Why is there an ADHD medication shortage?

You may have seen that recently I started a petition regarding the national shortage of ADHD medication. There are a lot of stories surrounding why this shortage has happened. In this article I will be exploring insights from a conversation I have had with an anonymous whistle blower in the South of England. My hope is that this will give people some insights into the ongoing shortage.

ADHD has been an area of interest for me for a number of years. As someone who has recently started ADHD medication, I have a vested interest in addressing this shortage to the best of my ability.

ADHD medication shortage from the inside

The following is a direct quote from the anonymous source that discusses their understanding of the shortage and why it is so difficult to acquire the medication:

"I help deliver the psychoeducation training for parents after an ADHD diagnosis for their young people, if they want medication. Unfortunately, it's not just the shortage of meds, as you know. In October 23 the government stopped any more young people going on the waiting list for meds as the global shortage meant that they were worried about keeping up the supply for those already taking meds. Now, we are prescribing again, but we have a shortage of trained prescribers. It's a mess. I'm doing all I can to get young people on the pathway for assessment and meds (if they want) but it's a systemic problem."

There were a few take away points from my perspective-

1. The government closed the waiting list for medication

My source states that in October 2023 the waiting list for ADHD medication was closed by the government. This was done to protect a limited supply of medication for people who have already been titrated onto them. I find it bizarre that the answer to a medication shortage is to just stop prescribing.

If this approach was taken with medication for physical health issues, the country would be up in arms. I suspect that due to incorrect opinions and attitudes surrounding ADHD medication people do not understand the importance of this issue. Let us not forget that research has indicated that access to ADHD medication can reduce the mortality rate of ADHD people. For some of us, access to this medication isn't just life changing, it's life saving.

2. A Lack of trained ADHD medication prescribers

My source mentions that despite prescribing starting up again, there is a significant lack of trained prescribers. This means that ADHD people may be facing long waits. Also, professionals who lack the skills to successfully titrate people onto their medication. This strikes me as particularly reminiscent of issues that Autistic people face with CAMHS professionals who lack the skills to engage properly. This represents yet another issue for neurodivergent people trying to access support and care.

3. The shortage is a systemic problem

It is not as simple as pharmacies not having access to stock. At every level, this shortage has been badly managed and even at times hidden away by the government. In order to solve this issue we need our government to address the systemic failures that are causing this shortage. ADHD people need medication to be an option, and they need consistency, not to have to change medication every month due to shortages.

What does the NHS say about the ADHD medication shortage?

There are a number of updates available on local NHS websites. The following captures the position of the NHS quite succinctly:

"There is no one reason there are shortages in the ADHD medication supply. There has been an increase in demand for medication to manage ADHD. There has also been a change in the companies who produce and supply the medication. All this combined has led to difficulties in meeting the supply needs of patients."

NHS Cheshire and Merseyside

It stands out to me that they do not address the systemic issues highlighted by my anonymous source. Yes the issues they describe are certainly part of the problem, however parliamentary inaction and lack of resources (including trained prescribers) are a significant issue that needs addressing. It is not reasonable to place all the blame on increased demand. The change in manufacturers is also not enough to explain this issue.

It is clear that the government and NHS need to work together to tackle this problem. We can not sit quietly while this happens. ADHD people need to be at the forefront of tackling this problem and making their opinions and wishes heard. Until this is done, we are likely to be stuck in this crisis for some time.