Study points to supply chain failures behind ADHD drug shortages hitting families
For parents of children with attention-deficit/hyperactivity disorder (ADHD) and other neurodevelopmental conditions, the nationwide shortage of stimulant medications has turned daily routines into a cycle of phone calls, pharmacy visits and hard choices that can ripple through a child’s school and home life.
At Mercy Kids Center for Neurodevelopment in Missouri, nurse practitioner Shannon Harris and registered nurse Holly Jarus say the shortages have affected families long before supplies began stabilizing and, for some, the struggle continues.
“It’s been very frustrating,” Harris said. “For our pediatric population, especially kids who are neurodivergent, medication changes can be significant, and many of our kids can’t tell you exactly how they’re feeling.”
When prescriptions can’t be filled or suddenly come from a different manufacturer, Harris said children may experience behavioral changes that show up at school or at home, disrupting routines that are critical for kids with autism or ADHD.
“It turns into behaviors at school, disruption at school, and just not the best quality of life for a lot of our kids,” she said.
While national attention around the ADHD drug shortage has largely focused on adults, Harris said the impact on children and families is often more immediate.
Many children can only tolerate specific medication formulations, meaning prescriptions can’t simply be swapped when a particular drug is unavailable. Even a change in manufacturer for the same generic medication can lead to noticeable differences in how children respond.
“We’ll have families go to the pharmacy, pick up their refill, and it’s a different manufacturer,” Jarus said. “The child was doing well, and then suddenly everything is off.”
Because children often can’t clearly articulate side effects, clinicians and parents are left to piece together what’s happening.
That uncertainty has pushed much of the burden onto families.
When shortages surged in 2022 and 2023, Harris said parents routinely called dozens of pharmacies on their own, trying to locate medication that pharmacies themselves couldn’t reliably predict.
“It turned into a lot of legwork for families,” she said. “And when they’re already managing work, school, therapies — it just made everything harder.”
In Missouri, state regulations add another layer of difficulty. Prescriptions for Schedule II controlled substances, including many ADHD stimulants, generally can’t be freely transferred between pharmacies. Even when a parent finds medication at a different location, clinicians must often issue a completely new prescription.
Missouri is not alone. Although the Drug Enforcement Administration updated federal rules in 2023 to allow a one-time electronic transfer of an unfilled Schedule II prescription, the change applies only if state law permits it. Pharmacy boards in several states, including Texas, New York and Georgia, maintain restrictions that often still require a new prescription instead of allowing a pharmacy-to-pharmacy transfer.
Even in states where limited transfers are allowed, rules commonly require direct pharmacist-to-pharmacist communication, restrict transfers to pharmacies within the same chain, or apply only to electronic prescriptions — leaving many families with little relief in practice.
“The federal rule sounds helpful, but state law still controls,” Harris said. “For families, it still means starting over and calling pharmacy after pharmacy.”
Frustration has sometimes boiled over. Parents have questioned whether prescriptions were sent correctly or why another medication couldn’t simply replace one that was unavailable.
“There was anger — not necessarily at us — but at the situation,” Jarus said. “Some families didn’t fully understand that the issue wasn’t the prescription — it was the supply.”
The shortages have also led some parents to make risky decisions, Harris said. She has heard from families who rationed doses, skipped days, or even shared their own medication with their children.
“That’s scary,” she said. “You don’t know what someone else is taking, and some medications need to be taken consistently or carefully tapered.”
For children taking antidepressants or other medications alongside stimulants, suddenly stopping treatment can lead to serious side effects.
Research suggests the shortages were driven less by prescribing increases than by breaks in the pharmaceutical supply chain. A 2026 study published in JAMA Health Forum found the shortages coincided with a sharp decline in U.S. imports of raw amphetamine ingredients used to manufacture stimulant medications.
A separate pediatric-focused review published in the Journal of Pediatric Health Care described stimulant shortages as a structural health issue, noting that families with fewer resources often lacked the time, transportation or insurance flexibility needed to navigate disruptions.
Insurance remains another obstacle. Some plans cover only generic drugs, others only brand names. Age restrictions and prior authorization requirements can delay changes even when alternatives exist.
“You might have coverage for a medication that just isn’t an option for that child,” Jarus said. “When you layer insurance rules on top of a supply issue, it’s overwhelming.”
Although access has improved in recent months, Harris said the experience exposed vulnerabilities that remain unresolved.
“Health care has become very reactive,” she said. “It’s cost and supply and demand instead of proactive planning for kids who need stability.”
For parents, the toll hasn’t been easy to forget.
“I can’t tell you how many CVS and Walgreens I’ve called,” Harris said. “It’s just been crazy.”
Ella Rae Greene, Editor In Chief
