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Adderall Shortage: Down to the Last Pill

By: Allie Watson, Journalism Graduate Student

Adderall Extended-Release (Adderall XR) is a combination medication used to treat attention deficit hyperactivity disorder. Photo by Allie Watson

When Jessica Smith was a child, she would often forget the content of a conversation she had just had with someone. 

 “I actually had a conversation every day on the bus for two years, when my friend sitting right next to me would talk to me. I couldn’t hear anything she said, and yet, I was like ‘Mmhmm. Yes,’” Smith said.

“She had no idea for two years,” Smith said. “I am really good at that…I remember thinking, ‘What is she saying? Oh, she said something about this, and I would try to figure out what she was meaning. And then I’d be like, wait, I just missed 30 seconds. I think something important just happened, but I have no idea what it was.’” 

Smith is a kindergarten teacher at Nichols Elementary School in Biloxi, Mississippi. As an adult, she was diagnosed with ADHD, in 2020.  

“I definitely think some of my personality masked some of my symptoms growing up because I love reading. I would hyperfocus on reading all the time. I was always the quiet kid who was afraid to make mistakes.” 

As a child, she developed ways to compensate for her condition.

“I was always like, I’ve gotta study. I’ve got to sit still here, and I have to focus. I was never a daydreamer. I would get all my work done in school.”

According to the Centers for Disease Control and Prevention (CDC), common symptoms people with ADHD experience can include: failing to pay close attention to details, having trouble focusing on tasks, not seeming to listen when spoken to directly, and having trouble organizing tasks and activities. A person with ADHD may also frequently leave their seat when remaining seated is expected or talk excessively.

“I would get all my work done, and then I would pop up and go help my classmates on their work,” Smith said. 

Smith exhibited some ADHD symptoms as a younger person, but it was her trouble with sleeping that eventually led to her diagnosis. Her doctor referred her to a psychotherapist for help.

“I was confused by the psychotherapist. It was really hard for me to understand some of what she was asking, but I finally realized that I do lose things and that yes, I do not pay attention. So when people are talking to me, and I’m trying to figure out what they are talking about, that is what she is meaning. I just thought all of those things were normal.” 

Smith had found a doctor who knew what questions to ask. According to Chadd.org, “The examiner is also likely to ask questions about the person’s history or health, development going back to early childhood, academic, and work experience…Many adults with ADHD may also have limited awareness of how ADHD-related behaviors cause problems for them and have an impact on others.” 

“I mean I didn’t have the classic little boy ADHD that everybody thinks of,” Smith said. But growing up more than once my mom had told the doctor, “‘She doesn’t sleep at all. I will wake up at midnight or 1 a.m., and she’s still wide awake literally laying in her bed. Laying there just wide awake and sometimes she’s like the Energizer Bunny and just won’t ever turn off,’” Smith said.  

According to John Hopkins Medicine, the hyperactivity portion of ADHD can include, “Seeming to be in constant motion; running or climbing, at times with no apparent goal except motion, fidgeting with hands or squirming in his or her seat; fidgeting excessively, difficulty engaging in quiet activities, losing or forgetting things repeatedly and often, and inability to stay on task; shifting from one task to another without bringing any to completion.” 

Shortly after her diagnosis, Smith’s physician prescribed Adderall extended-release (XR) to help her cope. Just when Smith felt she was getting a grasp of her diagnosis, the Adderall shortage began. 

According to a January 2023 National Community Pharmacists Association survey, 95% of independent community pharmacies nationwide have reported experiencing an Adderall shortage.

Pharmacists’ Perspective

Janet Johnston, a pharmacist at Davis Drugs in Pass Christian, Mississippi, has witnessed the Adderall shortage firsthand. “People call Davis Drugs every single day. Each day, there are countless calls. If a patient cannot get their medicine filled, their normal response question is ‘When will you get it?’ We get that question every day, and we get tired of being asked the same question over and over. And unfortunately, the answer is always the same.” 

“We are definitely sympathetic, but it is truly out of our hands. But customers call around to all of the pharmacies looking for it, and doctors now do the same before they send the e-script prescription in,” Johnston said.

Data from New York Post shows increase in female Adderall prescription refills after COVID-19. By: Allie Watson

Alicia Puckett, head pharmacist and owner of Davis Drugs believes, the Adderall shortage stems from several things. “Over the last three years, with more adults working at home, we may be experiencing an increase in prescribing of Adderall. This coupled with the possible shortage of raw ingredients from outside the U.S. and possible reduction in allocations from the DEA has created the perfect storm.”  

Alicia Puckett, owner, and head pharmacist of Davis Drugs in Pass Christian. By: Allie Watson

Living with the Challenge

“Beforehand, I would just call my doctor and say, ‘Hey, I need a refill,’ and she would just send it off to the pharmacy,’” Smith said, “but now she doesn’t do that. She has to give me the actual, written prescription now, so I can go shop around. It is great in that sense, but everywhere I go, they are out. When I do find somewhere with my Adderall in stock, they often don’t take GoodRx with my insurance, and it is $100.” 

“I’ve cried a few times about that. It is so freaking expensive at certain places,” Smith said. 

Smith recalls a time when she was unable to get a refill before flying home for Christmas. “I had been trying to get my refill and kept going to Walmart. I had actually given my prescription to Walmart. I told them what I needed for when they got the Adderall in. I was told it would be by the end of the day or tomorrow, but it kept getting pushed off and pushed off and pushed off. I kept calling and was like, “Hey, do you have any, you know I’m on my last pill. I ended up getting my medicine five hours before I was supposed to be on my plane.” 

To help offset the shortage, Smith’s doctor suggested she attempt to withhold from taking her medication on days she could stay home. 

“The days I didn’t take it I struggled to sleep and my head was hurting,” Smith said. “I was so exhausted I couldn’t do anything. I was so exhausted, I didn’t know if I could make it to the bathroom. I tried skipping Saturdays and would tell myself I could skip church next Sunday in an effort to save a few pills up. I ended up skipping church three Sundays in a row. At one point, I even contemplated calling in sick to school, but I couldn’t do it. I had to teach. I would show up all irritable. I was definitely not cool.” 

Eventually, Smith’s doctor asked her to take her medication daily. 

“Yeah, I probably won’t ever do that again until summertime,” Smith said. 

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