William: There is a national
shortage of the drug adderall,
which is used to treat attention
deficit disorders.
Manufacturing delays, low
supply, and rising demand has
left those who rely on the drug
every day unsure about how or
when they will be able to get
their medication.
We reached out to people across
the country who have had trouble
filling their prescriptions
recently.
>> I'm Elaine Kozinski Thomas.
I am retired.
I live in Madison, Wisconsin.
I thought for sure this little
snafu that they were having at
our pharmacy was going to be
fine.
I didn't know that it was like a
national shortage.
It was gone.
>> I'm violet kayaga.
I live in Brooklyn, New York,
and I am a freelance fashion
designer.
I take my medication to
literally just function, to be
what society would consider a
normal person.
So that means I need my
medication to do my laundry.
I need my medication to complete
my tasks.
I need my medication to work.
I need my medication just to get
out of bed and shower and to
feed my cat.
>> My name is Katy slater, and I
live in Kansas, and I am a stay
at home mom.
You have to almost pharmacy shop
to see who has the supply, the
right dosage, the right
supplies.
And that definitely is hard
because it looks bad.
>> The pharmacy doesn't have the
dosage.
I need 10 milligrams, and so I'm
breaking the tablets in half and
trying to stretch them out.
>> Right now, I'm looking for
work.
So for me, that looks like me
being terrified of applying for
jobs because I know without my
medication, I'm not going to be
able to keep my job.
>> There has been times where I
wasn't able to get it and I rely
on that for things like driving.
If I'm out of medicine, that
would be way too dangerous for
me to drive.
My kids have certain activities
going on in certain days.
And if there's supply issues,
not to come up with another
plan.
And it's hard.
They're your kids.
>> When I don't have it, I find
life hard enough without it.
And I don't think that people
really understand what it does.
>> I would just like people to
consider that children with ADHD
grow into adults with ADHD.
And there's a lot of us out
there.
And of course the kids are
struggling, but there's a lot of
adults that rely on this
medication and we're struggling
as well.
And it's not just a small thing.
Yes.
I'm not going to die if I don't
have my medication.
But the life that I lead without
my medication to me is not a
life worth living.
William: Clearly, people are
struggling amid the shortage.
Let's discuss this further with
Dr. Craig Surman.
He's an associate professor of
psychiatry at Harvard medical
school and the scientific
coordinator of the adult ADHD
research program at
Massachusetts general hospital.
Dr. Surman, very good to have
you on the newshour.
We just heard from women
who are clearly struggling not
having their adderall medication
to treat their add disorders.
For people who are not familiar
with either the medication or
the condition, could you give us
a quick primer on them?
>> Attention deficit
hyperactivity disorder syndrome
is recognized as a disability
under federal law.
It's a hardwired pattern of
brain function.
And national data big U.S.
Suggests about one in 10 school
aged children meet criteria,
while 4% of adults continue to
have symptoms.
And it manifests as challenges
getting to, sticking with, and
finishing tasks and organizing
life activities.
Adderall is one of a few
medications approved by the food
and drug administration that
just reduces the overwhelm and
reduces the challenges people
have.
As part of a treatment plan, it
really does make a huge
difference in people's lives.
William: We heard a little bit
from those women about what
experiences they are feeling
about not having these
medications.
Can you tell me a little bit
more?
What are the consequences for
someone when they suddenly don't
have access to that medication?
>> Withdrawal happens with some
of the medications we use to
treat ADHD in the stimulant
class, which adderall is in.
And ritalin is a generic name
for a generic product called
methylphenidate, which is quite
similar.
That class of medicine often
produces tiredness, fatigue, or
worse.
Or worse, mood and personality
changes in people.
And ideally, treatment is
sustainable, and not going to
start and stop, but as people
have learned, people need to
have plan B's.
William: There is a conception
out there that we as a society
are overprescribing these
medications, especially to young
people.
That is a slightly separate
issue to this shortage issue,
but I wonder if you could take
on that concept.
Do you think that is an issue
that we as a society are
funneling too many of these
drugs out there into the world?
>> But I can say is that it is
harder to do less convenient
things.
Behavioral therapies are hard to
come by and people may have to
self-guide their way through
strategies, environmental
accommodations, getting
accommodation with their
employer or at school.
And particular groups also seem
to be more vulnerable to risk of
over-diagnosis or treatment.
For children, younger age within
grade, leads to higher rates of
diagnosis.
And there are some subgroups in
society that seem to have less
access to behavioral therapies
which may alleviate symptoms.
So the story is a complex one
where there's probably both over
and under diagnosis and it
depends upon the particular
circumstance.
So this is the challenge on a
social level to understand how
to allocate these resources and
people are left doing their own
research to figure it out.
William: One other thing that
people have mentioned as a
possible driver of these
shortages is the growth of these
non-doctor prescribing websites
where you can go and sign up and
say, I have xyz and get
medications prescribed
for you.
Do you think those sites are
contributive to it?
That people are getting
prescriptions that don't
necessarily need them?
>> I think the biggest factor is
awareness that ADHD exists, and
as one of the interviewees
mentioned, it's really only in
the last 15 to 20 years that
adult ADHD has been a concept
that's diagnosable.
So we shouldn't be seeing rising
-- so we should be seeing rising
rates of diagnosis and
treatment.
But I think it's really
important that people know
there's a way that they can
figure out if the diagnosis is
being done.
I would recommend people use
resources like nih, CDC, or
children and adults with ADHD
online to ask themselves, is
this fitting the bill or do I
want to change my brain versus
other strategies?
William: What do you tell your
patients as far as how long it
might be before this medication
becomes available?
>> My main concern is that they
minimize the anxiety and have
plan B's, whether it is other
medications they might go to,
that they have some small
stockpile that they can use or
that they can taper off of
medication and be off for a
while while they figure out what
is a sustainable plan for them.
But unfortunately, collaborating
with a pharmacist, collaborating
with a prescriber ends up
becoming the work to get these
treatments.
William: Dr. Craig Surman,
thank you for being here.