More than three months after the FDA announced a nationwide Adderall shortage, people with ADHD, narcolepsy, and long COVID symptoms continue to face difficulties getting the medication they need.

In interviews with PGN, physicians say they’ve had patients go anywhere from a few days to a month without being able to refill their prescriptions. Some physicians also report that patients are struggling to find other stimulant medications that can serve as alternatives to Adderall—likely because many people are unable to get the Adderall they usually take.

Although Adderall shortages aren’t new, the current situation stands out for how widespread it’s been and how long it’s lasted. Dr. David Goodman, a psychiatrist who specializes in ADHD treatment for adults, says the issue likely began around August 2022 and has become worse since. He blames the shortage on several factors coming together to form a “perfect storm”: an increase in ADHD diagnoses, easier access to prescriptions through new telehealth services, a jump in Adderall demand in the fall as students returned to school, and labor and manufacturing delays.

For people who are having trouble accessing Adderall, we’ve provided practical, expert-informed advice on how to navigate this shortage, including tips on accessing alternative medication and managing a return of symptoms. This article is meant for informational purposes and does not substitute for professional medical advice or conversations with your health care provider.

Check if other pharmacies can fill your prescription

If your regular pharmacy does not have Adderall available, call other pharmacies to see if they are able to fill your prescription. Dr. Jessi Gold, a psychiatrist and assistant professor at Washington University School of Medicine in St. Louis, says there is no database that allows doctors to see what medications are available where, so unfortunately the burden falls on the patient to make the calls.

“I’m aware that asking people with ADHD to have the ability to call people and organize around that when they don’t have their medication is not a small task,” Gold says. “It’s even more frustrating when we’re telling you to fix a problem that you didn’t cause. I think that’s what feels really hard for people, and I get it. I wish there was a better way, but as of now I don’t know a better way.”

Once you find a pharmacy that has your medication available, you will need to tell your doctor to resend the prescription there. This is because your doctor’s office needs to cancel the previous prescription and re-issue it to the new location. Goodman says you can avoid this back-and-forth by getting a written prescription, which you can then bring to any pharmacy with the medication in stock.

Under no circumstances should you obtain Adderall from anyone who is not a licensed physician, including friends and online sellers, Goodman says. “The issue with that is you don’t know what you’re getting, and the likelihood is you’re going to get counterfeit Adderall pills,” he says. With counterfeit pills, there is a very real risk that they are laced with deadly doses of fentanyl, which the Drug Enforcement Administration issued a warning about in 2021.

Ask your doctor about alternative medications or dose-skipping

If you can’t find a pharmacy that can fill your prescription, check if any locations have Adderall in different dosages or forms than what you are prescribed. If Adderall is available in a different dosage, ask your doctor if you can take it in fractions or multiples to reach your originally prescribed amount. If a pharmacy has extended-release capsules (Adderall XR) but not your usual immediate-release tablets, or vice versa, you may be able to switch to what’s immediately available.

Goodman also suggests talking to your doctor about skipping a dose once in a while if you can—especially on days you don’t have school or work—to accumulate a stockpile that can get you through any refill delays.

If you are still unable to get the medication you need, consider asking your doctor about switching to an Adderall alternative, including stimulants such as Concerta, Dexedrine, or Ritalin. There’s always a chance that the alternative does not work as well for you, but Dr. Max Wiznitzer, a pediatric neurologist and board member of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), says the vast majority of his patients who have made a switch have been successful. “Only 5 to 10 percent have some ongoing difficulties, and then all you do is try different products, and that should take care of the issue,” he says.

It’s worth noting that the supply of non-Adderall stimulants has also been under pressure lately with increased demand. Dr. Sasha Hamdani, a psychiatrist who specializes in ADHD and runs a popular ADHD-related TikTok page, says stimulants across the board are now harder to get than they were half a year ago. She brings up the option of non-stimulant medications for patients with ADHD who have never tried them before, such as Strattera, Qelbree, high blood pressure medicines, and antidepressants.

“Each person’s ADHD management looks different based on what their needs are, how they metabolize things, and what their underlying psychiatric conditions are,” Hamdani says. “So it’s important to take all of that information in while you’re making an assessment of what the next reasonable option would be.”

Always communicate with your doctor

Hamdani says her biggest piece of advice for people impacted by the Adderall shortage is to keep an open line of communication with their doctor. “A lot of people are tempted to make big changes to their medication because they’re trying to ration it out,” she says. But without a doctor’s input, these decisions can be misinformed and risk making things worse. 

Even if you have not yet run into difficulties getting refills, Hamdani recommends talking to your doctor now to create an action plan before problems arise.

Plan, organize, and ask for help

If you run out of Adderall before you’re able to get a refill, be prepared to experience a return of the symptoms you were treating. Some of these symptoms, such as difficulty concentrating or remembering things, can impact your performance at school or work and interfere with your ability to complete daily tasks. 

Planning ahead can help manage these symptoms. Goodman recommends spending 10 to 15 minutes every night laying out your plan for the next day: What are you doing, at what time, and with whom? Setting reminders on your phone can be a good way to stay organized. Asking a partner, parent, coworker, or friend to remind you about your responsibilities during this time can also help you stay on track.

You may want to inform your school or workplace about your situation, especially if it’s interfering with your performance. Gold recommends going to your school’s disability office or your workplace’s human resources department and asking about potential accommodations, such as getting more time on tests or more patience from supervisors. “People have a barrier to talking about all things mental health, but if it’s really impacting your day-to-day life, it’s worth bringing up,” Gold says.

Goodman also alerts his patients to be especially aware while driving when off of their medication, as the tendency to get distracted increases the chance of car accidents. “Put your cell phone in the glove compartment, turn off the music, and pay attention to the road, signs, and traffic lights,” he says.

The FDA expects shortages to continue into March.