Soaring demand and supply chain issues has led to a shortage of ADHD medications like Elvanse
James, 26, has been on Elvanse to treat his ADHD since July. He’s coming to the end of the ‘titration’ process now – the process where doctors and patients work together to ascertain an appropriate dosage of medication – and has been pretty happy with a 50 milligram dosage. “It tones down the symptoms without overwhelming me,” James tells Dazed. “After 25 years of not having medication, to have my symptoms sorted… It was a huge relief.”
In late September, James requested his next prescription, only to be told that the pharmacy only had 20 milligrams and 40 milligrams in stock – and that he could expect problems with supply of his medication until October. “They offered to issue me 40 milligrams in the interim, which is ten milligrams fewer than my usual dose,” James says, adding that he accepted their offer as at least “it was something”. But the next day, James was told that there was no stock of Elvanse nationwide. “Since then, I’ve not been able to access any new medication.”
James isn’t alone. An estimated 150,000 people in the UK are in the same position, after the Department for Health and Social Care (DHSC) announced a shortage of medications used to treat ADHD in September. “Medicines go in and out of shortages due to issues with supply chains. In this case, the supply disruption of these products is caused by a combination of manufacturing issues and an increased global demand,” explains Professor Claire Anderson, president of the Royal Pharmaceutical Society, adding that hospitals and community pharmacies are “working hard to maintain supplies in light of the surge in demand.”
In the UK alone, there was a 20-fold rise in ADHD diagnoses between 2000 and 2018, the number of prescriptions for central nervous system (CNS) stimulants and drugs used for ADHD has increased steadily by about ten per cent a year since 2018. It’s a rise which can be partly attributed to increased awareness of the condition.
“Over the past couple of years, an unprecedented number of people have had ADHD diagnoses – children, young people, and adults – and been prescribed medication that has, for many of them, been beneficial,” explains Dr Beryl Navti, a senior NHS pharmacist. “Supply disruption means many patients will struggle to have their prescriptions filled by local pharmacies, and in addition to increased anxiety about the situation to families and patients affected, there is a cost implication for those who need to travel far afield to find a pharmacy with available stock on the shelves.” In a bid to tackle the shortage – which could last until the end of the year – doctors have even been told not to prescribe ADHD medication to new patients.
Hannah, 22, has also been struggling to access her Elvanse prescription. “I got an email from my local pharmacy on October 2, saying they didn’t have my medication in stock,” Hannah recalls. She explains that initially she was hopeful another pharmacy would have her medication in stock, but after going to “multiple different pharmacies” it soon became apparent that none of them had any Elvanse available. “It put me in a state of absolute panic,” Hannah says.
@helena.mairi ((TW: su*cidal thoughts)) my (late) two pence on the adhd medicication shortage #adhd #adhdinwomen #adhdprobs #adhdemotionalregulation #adhdmoodswings #adhdmedshortage #adhdmedicationbeforeafter #adhdmedicationuk #elvanse #vyvanse ♬ original sound - hels ♡ autism | adhd
Naturally, many ADHD sufferers who are running out of their medication are getting desperate. When James realised he urgently needed medication, he asked friends, traipsed round pharmacies, and looked online in search of Elvanse, but still struggled to get anywhere. At present, he’s been rationing the small amount of Elvanse he had leftover from previous prescriptions. “I’m dissolving them in water, so one 60 milligram dose can be turned into two 30 milligram doses,” he explains.
Jamie, 33, is doing the same. “I haven’t been able to get any medication for about three weeks,” he says. “I've been rationing so that a tablet that I would take every day can last an entire week. I just dissolve one of my 50 milligram tablets in a pint of water and have a sip every morning.” It’s better than nothing, but Jamie says this hardly has any effect. “I suppose it helps a little bit – maybe it’s the placebo effect – but it doesn’t really do anything.”
Hannah has since rung up over 15 different pharmacies to inquire about their Elvanse stock, and even asked if any different dosages of Elvanse are available, but she’s still had no luck. “I have completely run out of my medication,” she tells Dazed, adding that she also tried and failed to source some online. To cope, Hannah has resorted to “drinking about five cups of coffee a day” and has even “started stress smoking” after quitting two years ago. She adds that she’s also heard of people using recreational drugs to help curb their symptoms.
“Work was going great, I was more functional outside of work and more sociable [...] it was really frustrating, because I had just solved this problem and now the solution has been taken away from me” – James
ADHD can severely affect a person’s behaviour and ability to concentrate, while fatigue and depression are common Elvanse withdrawal symptoms, making it exceedingly difficult for sufferers to manage work, relationships, and general life. Jamie – the founder of Mattr, a neurodivergent dating app – explains that he’s struggling to do his job without the right medication. “It’s very difficult to try to concentrate on things, my way of working has been completely affected by it,” he says, adding that he’s struggling to regulate his mood. “I’m having a lot of quite severe downs.”
James says he’s also been “badly” affected by the shortage. “I was just about to start doing better,” he says. “Work was going great, I was more functional outside of work and more sociable [...] it was really frustrating, because I had just solved this problem and now the solution has been taken away from me.” Hannah adds that she has been sleeping for over 12 hours a day, has “no energy and no motivation” to go to the gym like she usually does, and is struggling to look after her personal hygiene too. “I have been an absolute zombie,” she says.
The situation has thrown into sharp relief just how far away we are from achieving ‘parity of esteem’ between mental and physical health, with mental conditions generally still regarded as less urgent or serious than physical conditions. “It’s not great, ringing up to get your medication and being told ‘we just don’t have any’. I don’t really [think] any other illness would be treated in the same way,” Jamie says. “There’s a real lack of respect for the condition.”
As the DHSC has said, unfortunately, it’s possible the shortage could continue until the end of the year. “If you are worried and are running low on your medicines, get in touch with your usual prescriber – this could be your hospital doctor. Some ADHD medicines can be switched to an alternative preparation if available which may help control your symptoms,” explains Professor Anderson, who adds that it’s also worth informing your university or employer about the shortage “as they may be able to make some adjustments in your place of education or work.”