangerous, like getting distracted driving. Treating us, every single time, like we are possible criminals? It just makes everything so much harder.” —An ADDitude Reader

“I have to meet with the pharmacist each time I pick up my prescription, as if I don’t know what the medication does. It’s extremely embarrassing and it makes me debate whether I need to take it at all. Because I’m Black, there’s an additional layer to the stereotype of being ‘on drugs.’” –Paris, California

[Read: How the Adderall Shortage Is Casting a Long Shadow on ADHD Treatment]

“I compare it to making a heart patient run a marathon before filling their medicine. They are asking us to do the hardest task (that the medicine helps us with) and then they look at you weird for making the mistakes that ADHD causes! It usually ends in tears monthly.” —Brandy, Louisiana

“I’ve had pharmacies tell me to “take my drug-seeking somewhere else” when I called to ask if they had 10 mg Adderall in stock. Others have commented that I ‘don’t look like the kind of person who uses this,’ as though ADHD has a ‘look?’” —Mel, Idaho

“I had to have the pharmacist speak to one of the techs once because she made a comment about ADHD being a ‘made up’ thing. I was incredibly offended and was made to feel ashamed.” —Jennifer, Colorado

“I feel uncomfortable each time I have to get my prescription filled — a prescription that helps me function and not self-medicate as I used to prior to my diagnosis. It is incredibly frustrating!”  — An ADDitude Reader in Tennessee

[Read: “This Cannot Be the Price We Pay to Function.”]

“It’s a crappy process that I repeat for myself and both of my kids. I feel like I am begging for meds; it makes me feel looked down on and judged.” —Sarah, Washington

“I feel like a criminal every time I call a pharmacy. Often, I just go without, instead of feeling like a criminal.” —Mary Kate, Massachusetts

“I have to mentally prepare myself before I call the pharmacy because I never know how they’ll react. Phone calls are one of my biggest anxiety triggers, so it’s been really difficult to manage.” —Rachel, Kansas

“The pharmacy often has to revalidate the prescription, which makes me feel like I am being monitored for misuse. Increased inaccessibility makes me second-guess my choice to get medication assistance for my ADHD.” —Isabella, Ohio

“If you call for a refill a day early, you can get labeled as a drug-seeker. If something isn’t working or isn’t helping, I can’t talk to my doctor the way someone might be able to do with a sprained ankle.” —An ADDitude Reader

“We have never had a problem misusing our medications or being over-prescribed, and yet most mainstream pharmacies act like we’re trying to do something wrong when filling these prescriptions. I worry about my child not being willing to deal with this when they get older if they still need these medications.” —An ADDitude Reader

“My medication was out of stock everywhere and when I called around, the vast majority of pharmacies were very cold and callous about it and treated me like I was a crazy person for asking questions. They acted like if I needed ADHD medication I must be abusing it. Absolutely zero empathy for the fact that you can’t access a prescribed medication you need.” —An ADDitude Reader

Adderall Shortage: Next Steps

• Free Download: 2024 Scorecard of ADHD Treatments
• Read: Call to Action! Speak Up to End the ADHD Drug Shortage
• Read: The Real Reason ADHD Medication Supply Is Lagging Demand
• Hub: Stimulant Shortage

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.