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Chris Langer for msnbc.com
Kate Skinn, 32 of Sheffield Lake, counts out the remaining doses of Adderall that treat her attention-deficit hyperactivity disorder. Skinn is among millions of Americans affected by a lingering shortage of vital medications.
After nearly 10 months, the nationwide shortage of ADHD drugs has taken a toll on Kate Skinn.
The 32-year-old Ohio woman had to take a medical leave from college because she can’t focus on her reading. She’s lost income from her job as a waitress because she’s distracted at work. And she’s had to struggle even harder than usual juggling the needs of her boyfriend and their four children, all because she can’t reliably get the Adderall that helps her cope.
“It’s impossible to manage all the facets of my life and do my schoolwork,” said Skinn, of Sheffield Lake, Ohio, who was diagnosed with attention-deficit hyperactivity disorder three years ago. “When I can’t take my medicine, I can’t concentrate. I’ll start everything I need to do, but never complete any of it.”
She’s among millions of Americans struggling to deal with the worst drug shortage in United States history. ADHD drugs such as Adderall and Ritalin, first reported as scarce last spring, are only a fraction of the 251 medications in short supply so far this year, up from 211 in 2010, according to University of Utah Drug Information Service.
The issue drew renewed attention Thursday, when the White House issued an interim rule that requires drugmakers that are the only producers of certain critical medications to report to the Food and Drug Administration all manufacturing interruptions that could disrupt supplies.
It follows an October executive order in which President Barack Obama directed the FDA and the Department of Justice to take bolder steps to resolve the worsening scarcity.
Shortages of life-saving drugs, such as those used to treat cancer, and medically necessary drugs, such as anesthetics and painkillers, have sparked the most dire concerns, experts say.
But shortages of the ADHD drugs widely used to help an estimated 5.4 million children and 1.5 million adults concentrate daily are also worrisome, especially as the problem continues.
“We get those reports from patients saying I had to drive three hours to get my ADHD prescription and this is the third, fourth or fifth time,” said Erin Fox, manager of the Drug Information Service, which tracks drug supply issues. “We’re hearing from moms who are so worried and upset about not getting the drugs their kids need every day.”
FDA officials, too, say the ADHD drug shortage has drawn a lot of attention.
“We’re hearing the same thing: that patients aren’t able to get these drugs,” said Valerie Jensen, associate director of the FDA’s drug shortage program. “We’re continuing to check with the companies about their expected resolution dates.”
Drugmakers say that increased demand and difficulty obtaining supplies of the raw materials used to manufacture the drugs are behind the ongoing ADHD pill shortages. But an official with the government agency that allocates those controlled substances says from his vantage, there’s plenty of raw material out there.
Chris Langer for msnbc.com
Kate Skinn watches TV with her 4-year-old son, Markus, who also needs medication to treat his ADHD.
The DEA allocates an aggregate amount of medically necessary supplies of controlled drugs -- for instance, 56 million grams of methylphenidate in 2011 -- and then doles out confidential portions to each drugmaker.
“We’ve given them quota sufficient to meet the needs and then it’s up to them how they manufacture their product,” said Gary Boggs, a supervisory special agent for the Office of Diversion for the federal Drug Enforcement Agency.
Company business decisions surrounding competition, marketing -- and profit margins -- are behind many of the troubles that patients have encountered, Boggs added. Manufacturers might make more of an expensive brand-name drug and not enough of a generic version. Or they may distribute too much product in one place, causing a shortage somewhere else.
“This isn’t just a clean there is either product or not product,” Boggs said. “There’s a whole lot of different dynamics in here.”
Drugmakers declined to discuss specifics of their DEA allocations.
Still, those dynamics have reshaped Kate Skinn’s life.
In the past 10 months, she’s had to drive to multiple pharmacies trying to get the different ADHD drugs used by four members of her family, including her 4-year-old son, Markus.
“I have to actually block out a whole day of my life to figure out if I’m going to have medication for the next day,” said Skinn.
Because the drugs are controlled substances, she and other patients have to follow strict rules governing prescriptions and refills. Skinn sometimes skips a dose at night in order to hoard them for times when she might run out.
“For people with ADHD, there’s already a stigma attached to it,” she said. “You end up feeling like you’re drug-seeking. It doesn’t make you feel good.”
In recent weeks, the ADHD shortage has shown signs of easing. Brand-name Adderall XR, the extended-release version produced for the drug company Shire Pharmaceuticals, has been logged as available in “adequate” supplies. Company spokesman Matt Cabrey said that’s because the DEA granted an increase in the firm’s allocation of amphetamine mixed salts used to make the drug.
Other firms, as well, say that as they receive their new DEA allocations in the new year, the shortages may subside.
That would be welcome news for patients like Skinn, but drug supply experts say they've heard that before -- and no one should count on it.
Related stories:
Shortage of ADHD drugs sends parents scrambling
Price-gougers hike drug costs during shortage
Drug shortages slam patients, health workers, surveys show
Half of hospitals buy back-door drugs, survey shows
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The problem with mental illness is that it doesn’t show up as a big spot on your head. Because you just can’t see it for what it is you get all this prejudice, ignorance and misunderstanding about it. The sad thing is that probably in most cases it is very manageable with a little assistance. Unfortunately at this period in time we as a people and a country would rather build greedy empires rather then a nation by the people for the people. You will have these problems because our nation supports serving a select few making a lot of money not healing the sick.
gtfyre: Adderall doesn't make you more intelligent, it just allows you to better harness your intelligence. Sounds like sour at the world cause your a little on the slow end. I was diagnosed ADHD when i was 7. I also had an IQ test during the testing, which netted an average of 150+... which of course I couldn't get better than 2.0-2.5 gpa all the way through HS because I refused to take meds after a bad reaction to ridelin when I was 12. It took massive amount of time trying to study for test and such, which was all futile. It took me an hour to read one page in a text book. I survived off my high intelligence but it was miserable. I finally decided to give meds another shot in college and found Adderral made a impact on all my symptoms and life has changed 100% for the better. I no longer feel lazy, uninterested, frustrated, and angry with life. I'm not addicted to it and I stop taking it sometimes just because, or I just forget to take it in the morning and have to cope at work. I dont know were your getting your info from but at least for me, there is no physiological addiction, I could stop at anytime without any withdrawal symptoms, which I have before more a month here and there just to test myself. For those who said there child took adderall and couldn't go to sleep, then maybe your child really is not ADHD. I dont know about other ADHD people, but I could take 90mg of adderall and go take a nap without a problem... which to me is a TRUE validity that ADHD is REAL!! Nobody could take that much stimulant and be able to fall asleep or just relax and read a book, NOBODY who is not ADHD could do that. I've seen kids in college take just small amounts like 5-10mg and be wired like on speed for 12-24 hours. I could have offered them 500$ to fall asleep and they would have all lost their money. I do believe that it is over diagnosed, but so is pain killers by far!! But for those who have it ADHD or live with chronic pain, drugs may be necessary for quality of life.
Yours sounds like a success story for one medication. But, just as you said, it took many years; a bad experience, and a major learning process, while attempting to "own" the disability. This is a similar story, with persons with chronic pain (different meds) or fibromyalgia. Too much of a med, wrong med, too little of a med, or a combination of meds and therapy. ADHD is real, and very difficult to treat, agreed.
First and foremost, the reason for the shortage deals with regulations on the medicines themselves. Medications like Adderall (regular or XR), Concerta, and Ritalin are classified by the FDA as CII narcotics, meaning that they have a high chance of addiction and abuse. Because of this, the government limits how much of them can be made per year, and usually by November or early December, the drug companies have met their quota and have to wait until the new year to produce more. This is the reason for the shortages now... and it happens just about every year. This also happens with other CII medicines such as oxycotin and oxycodone.
Take it from someone who works in a pharmacy, this is a pain, not only for us but for the customers.
Now... I'm not going to get into the debate on whether or not ADD/ADHD is real or not. All I'm going to say is that these medicines are over perscribed and can have very nasty consequences. I'm not going to lie; these medicines, due to how they work, can negatively affect someone's personality and behavior.
There's something else I want to point out... and that deals with people harping about the brand names. The generics are availble... for most of the CII ADD medications (I think that Daytrana is the only one that doesn't...). Because of that, the brands really aren't dispensed nearly as much as you would think. Generics are a cheaper alternative, not only for the patient, but for the pharmacy and for the insurance companies. And... unless told otherwise by the doctor, pharmacies perfer to give the patients the generics. Besides, patients always have a right to refuse to take the brand and ask if a generic is available.
This is what happens when our health care is left up to companies that only care about profits. There isn't enough profit in these drugs so the makers are dropping out. The price of gasoline has quadrupled in 10 years. Not because of supply and demand, because of speculators and profiteers. Why have food prices shot up? Because more and more farmland is being diverted to corn production for ethanol. Less "edible" food is being grown. Capitalism is fine, but when we can't get basic needs met, we are forced to intervene.
Interesting commentary, esp since many commentors have likened the disorder to a diabetic needing insulin. In some instances of both ADHD and Type 2 Diabetes, and Ketogenic diet has been shown to have terrific outcomes, resulting in being able to wean off of drugs. But we've been brainwashed that "fat is bad" with no real evidence, and it is sorely missing from "healthy" diets . . . things that make ya go "hmmmm".....
i have an adult child that struggled her entire life until we had her tested. she takes adderall and the difference in her concentration is like night and day. she now is a magazine editor, has a bs in photojournalism, and a minor in english. last month was the first time she had problems finding her meds. thank heavens she only had to go to two pharmacies. she's one of the ones that CANNOT function without it. capitalism at it finest!!!!!!!
I'm 29 and have been back on Ritalin since 20 after not taking it since high school. I got back on it because my ADD was affecting my job/life. I can tell you that in Vermont the shortage was bad enough I could not get any meds the whole month of December, I almost lost my job over it. I was basically sleep working, and this after 9 hours sleep, falling half sleep in front of machinery. Yes, some people can get by without the use of meds, some can truly excel with drive and ambition, but some cannot - some cannot find their drive and ambition through the haze of ADD. It's not bull@!$%#. I do not agree children at a young age should be on these meds though. Your brain is still developing and sometimes needs to wander.
Free birth control pills will solve this problem.
This is ridiculous! The only reason the drug companies do this is to jack up the price so the CEOs can get a big fat bonus. The government wants to mandate everything in our lives but can't take care of this problem? What a crock of crap!
This mythical disorder is a product of environment. I bet the woman featured in this story can sit and watch TV just fine. 4 kids, a husband, and school? Who would be able to juggle all of that?
I can't believe what the world is coming to these days. sure we're making wonderful advancements in science and technology but does that mean that every kid that doesn't do his work or sit down and do what their told, needs to be given all these SYNTHETIC drugs? I understand that some children and even adults need to be treated for any raneg of mental or physical illness, but i think we're taking it a little far.
I have an employee who's son has not only suffered from ADHD symptoms but from seizures by the boat load daily. After spending literally tens of thousands of dollars (under our health care plan which has increased over 40% due excessive use) one of their doctors recommended an entirely different course of action... which by they way most of their physicians poo-poohed.
The cure you may ask? Cut out eating crap food and change his diet to one which eliminates (I mean eliminates) carbohydrates. Granted, it's been very tough measuring every thing he eats to the 10th of a gram, but bottom line is he's lost 18 pounds, is much better behaved and more importantly his seizures have virtually ceased to exist.
I'm not saying a woman shouldn't have 4 children, or live with a boyfriend... what I'm saying is they obviously aren't getting a lot of exercise nor eating wholesome foods based on their photo. She has enough money to get a tattoo, but says the government is basically to blame for her predicament (does she get food assistance?). Maybe if she spent more time shopping for proper foods and got out and worked off about 40 extra pounds she could concentrate.
I'm no doctor... no expert of any kind. But when people are obviously overweight and spend their time watching TV rather than going for a walk, or playing baseball or what ever else they could be doing to move their bodies instead of sitting maybe their ADHD would get better without expecting some sort of pill to "fix" the problem.
Maybe I'm just a fool... then again, I've seen the results first hand what happens when drugs are replaced with common sense and a structured environment to act in a health manner.
Stabilizing one's diet would be the first thing in almost any situation. The problem is that in some cases there are no dietary issues. Although, there are definitely cases where food allergies mimic ADHD symptoms. It is a hard nut to crack. I wish it on no one.
As long as a can remember I had extreme difficulty focusing and concentrating on school work as well as having some problems with inability to sit still. I struggled in high school but got into college and decided to make a Herculean effort to do well and get my BS in Astrophysics. I spent practically all my time in college spending an enormous amount of time trying to focus well enough to get good grades. I managed to graduate with a 3.7 GPA but decided to go to medical school and become a doctor. I studied many hours a day for months on end but ended up getting a high score on the Medical School Admission Test (MCAT) and was accepted by a highly regarded American medical school.
It was enormously difficult to keep up with the vast amount of material that a medical student must learn but I made it through my first two years. My medical school had a policy that in order to move on to our third year clinical rotations we had to pass Step 1 of the U.S. Medical Licensing Exam (USMLE) and gave us six weeks to study for this national all day exam that was to cover everything covered in the first two years of medical school. I tried to get ready for the test but just could not focus and a month before the exam had to come to terms with the fact that I had finally hit the wall, just could learn the material in time and was going to fail the exam. I went to a psychiatrist severely depressed and he diagnosed me with adult ADHD and prescribed Ritalin.
The effect was instantaneous. Suddenly I could sit down at 8:00AM at my desk and study without distraction or inattention for the next 10 hours straight and absorbe in one day as much information as it had been taking a week for me to learn. I passed USMLE step one saving my medical career. I became a much stronger student, passed step 2 of the USMLE in my fourth year and step 3 in my first year of Residency. Today I am a doctor practicing Nuclear Medicine.
I realize that at the cognitive level we are talking about here with passing the USMLE I could hardly could have been labeled as disabled if I had not passed the exam and that for me Ritalin was nothing more than a performance enhancing substance. But as I see it stimulants did not make me any smarter, they helped me overcome a medical condition was keeping me from reaching my full potential.
Just remember - everything you don't understand is easy. It has been my experience that parents with true ADHD children know far more about their kids, intimently so, that most other parents. Why, necessity is the mother of invention. Think you have the "ultimate" answer - those parents have probably tried your suggestions and everyone else's suggestions many times over looking for a solution. If there was a one size fits all solution - everyone would be using it. The brain and the interaction of the millions of neurons present mankind with a real big problem - you just can't get at the darn thing. And, if ADHD is on the upswing - well, so are vaccinations, pollutants, and population. Try work out all of those variables. Hopefully, one day, there will be a solution. Right now, attacking the symptoms is really a bridge to (hopefully) somewhere. Many kids "outgrow" the symptoms. Perhaps hormones are playing a role and they become stable after puberty. Not for all though.
"all they needed was a good swift-kick in the azz"
People need drugs to deal with lame human beings like this. (when this anti-human behavior ends then we can see how much drug help we really need)
Drugs deal with the symptoms not the root cause.
Unconditional love. (and a little Cannabis if needed)
All these drugs have side affects, which is hard to see how they really help in the long run.
So there is a shortage of these drugs because the government regulates the supply of materials needed to make these drugs. And people think the answer is for more government involvement?
"Government is not the solution to the problem, government is the problem" -- Ronald Regan
I know someone with ahdh, omg, such a difference when she's on adderall than when she's not. Anyone can tell if she's been taking her meds just by walking into her house. Somewhat clean versus really messy and dirty. She has been told by her therapist that she risks losing her children if she doesn't religiously take the adderall. Her house gets to be a complete disaster. When she runs out she says it's such a big chore for her to drive to the dr, pick up the script then have to drive all the way to the pharmacy. I believe she really needs it. Nothing gets done when she doesn't take her meds.
Why is a Government agency in charge of dolling out raw materials? How did the Government come to have control over it?
Did the business get comandeered? I would be asking that question How did the government get control over this? God knows that Police and Politicians are expert medical professionals that know better than God if you need a medication or not or more like if your rich enough to have medications.
You know in Russia cancer patients are left to die suffering horribly because outside of a hospital you cannot by law have pain meds AT ALL because they are addictive and SOME people may abuse them so NO ONE can have them. Suicide is common. I can't believe Americans are so lazy and stupid they let the Government take over their lives so easily I'm ashamed.
Aderal and other stimulants are not only for people with ADHD... I feel worse for the narcoleptics that need it to stay awake, I havent had any problems with shortages where I am... but if it does happen I would hope they would have a way to see whos needs are greater, Just saying
Adderall isn't the only drug affected by this but all sorts of different and sometimes life saving drugs are involved. The bigger issue is the GREEDY drug companies not wanting to make the cheap, yet infinitely useful, generic drugs because they won't turn as big a buck on them. How many patients will have to die before someone hold these corporations accountable? This is how outsourcing happens....these drug companies don't want to manufacture the cheap drugs when they can manufacture brand new, hugely expensive brand name drugs in which they hold the patent for (there is no generic version). so the cheap drugs have to come from China, where although they are SUPPOSED to follow US FDA guidelines, you can be pretty certain that once the cats away, the mice will play. I don't know which is scarier, the greedy pharm companies here or the greedy pharm companies in China......
My two sons were diagnosed with ADHD/ADLD early in their school years. The teachers couldn't take them "acting out" by doing such things as pretending to shoot at deer out the classroom window (he had gone hunting with my FIL and hubby over the weekend) or talking to self (have you never had an imaginary friend?). After their complaints and many doctor/psychiatrist visits, they were diagnosed with the disorder.
One of my boys got so bad on Ritalin that every day he dragged his bookbag into the house and then slept for 2-3 hours, he was a zombie. When I changed doctors and asked the new doctor if there was another way to control ADHD without drugs, I was told that you could do so with control of diet. We changed the way we ate, left sugar and chocolate out of the house, and got very little junk foods. I cooked fresh foods instead of quick things from the frozen food market and neither of my sons ever took another day of meds. There is a way to control them if you just look and take the time to do so. Also, they were overactive quite a bit, but I just gave them chores to work off their energy such as taking out the trash, working in the yard, etc. Both are grown now and doing great and do not need any meds at all.
Drugs are not always the answer!