If you’re like some Americans today, you’re looking for a place to fill your prescription for generic medication used to treat attention deficit hyperactivity disorder (ADHD). Or your parent is, since most people who take ADHD medications are actually children and teenagers.
But the U.S. federal agency responsible for the shortage — the Drug Enforcement Agency (DEA) — couldn’t care less.
Even when requested by another agency — the U.S. Food and Drug Administration — to help relieve the shortage, the DEA just turned up their noses.
It’s no wonder voters get so sick of government interfering in their daily lives: One short-sighted federal agency tries to lessen an already minor problem — abuse of ADHD medications by a tiny minority of people — that ends up significantly impacting thousands of others unintentionally.
The New York Times’ Gardiner Harris reported on the problem over the weekend. The DEA is simply in denial of the problem, rather than even trying to work with the FDA to try and resolve it:
“We have reached out to the D.E.A. and told them that there are shortage issues,” said Valerie Jensen, associate director of the F.D.A.’s drug shortage program. “But the quota issues are outside of our area of responsibility.”
Still, Special Agent Gary Boggs of the Drug Enforcement Administration’s Office of Diversion Control, said in an interview, “We believe there is plenty of supply.” [emphasis added]
You know why they believe that? Because there is plenty of supply — of brand name ADHD drugs, but not their generic equivalents.
The DEA’s simple and blissful ignorance of how this can negatively impact thousands of poor, lower-income and even middle-class families who rely on generic ADHD medications is simply astounding.
One stroke of the DEA’s pen is all it would take to fix this problem tomorrow. The problem is one the DEA created after all, because they require drug manufacturers to essentially guess at self-imposed active ingredient quotas they’ll be held to for the year. Then manufacturers get X tons of active ingredients to make Y number of brand-name products and Z number of generic products.
[DEA spokeswoman Barbara Carreno] said that the DEA consults with the ADHD drugmakers annually to determine how much of the “active ingredients” — the amphetamines — they’ll need, and that they can ask for an adjustment later if needed.
“We don’t tell companies how much they can make of any given drug,” she said. “We come up with a quota and then they get their quota,” she said. “A lot of shortages happen when companies miscalculate how much they need of one dosage unit and over-commit some of their active ingredients like amphetamines to, say, 30 milligrams when doctors really want to give 10.”
When the manufacturers mis-estimates the demand for one (in this case, generics), they basically run out of them and can’t make more, because all of the active ingredient is already gone or spoken for. What’s worse, apparently because of the DEA restrictions, manufacturers have no easy way to gain access to more of the active ingredient.
There’s apparently very little flexibility in the DEA regulations imposed upon the manufacturers. All in an attempt to stop the small amount of abuse that occurs because some people misuse the drugs.
All the DEA apparently has to do is say, “Okay, we see there’s a shortage of generic ADHD medications, you can have 10% more of the active ingredient to help alleviate the problem, as long as you only use it to make generics.”
Instead, reminiscent of a “let them eat cake mentality,” the DEA buries its head in the sand and suggests that people who can’t afford name brand prescriptions for ADHD simply go without (or somehow find non-existent money to pay for them):
Ruth Hughes, chief executive of Children and Adults with Attention Deficit Hyperactivity Disorder, a patient advocacy organization, said the drug shortages had become so acute that many patients were going untreated, increasing their risks of deadly traffic accidents and job dismissals. “The consequences of not getting treatment can be devastating,” Ms. Hughes said.
Upset or angry about the DEA’s actions? Call your Congressperson or senator today and ask they haul the DEA before Congress to answer for their inaction.
Because despite the potential for abuse of ADHD medications, it’s unconscionable that people who are suffering from ADHD cannot get treatment as a result of stupid regulations that inflexible U.S. federal government agencies will not relax in the face of a nationwide shortage of generics.
Read the full article: F.D.A. Finds Short Supply of Attention Deficit Drugs
Read the blog entry from CommonHealth from November on this issue: Where Have All The ADHD Drugs Gone? Patchy Shortages Abound
18 comments
I am a 48y/o male diagnosed since age 9 with ADHD. Over the past few months due to the “generic” ADHD medication shortage(s,) has affected my daily living in a big way. For example, 2 weeks ago I went to my mental health prescriber 3 days in a row to get my ADHD medication renewed. On the third day “without” my medication, I lost my composure, and threw 1 3 gallon plant through a window and a chair into a wall. I take my ADHD medication(15mg A.M./15mg P.M.) to control my temper which I lose due to my inability to concentrate in daily task. Also, I just lost my job for writing a threatening email to my boss, and all the issue was, my boss threw a pan and slammed the office door and I lost my temper thinking it his actions were directed at me.
Most recently, on New Year’s day I tried get a “temporary supply” of ADHD medication to no avail. My insurance(Medicare Part B) HealthSpring(Phone: 1-800-331-6293) denied my prescription, saying I was trying to fill my script too early.
However, due to a “shortage of 5mg “generic” Ritalin, I had to cut in-half my 10mg “generic” Ritalin, which the obvious result is running low in my ADHD medication. The pharmacy told me my insurancee would NOT allow the prescription to be filled because it was too early, and the end result is I will go without my ADHD medication and prone to violence causing a public safety concern.
I really believe medication is “half the pie”, an important piece, but not the whole cure…by adulthood, it is apparent medication without anger management, time management, etc, is not sufficient. I think the same goes for anxiety, bipolar, etc. Something is not right with treatment when an adult causes damage and potential for physical harm, when waiting for the renewal date of an amphetamine. Impulsive control needs to be active by the person with medication, not passive completely reliant on a medication. Hear me, I am not saying medication isn’t essential; it’s just that you and many could do much better with adjunct counseling. Thanks for listening to my opinion.
I’m sorry to hear about this situation in the U.S. I did a quick search to see if the Concerta Co-Pay card was available there, as it is in Canada.
Here’s what I found:
My RX Savings.com
access2access Prescription Assistance Program
I want to emphasize that I am not a psychiatrist or other medical health professional, I am a journalist who writes about ADHD (and who is herself diagnosed).
That said, perhaps those who are now taking Ritalin (short or long-acting), or generic Concerta, might consider talking to their doctors about switching to the patented Concerta, (which has the same active ingredient as Ritalin, but a different delivery system, allowing for a smoother, longer-acting delivery of the medication throughout the day).
The reason I suggest this is that the patented Concerta appears to be covered by the above plans; the first of which appears to help patients access a Concerta Co-Pay Assist Program card (which, in Canada at least, is issued by Janssen Ortho, the company making Concerta).
I have personally been using the Co-Pay card to purchase my Concerta at the same rate as the generic Concerta (which is different in Canada than the United States; here, most provinces will not dispense the generic form as it is NOT equivalent to the patented brand and has caused a lot of problems for many patients, but that’s another topic. For more info, click here and see Dr. Kenny Handelman’s blog: Generic Concerta in Canada)
The purpose of the Co-Pay card is to allow you to purchase the patented (original) Concerta at the price of the generic Concerta. In Canada, you have to have your prescribing physician specify “no substitutes” or something to that effect, on your prescription (i.e., that only the patented Concerta can be dispensed to you, not the generic).
I notice that the My RX Savings site lists other ADHD medications (such as Vyvanse, for one) for which there appear to be coupons or discounts available. I have NO personal experience with this site or company, I just found it during an online search, but perhaps it might be of use.
Zoë Kessler, B.A., B.Ed. (Adult Education)
Author and Psych Central Blogger, ADHD from A to Zoë
Here’s my take on this issue as a prescriber, note I have not prior, now, or in the future a real fan of Adderall nor the other amphetamine based meds: with Adderall and it’s generic forms scarce, now I am seeing an equal depletion of methylphenidate, and to me, it is a bit foolish for MDs to quickly turn to this as a substitute when I have seen more patients than not find going to Ritalin based meds after being on amphetamine based ones to not really respond as robustly.
And, ADD is being overdiagnosed as much as I have seen Bipolar disorder being applied to patient presentations just because patients use the words “mood swings”. It is time for the field to demand, not ask mind you, that insurance companies have to allow psychiatrists to get psychological testing done on people over the age of 18 who are seeking a first time diagnosis of ADD. This is the litmus test that really can determine what is a legitimate presentation, and who is just med seeking or looking for a quick fix to cognitive struggles that are not in the end ADD.
Personally for me, I am glad to see Adderall and it’s generic equivalents be marginalized, even if for a brief period of time. I feel this drug just snuck in and gained an application for the diagnosis that was not strongly tested first. I know I have patients who will argue otherwise, but, why I am seeing more and more people on dosages greater than 30mg a day? And why do I have colleagues who are eager to go over this threshold dose so quickly?
And why are ceiling dosages of psychotropic meds in general being so easily breached these days? I mean, really, 120mg of Cymbalta being prescribed like Pez, Lexapro over 20mg, Abilify over 30mg, and the list could go on, interestingly almost all being brand name meds?
Careful what you wish for, people seeking ADD diagnoses and meds for that quick fix. Check out a book called Living with ADD as an Adult, by Harbinger publications. Might find it an interesting read, and not for selling meds first.
Dr. Hassman,
Your paternalistic attitude sickens me. If you had any idea what ADHD is about you’d know that there is no “quick fix.”
If you want to concern yourself with those who may abuse stimulants for short term gain, I suggest you hang up your white coat and apply for a job in law enforcement.
I am age 75, quite disabled with Parkinsons, my physician is on a DEA vendetta with drug tests and pill counts for all Class 2 meds. Each month I run from store to store to find Ritalin generics (each has different side effects). I’ve been diagnosed with Narcolepsy by three different hospitals. Have been taking Ritalin generics for at least 40 years now with no problems. Now I am miserable, Parkinsons much worse due to generics. I am scared. At this stage it’s almost life threatening.
It would seem to me that knowingly withholding or rationing required medications from any patient is something akin to medical malpractice . This action is endangering the lives of not only the patient but those who come in contact with them.
Patients with documented diagnosis of narcolepsy that require Ritalin for them to function on a daily basis are now being forced to experience major withdrawal due to a lack of availability of this drug . This is a serious issue that has serious potential risks and consequences for both the patients and those they come in contact with . This issue needs to be re examined for a better solution to what ever that problem was that prompted this irresponsible action
Hello All,
I am on Ritalin 5mg. But when I went to refill my medication they said that they can’t get 5mg anymore. The only thing that helps my situation is I don’t need it all the time. I have managed to have some saved up. And thankfully I have enough for 2 months to hopefully last long enough for the DEA to get their crap together. But I feel for those who need it all the time. I am on pain medication, and I would be in severe pain without the medication. Trying to function without ADHD medication is not too different. And basically telling people to find the money to buy the name brand is complete bull. I mean why does the goverment and ADHD care? They make way more money than even the average person and can afford to buy name brand medication with no problems. But those who are low income depend on the generic to make their budget. That’s just not fair to those who don’t have that kind of money. Got to love the government. As long as it doesn’t effect them, they could care less. The minute it effects them or their family the problem is instantly solved.
-Stanley
Before promotting so much medication for ADHD, we should try to find out the very many causes and that not all of them are the same. Most people would benefit much more from correct exercises like Mind Moves and other tipes, as well as a correct diet and many more natural ways of betting ADHD better than med.
From my experience, more than 80% diagnostics of ADHD is something else. Mostly related to lack of sensory integration.
Just imagine…a bunch of people with ADHD off their meds because they can’t get the generics and can’t afford the name brands “Occupying” the DEA….
Maybe we could get marijuana legalized at the same time…
I am one of the thousands of adults that has A.D.D.
I am mid 50 female on disability. I have a grown daughter that has ADHD, son has ADD. I have read, listened to and argued with people that insist there is no such thing, an imagined ailment for purposes of getting on or putting children on drugs to silence a kid that is “normal’, “just being a kid”, and all they need is discipline.
I watched my children struggle with school year after year. I did the same thing as a child but then I WAS labeled lazy, dumb. My daughter now age 20 began getting medication at the beginning of 2nd grade. This was recommended by the school system because after observing her the prior 2 years she would have continued failure if untreated. Monitered cafefully with meds then, she now is able to function w/o meds. Prior to the school recommendation she was restricted from dyes in foods and drinks. We followed every diet plan free from anything that would cause excessive and prolonged hyper activity. Yet she bounced off sofas and chairs burning energy till early a.m.hours.
There are many stories like this from parents with children that have ADHD and ADD. And on that I add there is a difference between ADHD/ADD, I lived through it myself and with my kids. but still read posts made that there is no difference. Granted there are kids that are placed on meds that don’t need it. But there seems to be a blanket theory that most people, children or adults are seeking these meds for other purposes.
I take the generic of Adderal. Going to a major chain drug store repeatedly being told they have none, finally getting an answer that this drug won’t be available for 2 to 3 months because the college kids are taking them for enhanced performance on tests. The pharmacist said basically it’s politics, the drugs are made in other countries. Not only ADD meds but Chemo has been restricted as well.
I have written to my Senator to help address this for the one’s that are truly in need of the medication’s and stop the people that abusing it for short term test enhancement and the other benefits they are recieving from it.
As a mother of a 13 yr old son who has been diagnosed with adhd for many years and who still to this day has troubles with it even medicated this “shortage” or lack of care seems ridiculous. Think about the damage its doing to these childrens bodies and minds. Like any drug prescribed or not immediate stoppage brings on withdrawals. I for one hate to see my son sick because of something so easily fixed. Maybe testing patients who claim to need the medication should be closer looked into maybe more test should be taken but our children who actually need these medications just to make it through a school day without disrupting a normal day due to impulses and actions due to withdrawals. Not to mention their grades going up and down because these people think they can play god and just decide to cut something so vital to many just to stop those who abuse it.
It’s simply infuriating that non-medical people – as in the DEA – with no connections at all to individuals who might need/use the particular drugs are allowed to exert so much control over people’s lives.If drugs are over used, that is a separate problem. This sounds like puritanical ignorant arrogance which has been allowed to disrupt supplies.
Our bloody Congress is so involved in preserving itself that too many members do not even care to see the consequences of their inaction.
What about Atomexetine ? It is still under patent by Eli Lily (brand name Strattera), but only just barely. Will this non-amphetamine based ADHD medication (it is a nor-ephinepherine reuptake inhibitor) help fill the gap, or is it regarded as ineffective for many?
Strattera seems to cause severe stomach upset and in some cramping along with upset stomach. My daughter and I both experienced these side effects severe enough to change meds that didn’t cause this much upset stomach. Along with those side effects and being a non amphetamine for those that need the amphetamine just wasn’t a good choice. For the ADHD individual the side effects again are too much to deal with on a daily basis of the sick feeling. There are others I’m sure that can tolerate it, but me and my daughter could not.
I was a 7 month premmie, who’s mother smoke 2 packs of Camels all through the pregnancy. I meet all the criteria, and finally at age 45 I find someone to trust me to take as directed. I have for over 10 years and feel that my best years were wasted because of the paranoia that the stigma of a C-II has. Reluctance to prescribe, I fell short changed all though college I wondered WHY? can’t I keep up? The answer ADHD. Born premature and toxin from the smoking and second hand smoke. I could get by, but USC or Stanford? YES with the Adderall I now have.
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