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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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I too have ADHD and mental focus is a huge issue. I've been on Ritalin, Adderrall, Adderrall XR and Strattera. I agree with the person who said they felt their thoughts were in a big blender. However, these drugs they prescribe are dangerous and can have adverse effects on your body. You may be able to focus for a short 1-2 hour period, but what price is your body paying? I had to have an EKG before I was prescribed these drugs which I have completely quit taking because how awful they made me feel once they wore off. THIS IS NOT FOR KIDS, but as an adult, try vaporizing marijuana. Why vaporize? Because vaporizing marijuana does not produce the tar and cancer causing chemicals released during combustion. Vaporizing it heats the marijuana only to a boiling point for the cannibinoids to be released in a vapor. Now for ADHD make sure your weed is Sativa not Indica. Indica will relax you but make you sleepy, Sativa gives you more of an energized feeling and helps with your mental focus. Vaporizing your sativa will not produce any side affects and is much safer than these crappy drugs they keep pushing. Although weed is not legal, its legality is based on lies, lies that we have been told since we were kids. Those liars can kiss my A$$!
You don't have ADHD - you just make excuses for bad habits. Get a grip.
There are many reasons why some people and kids are unfocused and a bit hyper; ADHD is just one reason. Ritalin is a powerful stimulant for people without ADHD and college kids call it steroids for the brain; but for people with real ADHD it has a calming effect. If people take Ritalin or other ADHD drugs and it makes them speedy, then they do not have ADHD, rather they have a condition that will not be helped by ADHD drugs, in fact the ADHD drugs will make them even more speedy, although they will get lots of chores done, just like a meth-head who can't sit still.
the government limits the raw materials, doctors over prescribe medications ,insurance companies limit benefits and drug companies make record profit!!!!!!!!! how long has adhd been a disorder? probably as long as drug companies have been munufacturing the drugs !!!! quit drugging children !!!!
Drug companies do not make a drug without any demand for it. ADHD has been listed in the psychiatric diagnostic books since the early 1900s, long before there were drugs for it.
whatever..... this ADHD crap and those other exotic invented disease like restless leg syndrome or whatnot are bullcrap invented by pharma industry. Since they can't really figure the real medicine for serious and life-threatening diseases for cancer, heart disease or diabetes they resorted into creating this hype of bullcrap disorder so people will pay them money for whatever concoction they claim to cure it. It's the modern version of snake oil salesman that is. Amazingly nobody want to expose them and instead people like me get attacked for making such notions.
I can't resist- Marie Amphetamine cried out, "Let them snort meth!"
Hardly anyone needs to take these drugs. It is just like fat people saying they have a thyroid problem (when most don't). When I was in law school, about 80% of the student population (but not me) used the excuse of ADHD to get drugs that helped them study harder for longer periods of time.
I don't mind if people feel they need to use a drug to gain an edge, but let's call it what it is. If you aren't bright enough to finish college or have enough work-ethic to do your job well, don't blame a shortage of ADHD drugs for your problems.
Coddling people in this way is just another example of why the US is losing ground internationally...
For all of you morons who say ADHD is not real, it is very real and it SUCKS! I know from experience. The problem is the treatment with these dangerous man made drugs. People need to do their due diligence on these things before letting your doctor prescribe this poison. It's a lazy and harmful way out.
ADHD is not real - you just have bad habits. Get a grip.
Kids are rebellious, poop-throwin', burger-eating, loud, obnoxious, inattentive monsters, who often don't give a damn what they're bein' told to do; some more than others ... THIS IS NOT A DISEASE!!
Right on.
Its a problem you just don't need drugs to handle it, you only went to law school. I have worked for lawyers and after getting to know them, a 3 year old could probably pass the bar - Your opinion is worthless!
That goes for some adults as well, by the way.
I know what she is going through these drugs are essential to my.....I have to do laundry and then get the kids oh my lunch i left it out....what was I saying about the article????????????
This is great news. For those on the drugs, I feel bad as I watched a cousin having withdrawals from Ritalin when her mother failed to send her pills with her while she spent a week with our family. As for those who have yet to be put on the drug or the wonderful parents who refuse to put you on it--now you can be kids. Some children have more energy than other children--for those teachers and for those parents--DEAL WITH IT! This is the child God gave to those parents and teachers need to calm down--maybe if most of these teachers would lay off the sauce, their own rxes, cell phones, FaceBook, and so many teaching rules and regulations; they could handle these children.
If they could find the thing causing the problem(diet,allergies,etc) they would have enough drugs to dull the people.
I think the real problem is adults being too lazy, weak-minded and irresponsible to handle their little bundles of joy. How do doctors diagnose this anyway? Do they make kids recite boring excerpts from their medical books to see how long it takes them to throw the book away, tell them to sit still and then time them? Whatup?
Did this make anyone else immediately think of the Ministry of Silly Walks? Just me, then?
I have a son with dyslexia and probably adhd also, however we dealt with it. I am not saying some kids or people don't need the meds, but schools get money for every kid diagnosed and doctors get kickbacks from companies. This is fact. So while ADD and ADHD does exist I find it hard to believe that it is as high as it is. Parents, schools and the such need to step it up and take control so that when the kids finally grow up they have coping mechanisms and don't just rely on meds to help them get through what life throws at you. Look at the stats!!
Schools do not get money for every kid with ADHD. None of the kids I know with it qualify for special ed (special ed gets money) they get classroom midifications such as more time on tests, seated near the teacher and such. This does not qualify the school for more money. Kids who are physically and mentally disabled get the school more money because it costs more to educate them as they need special teachers and lots more aides.
Interesting story: I was in Mexico a few years ago. The pharmacies across the border have touts, like on a carnival midway, trying to lure you in. Finally I figured, why not? Let's see if they have my daughter's medication. Maybe it'll be cheaper.
I was shocked when they gave me the price. Her particular medicine was over 300% more expensive in Mexico than it is here. I couldn't believe it. (But I did get a full contact lens exam with two boxes of contacts for about $40.)
booya-3388691, that is a great question. I believe ADHD does exist because I have it. I think too many doctors jump at the opportunity to diagnos kids as ADHD and the parents are just bad parents. The focusing part sucks due of the number of thoughts in your head. That being said, ADHD carries some benefits such as I love the high energy, and with practice you can multitask like no other. I get more done and drugs just bring you down. All it takes is discipline to get your mind under control. I think as the kids get older they will learn to control their ADHD. While growing up parents should just spend more time helping ther children focus instead of plopping them in front of the Xbox 360. I only suggested marijuana (for adults only) due to it's wonderful ability to slow the mind down and help you focus on one thought at a time.
For years my son was miserable at school, disruptive in class, had a hard time keeping friends, was teased because he stuttered. I tried to keep him busy with sports, he couldn't sit long enough to watch TV, and he had no self-esteem. In middle school his grades began to slip which was a surprise because he studied all the time. One of his coaches, who was also a teacher, suggested I have him tested for ADHD. What a difference it made. He was diagnosed with ADHD without the hyperactivity and his world changed. As the psychologist described it, as his school work got harder and involved more steps, his brain couldn't work through the steps in the proper order. His frustration was unbearable. With Ritalin his grades improved even though he was doing much less homework, he was no longer disruptive, made friends, and he quit stuttering.
I don't think there is any question that ADHD is overdiagnosed. However, for people with this very real condition, medication can be a life saver. In past generations, kids like my son often ended up as underachieving adults and many ended up in jail.
Brewster... Thanks for the support.... It's hard watching your baby suffer with frustration. I am glad you took the steps to help your child.
We live in a society that views access to quick and easy drugs to fix all our little problems as a privlage. People over medicate just to deal with the fact that their not living the high life. Even those that have way more than their fair share over medicate to deal with the guilt of having more than they could ever need.
You only have to look to the Michael Jackson case to see how people doctor shop to the get the drugs that they think they need, when they don't really need the drugs at all.
I have to agree with many people that the large percentage of people diagnosed with ADHD are in need of discipline, not drugs. Anyone can sit in front of a doctor and convince them they have ADD and need drugs for it. If you know how they want the questions answered you will get what you want.
A 6yr old not paying attention isnt a disease, its called being 6.
I never believed in ADHD/ADD, and I believe that it's WAY over-diagnosed and often without adequate examination.
But, if ADHD/ADD is real, and I believe it is in some cases, I believe that it's probably caused by all the crap (i.e. preservatives, additives, hormones, etc.) in our food.
Funny how we can't seem to find enough chemicals to take to counteract the effects of all the chemicals we put in our food. Maybe it would juts be easier to leave the chemicals out of our food???
Miker! That would impact the shelf life and therefore the profit margin of the corporations!
(Be very careful, Miker, such radical suggestions could get you picked up by the MIB and we would never hear from you again.)
Damn. That's right. Don't know what came over me.
Miker, I wish it were that simple. My son, who has ADHD and is on the autism spectrum, has always had a very good diet. I've always used organic foods; we don't eat sugary foods, pre-packaged foods, no hormones added, etc., etc. I make all of our food from scratch - breads, pastas, sauces, etc., etc. I'm very careful about what household products we use, etc., etc. Yet, he still has ADHD.
I do agree that having a healthy diet and lifestyle is very important - regardless of ADHD or any other illness.
Buy a pack of smokes!
I find this disturbing.
My step-son's mother has him on adhd drugs now, he's a freekin 13 year old boy, there's nothing wrong with him other than being a 13 year old boy, he wouldn't be so "hyper" if he was allowed to go outside and play like a normal kid, no instead he has to stay in the house while mom and step dad are gone to take care of his autistic sister (who is also overly medicated) I love summer because we get the kids then, I deal with K so that my step-son can go play and be a kid, when he's with us he doesn't need the meds and K doesn't need half of hers, I'm completely okay with doing MY job as a parent even if I'm only a "step-parent"
Is ADHD real? Yes, it is unfortunately.
Are ADHD drugs overprescribed? Totally
It's more than just about not being able to focus. It totally and completely makes your life unmanageable. I have so many kids who come see me, college age, who want a stimulant to give them an 'edge' in school. I've seen maybe two or three who would at least fit DSM-IV criteria.
NO it isnt real.. EVERY Scientist doctor and educated person above GED knows its a hoax a myth a lie and a scam
OK, I'll show you my MD if you show me yours. Ready, go!
I too was Diagnose with ADHD. My mother, being a nurse, refused to put me on Ritalin. she said all the kids she ever saw on Ritalin always looked like Zombies, pale, bags under their eyes and sickly. She instead put me on the Fiengold diet. which for a child was horrible. She swore up in down that it worked while I was on it. (In this diet you abstain from Artificial colors, sweeteners and preservatives.)
I was never allowed to use my ADHD as an excuse. I still had to get A's and B's, do my homework etc.
Is it hard to concentrate? Yes! But I am aware of it and have learned to force my self to get on track. I leave extra early for events, set my clocks ahead, try to leave myself voice notes. My family knows that I misplace everything, and try to help me on that.
I am a mom of 5, have a Masters degree in Science. Own my own home etc. I have done just fine without the chemicals.
People blaming the drug companies for the shortage, as though they did it on purpose... really??? Why does that even make sense? They are purposely causing a shortage of medication that people take daily, thus giving them daily profits?? so instead they are causing a shortage so they now don't make any money???
Maybe its because the shear numbers of people on this drug! The plant can't keep up production! Look into why everyone is on this drug! Pesticides in food?? Additives?? air quality?? Obviously it is something.
Is it hard to concentrate? Yes! But I am aware of it and have learned to force my self to get on track. I leave extra early for events, set my clocks ahead, try to leave myself voice notes. My family knows that I misplace everything, and try to help me on that.
Congratulation on being able to cope. You were given the tools as a child and your family continues to support you.
Now, face the fact that most people don't have your coping skills or support network for a very real problem that affects their ability to fully function in every day life.
My grandchildren have a friend who is impossible to have a structured conversation with unless he has his ADHD medication. He's 21.
Yes, it's real; yes, it's overdiagnosed; yes, medication is needed for some.
@cm - you definitely have a point, and while the Rx corps are not selling while there is a shortage, there are people profiting from the shortage.
Perhaps some of the shortage is from more people being prescribed the drug, but the drugs are out there and they're being bought up by "corporations" that then go to the back-doors of hospitals and dr's offices and offer this "hard to find" drug at a 500% increase.
Check out the facts - hospitals are having to buy these drugs on the black market, and for some reason it is either legal, or nothing is being done to stop it. And we continue to hear about drug shortages for meds like these as well as life-saving drugs that are needed now, and since they can't be gotten through the pharma corps, they are bought from the people standing at the back door. Do they really know where these drugs have been, what's been added, or if they are just sugar pills? No, there is no oversight on where these drugs have been, if they are expired or haven't been kept at the right temp, etc, etc.
Instead of the DEA going after the pot grower's in Cali and OR, they need to start hanging out at hospitals!
Ritalin calms down an overactive brain and it absolutely neccessary for some children. Many parents are afraid that their children will think you can solve your problems with drugs and then become drug addicts but studies show that properly medicated ADHD patients are much less likely to become addicted to illegal drugs. Not medicating them is actually correllated with illegal drug use. If your brain is broken you need to fix it. Having said that it is overprescribed because the people writing the prescriptions arent' the proper people. Only psychiatrists should prescribe psychoactive drugs, not a regular physician (who is not properly trained in psychological diagnosis).