Prescription Drug Shortages

Americans are confronting a shortage of several major drug treatments.

Some cancer patients are struggling to get chemotherapy drugs. Antibiotics are scarce after winter’s severe flu season. Medications for attention deficit hyperactivity disorder are in short supply. Even children’s Tylenol has been hard to find, as my colleague Christina Jewett wrote.

“This is, in my opinion, a public health emergency,” Dr. Amanda Fader of the Johns Hopkins School of Medicine said.

Today’s newsletter will focus on the A.D.H.D. medication shortage, which is reflective of many of the broader drug supply problems. The Food and Drug Administration first acknowledged the shortage in October. Patients complain that they have to shop around at pharmacies to get their medications, if they can find them at all. And without the drugs, many say they can’t function.

Edward DiNola, a game programmer and designer, told The Times that getting off the A.D.H.D. medication Adderall had made his sleep schedule piecemeal and unpredictable. After a week without the drug, he went to bed one day at 7 a.m. “It’s a bit of a curse to not have control over your own energy,” he said.

The broader shortages partly reflect supply chain problems for generic drugs, which make up 90 percent of prescriptions. But the A.D.H.D. medication shortage is more expansive in that it has hit brand-name products, like Adderall, as well. That has left more people without the drugs they need.

Rising demand

One reason for the A.D.H.D. medication shortage: The use of such drugs has surged in recent years. From 2020 to 2021, prescriptions increased more than 10 percent across many age groups, a recent C.D.C. study found.

Why? Experts point to the collision of two recent trends in the U.S.: the growing acceptance and acknowledgment of mental health issues, and policy changes brought on by the Covid pandemic that increased the use of telemedicine.

First, activists and policymakers have for decades pushed Americans to take mental health issues more seriously — to view them not as moral failings or character flaws, but as health problems that need treatment.

A.D.H.D. is an example of this acceptance. Experts long believed it mostly affected adolescent boys. In recent years, activists and patients have argued that A.D.H.D. can be a lifelong condition and that it is underdiagnosed and undertreated among girls and adults. Their view has gained ground, despite some criticisms that A.D.H.D. is already overdiagnosed in boys who are then treated with powerful, potentially dangerous stimulants.

Second, telemedicine got a big boost during the pandemic, as policymakers and medical facilities tried to limit in-person doctor visits. The shift not only allowed existing patients to continue getting treatment, it also allowed treatment for new patients who might not have made the trip to a doctor’s office or a hospital before.

These two trends acted together to increase demand for A.D.H.D. medications. As more people started to take their mental health more seriously, they had greater access to treatment. So more got on medications for A.D.H.D.

Supply chain problems

Beyond demand, several issues have potentially constrained the supply chain. Drug companies claim that government-set quotas have hindered supply, although the Drug Enforcement Administration has said that companies have not fully used what they have. Some pharmacies also argue that tougher rules for opioid painkillers have spilled over to other drugs, making it harder to get the supply they need.

For generic drugs, there is a more systemic problem. The companies are under constant pressure to offer the lowest prices possible, and they often cut corners to reduce costs and keep prices low. That leaves them unprepared to increase supply as needed if, for example, demand rises.

All of these factors are probably playing some role in the A.D.H.D. medication shortage, said Erin Fox, a drug supply chain expert at the University of Utah. But because much of the drug supply chain is opaque, it is difficult to know what, exactly, is going wrong.

The lack of transparency is itself a problem, not only for A.D.H.D. medications but for other drug shortages. If the public and policymakers don’t know what’s going wrong, they can’t help find a solution.

For more: Drug shortages will probably get worse, experts say.



Lawmakers in Texas banned transgender medical care for minors, including hormone therapies and surgery.

Gov. Ron DeSantis is trying to get national attention with signing ceremonies of right-wing bills that sometimes feel like political rallies.

The South Carolina House approved a six-week abortion ban. It goes to the Senate, where a bipartisan group of female lawmakers has vowed to filibuster it.

TikTok will be banned in Montana with a law that prohibits app stores from offering it. Apple and Google say that may not be feasible in a single state.


Floods in Italy killed at least eight people and left thousands of people homeless. Some places saw half their average annual rainfall in 36 hours.

As the U.S. attends the G7 in Japan, China is hosting its own summit with leaders of five countries in Central Asia.

Some European countries want to give F-16 fighter jets to Ukraine. The U.S., which needs to approve the deal, has resisted the move.

Other Big Stories

Military officials caught Airman Jack Teixeira mishandling secrets months before he was charged with leaking documents.

Climate change will probably send temperatures to record heights over the next five years.

Nearly 110,000 people died last year of drug overdoses in the U.S., a leveling after two years of sharp increases.

Deutsche Bank has agreed to pay $75 million to sexual abuse victims of Jeffrey Epstein who accused the lender of helping to enable sex trafficking.

Prince Harry and Meghan said paparazzi chased them in Manhattan. An initial description recalled the chase that killed Harry’s mother, Diana, in 1997.


Drug tests don’t predict if workers will be impaired and there is no reason to keep doing them, Kevin Boehnke argues.

Remember when Donald Trump and DeSantis loved each other? Neither do they, Gail Collins writes.


Coming of age: A park in Los Angeles is a meeting place for young queer people.

A celebrity hawk: Pale Male died at 32. Or did he?

Health: Chronic pain is common.

Work from anywhere: Move your home office outside.

Advice from Wirecutter: Try this induction cookware.

Lives Lived: Marlene Bauer Hagge emerged on the national golf scene at 13 and went on to win 26 pro tournaments, including the 1956 L.P.G.A. Championship — an event she had helped create. She died at 89.


N.B.A. playoffs: Jimmy Butler pushed Miami to another improbable playoff win over Boston.

Horse racing: Mage is the favorite to win the Preakness, which would please his 391 owners who bought shares in the horse via an app.

Thick rough: The P.G.A. Championship tees off today. Jon Rahm, who won the Masters last month, is the favorite.


An ancient treasure

An ancient book known as the Codex Sassoon — the oldest known near-complete Hebrew Bible — sold for $38 million yesterday. Even in its own time, the book was an expensive object, requiring the skins of more than 100 animals to create its parchment leaves. Experts thought it might become the most expensive book over sold, but it fell short of the record set two years ago by the sale of a first printing of the U.S. Constitution.


What to Cook

Tips for juicy, crisp-skinned salmon: Add salt and wait.

What to Read

Here’s where to get started with Neil Gaiman’s books for adults.


Why is Ted Lasso’s shoe game so strong? Credit the show’s star Jason Sudeikis, a sneakerhead who owns 250 pairs.

What to Watch

The documentary “Anna Nicole Smith: You Don’t Know Me” is short on insight.

Now Time to Play

The pangram from yesterday’s Spelling Bee was gamecock. Here are today’s puzzle and the Bee Buddy, which helps you find remaining words.

And here are today’s Mini Crossword, Wordle and Sudoku.

Thanks for spending part of your morning with The Times. See you tomorrow. — German

P.S. Claire Moses, a writer for The Morning, is joining The Times’s Express team.

Here’s today’s front page.

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