In October 2022, the Food and Drug Administration announced a shortage of certain prescription stimulants.
Stimulants, like Adderall and Vyvanse, are prescribed to patients to treat ADHD symptoms like inattentiveness, hyperactivity, and impulsivity.
And despite work done by the FDA and the Drug Enforcement Administration to alleviate the shortage and its burden on patients, it remains an issue.
College students are uniquely affected.
“I think the context and environment of college can uniquely kind of fan the flame of those core symptom clusters,” said Greg Cooper, Assistant Director of Psychiatric Services for UD’s Center for Counseling and Student Development. “And if students have not developed good coping skills, studying skills, and behavior patterns to manage impulsivity, then the freedom, intensity and all of the other opportunities that college affords can have negative impacts.”
These students also face challenges in accessing medication.
Prescription stimulants are controlled substances, meaning there are no refills, and a new prescription is required for a 31-day supply.
Prescriptions also become void if not filled within seven days.
And Cooper says being on a college campus makes accessing medication more challenging.
At UD, one of the most accessible pharmacies just closed down. Only two remain within a reasonable walking distance.
“When the student has to go to an off-campus pharmacy, they either have to find a friend to take them, take an Uber, which costs money, or take a bus, which costs time,” said Cooper.
Now, the stimulant shortage means those students may need to contact multiple pharmacies, some far from campus, to find their medication in stock.
Some changes have been made to help make that process easier.
In September, as a response to the shortage, the DEA revised its regulations to allow pharmacies to electronically transfer prescriptions if they did not have the medication in stock.
Before that, patients would have to go through their practitioner to cancel their prescription and have it re-issued to a different pharmacy, requiring multiple levels of communication.
Losing access to medication can be detrimental, especially if it is the primary source of treatment.
“If you don’t have access to your medication, and you’ve been on this medication for a while or even recently, and it has had a robust effect - you are now able to sit down when you want, to start the material when you want, to stay dialed into the material when you want to for as long as you want to - and then you can't do that, that can cause significant disruption to your learning and your grades. Which then cascades to future hopes and dreams, and broader mental health concerns due to anxiety, stress, and depression,” explained Cooper.
He adds students are also at higher risk for accidents and disruptions in social relationships due to impulsivity.
Last October healthcare officials warned that the loss of access to medication could cause some ADHD patients to turn to alternative and possibly dangerous sources - noting that college students were at the highest risk.
That could mean asking friends of family members, abusing other substances, like caffeine, with similar effects, or turning to online sources to buy counterfeit medication.
UD is working to avoid all of those outcomes by helping to make sure students don’t lose access to treatment.
The Center for Counseling and Student Development offers supplemental cognitive behavioral therapy, financial assistance, and other programming.
Harm reduction tactics are also used. The Division of Public Health works with colleges to distribute harm reduction tools, like Narcan and fentanyl testing strips, to help combat potential overdoses from counterfeit stimulant use. UD also offers Narcan training.
There is no end in sight for the prescription stimulant shortage, but progress has been made.
The last update was in November when the DEA issued a statement outlining their most recent actions to combat the shortage.
