Alternate supply: Wyoming patients feel effects of ADHD drug shortage

2012-01-18T00:05:00Z Alternate supply: Wyoming patients feel effects of ADHD drug shortageBy JOSHUA WOLFSON Casper Star-Tribune The Billings Gazette
January 18, 2012 12:05 am  • 

CASPER, Wyo. — A national drug shortage has made it more difficult for people to obtain attention deficit hyperactivity disorder medications in Wyoming, pharmacists say.

People who take ADHD medications can usually work with their physicians and pharmacists to find alternatives, either through different dosages of the same drug or with comparable medications.

But alternative drugs can be more costly and are not always covered by insurance. In some cases, people have had to go without medication for a short time until a solution could be found.

"It may take a number of days to get it arranged to get something as an alternative," said Dr. Stephen Brown, a Casper psychiatrist and medical director for Wyoming Behavioral Institute.

The shortages affect the generic equivalents of Adderall and Ritalin, medications that can help calm and focus people with ADHD. Both medications remain on the U.S. Food and Drug Administration's drug shortage list.

Experts have blamed the shortage on increasing demand and manufacturing quotas set by the Drug Enforcement Administration.

In Wyoming, supplies of the drugs began to dwindle last fall, and the shortage intensified in December.

"We try to reorder and there is nothing to reorder," said Joel Nicholls, a pharmacist at Family Pharmacy in Casper. "We receive prescriptions from patients that we have had to send elsewhere because we don't have medication in stock at the time."

Earlier this week, Nicholls said he couldn't order certain dosages of methylphenidate, the generic equivalent of Ritalin. The pharmacy, however, still had existing supplies of the drug.

When Nicholls can't fill a certain prescription, he sends customers back to their doctors. In many cases, a physician can prescribe a different dosage of the same drug.

Brand-name drugs are another option. But they're typically more expensive and some insurance companies refuse to pay for them.

Nicholls has been practicing since 2002. Last year was the first where he had real difficulty getting ADHD medications, he said.

He's not alone. Will Schultz, pharmacy supervisor at the University of Wyoming Student Health Service Pharmacy, has also noticed supplies of ADHD drugs becoming more scarce.

"We take a look every day to see what we can get just to try and keep it in stock," he said.

Schultz had never run out of all strengths of a medication. So if a 10 milligram pill is unavailable, he might work with a doctor to get a customer 20 milligram tablets that can be cut in half.

He's found there's no consistency to which dosages will be available.

"It's just kind of hit and miss," he said.

State pharmacists have also managed the shortage through the use of different dosages, said Donna Artery, a pharmacist consultant at the Wyoming Department of Health.

"With all of us working together, the network of pharmacists around the state, we are able to help each other and get it resolved," she said.

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