Reflections on a Crisis of Limited Supply and Significant Impact

Matthew Goldenberg D.O. 
President-Elect, SCPS 
Chair, SCPS Private Practice Committee

Is this Adderall shortage ever going to end?

Whether it is caused by a manufacturing plant shut down, over-prescribing by the online consumer based ADHD companies or an act of God, has anyone been spared? 

Our patients are suffering, missing their needed medication, spending hours calling endless pharmacies looking for a refill and being told there is no end in sight. Pharmacies are suggesting medication changes and alternative medications to our patients. We spend 2x, 3x, 4x more time than usual fielding patient calls/emails and sending duplicate refills to multiple pharmacies. What started with only Adderall, the shortage is now impacting other stimulants downstream as patients are forced to switch medications to what is available, further compounding the problem. 

Throughout it all, I have wondered when someone would take notice and find a solution. With this in mind, it has been an honor to have been selected to serve on the American Psychiatric Association’s Council on Addiction. So when the council asked me to speak with a national health reporter from Reuters about pharmacy and prescribing issues, I jumped at the chance to tell the story! Representing APA, SCPS, CSAP, my profession and my patients, I hoped that we would get this problem out in the open and hoped that those in positions of power would be moved to take action. The story is out and you can read about it here

Are those in power taking action… I will be honest, it does not feel like it. However, I am optimistic because SCPS has several committees and the SCPS Council discussing these pharmacy and prescribing issues. I am optimistic because CSAP and Paul Yoder are taking notice and are likewise discussing the problem and possible solutions. I want to applaud CSAP GAC Chair, Emily Wood MD for spearheading the survey that has better helped to quantify and qualify the extent of the problem. (If you have not already submitted your experiences, take a minute and do it!) I am additionally optimistic because APA appears to also have this on their radar. 

But more work needs to be done. Medication shortages are not limited to psychiatry or mental health treatments. However, there is often additional stigma and shame associated with mental health conditions. I also fear that Adderall and other stimulants are viewed by some in the public as unnecessary luxuries. As psychiatrists, we know how transformative ADHD treatment can be for our patients’ functionality and quality of life. We also know how detrimental a sudden loss of access to a needed treatment like Adderall can be. Without access to their regular treatment, our patients are forced to go without. Our patients are forced to try less optimal doses and formulations. Is this any less a crisis than if this were an insulin or lipitor shortage? 

Organized psychiatry has power in numbers and I am encouraged by CSAP’s ability to bring all five APA district branches together, in real time, to work towards a solution for us and our patients.  

SYASL Talking to Retailers and Large Drugstore Chains

Whether it is caused by a manufacturing plant shut down, over-prescribing by the online consumer based ADHD companies or an act of God, has anyone been spared? 

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