Some ADHD Medications Are in Short Supply. Schools Are Feeling the Fallout

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Recently teachers have been sending messages sent by parents and teachers to Kelly Barlow-Eichman the school nurse who is the sole one for the Shorewood, Wisc., school district, concerning potential behavioral issues their children might be experiencing in the classroom.

The emails, according to Barlow-Eichman that they read like the following: Hey If you’re experiencing behavior issues, please be aware that my child isn’t taking their medication. They may be looking at a different dosage.

It’s a message with which California mother Jess Berthold can relate. Berthold explained the sudden shift in her son’s behavior to be “night and day” when at the age of 6 years old, age it was discovered that he had ADHD, also known as attention deficit hyperactivity disorder or ADHD and was recommended Adderall which is a stimulant widely used to control inattention and hyperactivity that are associated with the disorder.

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Before he started using the medication, Berthold said, “he was constantly climbing over the place, unsteady and uncontrollable. He couldn’t be still, let alone consume a meal.”

There was also a problem at school. He wasn’t paying attention, was not keeping his hands to his own. “His behavior was interfering with his learning,” she stated.

In seventh grade, the son of Berthold is still taking the generic form of Adderall to treat the ADHD symptoms. However, a recent national shortage of the drug has caused Berthold expanding her son’s current supply of medication–he’s taking smaller doses and isn’t taking it on weekends. She also remains vigilant at the local pharmacy for replenishment of their stock.

“He doesn’t like it. He feels overwhelmed,” said Berthold.

This is a sentiment that is shared by many families, and by extension school nurses who supervise students’ medical needs in the 40 percent of schools with nurses on campuses.
“It’s just a bit of despair for families and school nurses. The shortage [is] having a negative impact on a lot of children,” said Barlow-Eichman, who is vice president for the Wisconsin Association of School Nurses.

The issue, mainly blamed due to manufacturing delays it was first reported through the national Food and Drug Administration in October. The issue continues to affect different parts of the nation periodically. It poses a risk to children who live in areas that are affected and require medication to help them stay on track at the classroom.

Nationally, approximately 10% of children aged 3-17 have been given a diagnosis of ADHD According to Centers forDiseaseControl and Prevention, and as high as 81 % of them depend on medications as part of their treatment regimen.

School nurses monitor the situation

School nurses keep an eye for the lack of Adderall. They are often taking the leading role in distributing updates and giving advice to parents, school personnel as well as health professionals.

“It is quite a lot for school nurses to manage. We manage the health care and education systems and are able to integrate them,” said Kate King as the president-elect of the National Association of School Nurses. “This is why we need a full-time school nurse in every building, every day.”

This is especially true during an era such as this. “Early last week, we started to have parents come to us letting us know their child was not going to be taking an afternoon dose of their ADHD medicine, because they either couldn’t get it, or switching to a different medication wasn’t an option for them,” Barlow-Eichman explained.

Solutions may not be easy.

There are many kinds of stimulants available to help manage symptoms of ADHD however, determining the most effective one will require trial and error. Moreover, families are often reluctant to switch to a different drug that might not function as effectively or cause unwanted negative side effects, Barlow-Eichman stated.

Berthold Berthold, the California mom, is able to understand. “I’ve talked with my doctor about switching to a different medication that’s not in shortage, but I’m terrified of it,” she explained.

She’s so uneasy that she’s decided to limit her son’s Adderall pills, rather than attempting an alternative, such as methylphenidate which is a common stimulant for ADHD that is marketed under its brand name Ritalin or Concerta.

Berthold claimed she’s spent more than five hours calling with different pharmacies to locate Adderall. “I’m lucky. I’m employed in a position that allows me to take hours from my work,” she said. “I really feel for parents who aren’t in my position.”

Being able to devote time trying to find Adderall is one aspect. Having the budget to spend on the brand-name version, which sources said is no longer in as short supply as its generic and less costly form (dextroamphetamine-amphetamine) is another. Berthold was pondering the possibility of spending $400 for the month’s supply brand-name Adderall that she could find as opposed to the $5 she usually spends for generic versions that is not currently available close to her. However, for the moment she’s sticking with the rationing system.

Barlow-Eichman is aware of this even in schools whose demographics like her district, tend to be upper or middle class. “I believe that the financial situation of a lot of families have the ability to adjust their lives. But I think we’re now at an age where it’s not always feasible or something that the families can keep doing,” she said.

Barlow-Eichman checks regularly frequently on the FDA site on her computer at work to stay informed about the shortage. She will share with affected families.

She’s also focusing on communication with employees. “I’m working with principals now on a statement that will go out to all our staff that will let them know about shortages,” Barlow-Eichman explained. “Making sure teachers understand that this is out of the control of parents and students.”

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