(NEW YORK) — Months after the Food and Drug Administration first indicated that there was a shortage of ADHD drugs, suppliers are warning that those shortfalls could continue throughout the year — a source of frustration amid increased demand and diagnoses.
Amphetamine mixed salts, commonly referred to by the brand name Adderall, is a stimulant medication that can treat ADHD. It requires a prescription and as a controlled substance, supply is strictly monitored, and distribution is limited.
According to the FDA, Adderall is no longer in shortage, but generic versions are still impacted.
The FDA told ABC News that the shortage started with a delay from a manufacturer, which has since resolved, and is now demand-driven.
A CDC report released Thursday estimates that prescription fills for stimulant drugs — which are primarily used to treat ADHD — grew by more than 11% among adults ages 25-44 during the first year of the COVID-19 pandemic. Notable increases were also seen for adolescent females, as prescriptions increased more than 8% for those ages 10-14, and over 15% for those ages 15-19.
Suppliers are echoing demand issues, with Sandoz Pharmaceuticals, a division of Novartis, telling ABC News they expect the product to remain in tight supply for the entirety of 2023.
“At this time we are meeting current customer orders but have not been able to fill increased demand due to the initial quota in 2023 given to us by the DEA… We submitted our requests to the DEA for an increase in volume in 2023, but have not been granted our full request,” Leslie Pott, vice president of corporate affairs at Sandoz told ABC News.
Each year, the DEA sets a limit for the amount of active ingredient in controlled substances that can be produced by manufacturers.
Teva, the largest manufacturer of generic and brand name Adderall in the U.S, told ABC News that while the company is not currently experiencing manufacturing issues or shortages, “they are still seeing unprecedented demand which may cause intermittent delays for some pharmacies or patients.”
Alvogen and Teva have reported to the FDA that demand increases are behind the shortages, while Epic Pharma and US Pharma Windlas (a new manufacturer) have reported a shortage of the active ingredient.
Aurobindo Pharma and SpecGX are predicting supply issues through April 2023, according to the shortage database.
Dr. Anish Dube, chair of the American Psychiatric Association’s Council on Children, Adolescents and their Families told ABC News that there may be an increase in diagnoses due to increased awareness.
“I think there’s been a lot more awareness and knowledge and folks are getting assessed more frequently for ADHD and this could be a cause for increased diagnosis and treatment,” says Dube.
While people of all ages are affected by the shortage, school-age children and families are especially feeling the constraints.
Millions of US children rely on the medication. The latest estimates suggest that roughly 10% of US children ages 3-17 have been diagnosed with ADHD, according to the Center for Disease Control and Protection, and these numbers may have increased since 2019.
“Especially for children who are in school, or that are still doing any kind of virtual options, having to be in front of the screen for extended stretches of time, it can be particularly challenging for them to be sitting still or to be stationary for extended periods,” says Dube.
The American Academy of Pediatrics recommends medication, in combination with parent training in behavior management and behavioral classroom interventions for those in a classroom setting for children and adolescents ages 6-18 with an ADHD diagnosis.
Parents who are struggling to obtain their child’s medication and feel they’ve exhausted all options, should call their pharmacist or doctor to discuss a plan.
“It’s important that parents have a contingency plan with their prescribing physician… At least temporarily, you might be looking at other treatment options to help the young person to manage those symptoms,” says Dube.
The FDA says they recognize the potential impact that increased demand of certain products may have on health care providers and patients, and are working to alleviate constraints.
“The FDA is working closely with numerous manufacturers, agencies, and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or increased demand of certain products,” an agency spokesperson told ABC News.
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