Lake Park pharmacist Nirav Patel finds himself fielding nearly a dozen phone calls a day from patients frantically trying to fill prescriptions.
The owner of Robalo Pharmacy says his suppliers give him only enough to fill one or two a day.
"It's rationed out. The problem is big. It is huge," Patel said. "This is one of the biggest shortages right now."
And health authorities nationally expect the problem to worsen through the holidays and into the new year.
Th e shortages were first seen last spring, when one of the most commonly prescribed medicines, Adderall, went generic, said Ruth Hughes, chief executive of the national advocacy group Children and Adults with Attention Deficit/Hyperactivity Disorder.
"There were lots of problems: distribution issues; issues of production involving the active pharmaceutical ingredient," she said. "We talked to a number of people at the time who thought it was going to be a short-term problem, but it has continued over the summer and recently it got worse."
Walgreens and Publix pharmacies confirm that they are experiencing some shortages in these drugs. Sometimes the drug is available, but not in the prescribed dose. For example, the shorter-acting drugs seem to be a bigger issue, Hughes said.
Adderall has been listed among those in shortage by the U.S. Food and Drug Administration off and on since 2009, said Erin Fox, who tracks the shortage data as manager of the drug information service at the University of Utah.
Then this month, the active ingredient in Ritalin and its generic counterparts, methylphenidate, joined the list.
The reasons for this shortage, like the reasons for the myriad of other drug shortages nationally, are difficult to pinpoint, Fox said. Companies cite increased demand, problems in distribution and tight Drug Enforcement Administration rules on how much of the active ingredient each maker can use in a given year.
"It's a very complex problem, and I have to tell you that I'm not seeing many easy answers," said Hughes, the ADHD advocacy group official.
Drug shortages have plagued the medical field for at least the past year, but most of the drugs in question have been intravenous ones used by hospitals or drugs that catered to a very specific illness, such as a brain cancer.
The population relying on these ADHD medications is vast, Hughes said. An entire generation of children with the disorder have grown up with the option to address their problems with these drugs.
They are, however, powerful drugs.
The DEA classifies them as Schedule II substances, which means they carry a "high potential for abuse" that "may lead to severe psychological or physical dependence." As such, the federal government sets limits on how much of these drugs can be manufactured each year.
Some might shrug at the situation - after all these are not life-saving cancer drugs that are in short supply - but Hughes would have them think again.
"It's not a shrug," she said. "If my teen goes out and is driving without his medication, the likelihood of him having a very serious car accident is three times higher than it was before."
For some teens, coping with ADHD in the long term without medication can contribute to alcohol or drug abuse, lead to criminal behavior and increased teen pregnancy rates, Hughes said, referring to more than a decade of research.
Younger children use these drugs to help keep them on task in school and to curb those impulses to act out at unexpected triggers.
But while children are more often prescribed drugs to cope with this disorder, there are at least 3.2 million adults taking these medicines to help them focus at work and at home, Hughes said.
Doctors and pharmacists are struggling to meet the demand.
Barry Paraizo, who owns Winships Prescription Center in North Palm Beach, says he also recalls having supply problems at the end of last year.
"You get patients bouncing around stores; they've tried Walgreens or CVS," Paraizo said. "But if I can't take care of my patients, I can't supply other pharmacies' patients.
"It gets frustrating," he said.
What to do?
If you experience difficulty in filling an ADHD prescription :
- Ask your pharmacist if the medication is available from another location, especially if you use a large chain pharmacy.
- Contact the manufacturer to help locate a pharmacy that has your medication in stock .
- Contact the doctor who prescribed the medication to request samples .
- Ask your pharmacist about the availability of other medications used to treat ADHD.
- As a last resort, discuss with your prescribing physician whether or not any of these available medications might be appropriate for you or your child.
- Finally, if you still can't get a prescription filled due to a medication shortage:
Tell CHADD: 800-233-4050 .
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