If you are scrambling to get your child's attention-deficit/hyperactivity disorder (ADHD) prescription refilled, you are definitely not alone. Families across the U.S. have been dealing with an ADHD medication shortage first reported in October 2022 that is now well into its second year.
I've heard stories of parents and caregivers having to drive as far as 50 miles to find a pharmacy with the brand and dosage their child usually takes. Others have tried rationing doses or skipping meds altogether, with significant impact on their child's well-being. Many have asked their doctors to recommend different brands—which doesn't always work, since a range of ADHD meds are in short supply.
To make matters worse, the cost of ADHD medication has risen sharply throughout the country,
federal data shows. This has created hardships for all families, especially those living on a tight budget.
No one can say for sure when the ongoing shortages will end. However, there may be things you can do to ease the impact on your child (and your own stress levels).
Talk with your child's doctor to explore your choices
Brand-name prescription drugs such as Adderall XR, Vyvanse, Focalin, Metadate and Concerta have all been hard to find in recent months. If your child takes one of these drugs or the generic equivalent, continue to work with your child's doctor. For example, you may want to set up an appointment to discuss if it is appropriate to:
Take a longer-acting or shorter-acting version of the same drug
Take a different drug that might be well-tolerated
Try a generic version of their usual medication, if available
Let your pediatrician know about what's happening so you can work together as a team. Every child and family is unique; it may take some careful strategizing to support your child through the next several months.
Look for ways to save money on meds your child needs
High prices for ADHD meds might tempt you to ration your child's doses. Instead, consider looking for savings on the prescription that works best for your child. Your pediatrician may have suggestions, since many newer (non-generic) drugs offer coupons and financial assistance programs.
If your family has prescription drug coverage, check to see which ADHD meds your insurer covers. Then you can discuss the alternatives with your pediatrician. It may help to check your insurer's directory of preferred pharmacies. They may offer better pricing on approved prescriptions.
Certain medications may need prior authorizations from your insurance company and extra time for approval. In these cases, your child's doctor can provide additional information about why this medication should be covered.
Explore additional ways to help ease ADHD symptoms
If your child's ADHD symptoms have been well-controlled until now, you may not have explored other helpful techniques to help your child manage them. Keep in mind that these approaches don't replace your child's medication, but may be part of the comprehensive strategy.
Behavioral treatment. Behavior therapy helps to improve a child's behavior, self-control and self-esteem. It has supportive evidence for improving symptoms of ADHD in children 12 years and younger.
Behavior therapy should include the parent or caregiver as an active participant. Your child's therapist can describe how to guide your child with clear instructions, for example, or help shape their behavior with reward systems and consequences.
In older children with ADHD and anxiety, depression or oppositional defiant disorder, cognitive behavioral therapy may be helpful for those related symptoms.
School supports. If ADHD is affecting your child at school, discuss with the teacher or principal if there are supports available. Examples of school support systems include include daily report cards, planners or meeting with a counselor about study skills.
Publicly funded schools may consider if the child is eligible as part of a
504 plan or special education individualized education plan (IEP).
Free time outdoors. Extensive research points to the value of time spent outside in easing ADHD symptoms. Even 20 minutes in a natural setting can improve concentration and focus. Look for wide-open settings where you can walk together or encourage safe, free play.
Mindfulness & mindful movement. Some research suggests that kids living with ADHD may benefit from mindfulness activities. Examples include identifying what's around them using their five senses. Or, they can practice slow, controlled breathing, tracing their fingers or a shape like a square to guide when to breathe in and out.
Activities like these can help with challenges regulating emotions or stress that are associated with ADHD. In addition, certain mindfulness and movement activities such as yoga and tai chi have small studies showing potential benefits.
For older kids,
a self-directed plan for organization and calm. Tweens and teens can feel more centered and in control by designing their own routines. Here are
4 ways you can support them.
Remember that your child's doctor is on your side
If it seems that no one understands what you and your child are going through right now, please know that your pediatrician is concerned, too. We are deeply worried by the shortage of ADHD meds. In many cases, we're also scrambling to help children waiting for other medications that are in short supply.
Since most ADHD prescriptions are controlled substances under federal law, doctors have to follow very specific rules when prescribing. Pharmacies face equally tough requirements—which is why they can't simply transfer an existing prescription to a new location. The best they can do is suggest another pharmacy that might have supplies on hand.
Once you relay this information to your child's doctor, a new prescription must be sent through the electronic system that handles controlled substances. By the time you arrive at the pharmacy, hoping for a refill, you may find that they ran out within minutes of your doctor's request. You may want to call the pharmacy first to confirm that they have the medication in stock and can fill the prescription.
How pediatricians are advocating for children and families
The American Academy of Pediatrics (AAP) is determined to do all we can to address future shortages of the meds your child relies on to focus, study and manage the tasks of everyday life. We are actively working with lawmakers and government agencies to find real solutions.
The AAP supports the
Drug Shortage Prevention Act of 2023. This is a bipartisan bill before Congress that would require drug makers to notify the Food and Drug Administration (FDA) when they see a surge in demand for essential medicines. The FDA has no direct control over drug supplies. However, being able to forecast shortages would allow better coordination and planning, which may ease the impact on children and families.
Pediatricians are also concerned about rising costs for ADHD medications, which add to the burden many families face in caring for kids who live with ADHD. Issues like this one have an uneven and unfair impact on millions of young people who already face elevated risks for mental health struggles. The AAP is advocating for wider access to insurance plans that help cover costs while seeking solutions to rising drug costs.
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