‘I was white-knuckling it’: Philadelphia patients are still struggling to get ADHD meds amid years-long shortage

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Madison Blank spent a day last month calling 50 different pharmacies in the Philadelphia region in an attempt to refill her ADHD prescription medication, which she has been taking since she was initially diagnosed five years ago.

She went without any medication for weeks, which she was able to manage. However, it wore her out.

“By the end of the day, it’s like you’re spent because you’re really just working all day to keep yourself on track,” Blank said. “I was white-knuckling it through the day.”

Blank said she had intense depressive crashes, which sometimes got so bad that she had to take a day off work for a mental health break.

She called her doctor for help, and her doctor put in prescriptions for three different kinds of ADHD medications.

“And we basically just played the lottery to see which one [would] get filled first,” she said.

Blank ended up finding a kind of ADHD medication she had not tried before, which she is still getting used to.

Blank said several of her friends have also struggled to get their prescriptions filled, and have asked her if she knows of any pharmacies that are filling them. She said it’s due to a shortage, which can be dangerous because sometimes people with ADHD will try to find alternatives to medication when they can’t get any, like cigarettes or even street drugs.

“I noticed immediately once I stopped taking my meds, it was making me want to come back to smoking because you’re like looking for something to kind of fill that void,” she said.

Not having ADHD medication is a big problem because patients need to be consistent with their medication, said Dr. Chris Pagnani, a psychiatrist, founder and medical director at Rittenhouse Psychiatric Associates in Philadelphia.

Pagnani said he has never seen an ADHD medication shortage like this in the 15 years he’s been practicing. In addition, the situation also changes because patients have had to switch between different medications depending on what’s available to them.

“It’s almost month to month,” Pagnani said. “The specific medications that have been in shortage will change. And even within certain medications, different strengths of those [doses of] medications will be on shortage.”

Why is there a shortage?

The shortage of ADHD medication has been going on around the world for years now, said Rob Frankil, the executive director of the Philadelphia Association of Retail Druggists, which represents community pharmacies.

Frankil, who is also a pharmacist, said one problem is that the medication is a controlled substance. The federal government sets limits on how much manufacturers can make, as well as how much of the controlled substances each pharmacy can sell, he said. When a desperate patient calls a pharmacy to find ADHD medication, the pharmacy may have more in stock, but those are already reserved for existing patients.

“That leads to the issue of the perception of the shortage being bigger than it actually is,” Frankil said.

He said these are difficult situations for pharmacists too, and suggests that patients who are struggling to fill prescriptions stick with a pharmacist they know and have worked with before.

The federal government increased the manufacturing limit for ADHD medication in 2024, but Frankil said that doesn’t mean companies have responded by making more medicine.

Frankil and Pagnani also point out that there has been an increase in ADHD diagnoses over the years, leading to increased demand for medication.

A recently published journal article also attributed the shortage to international supply chain issues, which led to a lack of the active ingredient used to make ADHD medication.