Tuesday, November 20, 2012

Brilliant and Three Years Younger

As my son Chris was growing up with ADHD and learning disabilities, one of the priceless pieces of information that sustained me was my understanding that most children with ADHD have a developmental lag of about thirty percent, or approximately three years.

Every time I was ready to tear my hair out, I would remind myself that Chris was not really his chronological age, but was three years younger. This always served to help me calm down and see the situation in a new light. With this insight his “inappropriate behavior” was not so inappropriate after all. And my response then could be geared to what he could understand and appreciate.

Dr. Martha Denckla, our closing plenary speaker at the CHADD conference in San Francisco earlier this month, added a new twist to this insight. She suggested we consider our children with ADHD as both absolutely brilliant and three years younger than their actual age. What a fantastic combination.

Your precocious and delightful seven-year-old is hiding in the body of a ten-year-old. That sixteen-year-old teen who wants desperately to get his driver’s license is really a twelve-year-old who wants to do what all the big kids do. No wonder there is such a sense of disconnect with what is expected in life and what our kids do.

Today my twenty-five-year-old son is a well-grounded and successful twenty-one-year-old. He is thriving as a junior in college who has found his passion in life. He is my late bloomer. And he is blooming beautifully.

Ruth Hughes, PhD, is the CEO of CHADD.

Thursday, November 15, 2012

CHADD—A Shame-Free Zone

Just back from CHADD’s conference in San Francisco, and it was incredible. More than 1300 people heard fantastic presentations and information. And then there was all the connecting with old and new friends.

Mark Katz, a clinical psychologist and contributing editor of the Promising Practices column in CHADD’s Attention magazine, was our inspiring plenary speaker on Friday with the intriguing proposition that “There’s never anything so wrong with us that what’s right with us can’t fix.”

Mark’s presentation reminded me that part of the purpose of CHADD is to provide a “shame-free zone.” It doesn’t matter how inadequate you often feel as a parent or as an adult with ADHD.

CHADD is the place where everyone understands what it is like to live with ADHD. In the CHADD community we can talk freely about our lives. We can celebrate our many, many strengths. And we can laugh at our ADHD moments.

In our struggling with what is wrong each day, we often forget to recognize what is right. So today build a “shame-free” zone or time in your life. Maybe the kitchen is the place where only the positive is allowed. Or maybe there is a time of the day when you routinely reflect on your strengths and what is right with the world—at dinner or when you tuck the kids in bed at night. The power of positive thinking and positive feedback is absolutely amazing and it is simple. Harness this power and reap the rewards in your own life and in the lives of your family members. You will increase the feelings of hope and happiness for everyone involved. And you will be learning and teaching an enormously important coping skill for dealing with life’s challenges.

Thanks, Mark, for reminding all of us how important it is to see what is good in ourselves and in each other.

Ruth Hughes, PhD, is CEO of CHADD.

Tuesday, September 11, 2012

Girls, ADHD, and Suicide

This week is National Suicide Prevention Week, and it reminds me once again of the risk to all of our young people. As a mother, I can think of nothing more devastating than losing a young person to suicide. Almost 16 percent of students in grades 9 to 12 report having seriously considered suicide, and 7.8 percent report having attempted suicide one or more times in the past twelve months, according to U.S. Surgeon General Regina Benjamin. These are sobering statistics for all of us.

To make matters more alarming for CHADD members, a ten-year longitudinal study of girls with ADHD suggests the risk for girls with combined-type ADHD is significantly higher than for others. Steve Hinshaw and his colleagues (2012) found that the girls with ADHD had higher risk of both suicide and self-injurious behavior than girls without ADHD. Twenty-two percent of the girls with combined-type ADHD (attention problems, impulsivity, and hyperactivity) had made a suicide attempt compared to 6 percent of the control group and 8 percent of girls diagnosed with inattentive-type ADHD. Self-injury was significantly more likely with 51 percent of the ADHD-combined group reporting self-injurious behavior compared to 19 percent of the control group. The researchers suggest the higher incidence may be related to impulsivity, depression, and difficulties with emotional regulation.

So, what is a parent to do? First, don’t hide your head in the sand. Every parent needs to know about the signs of suicidal behavior and what help is available. There are great resources available to help you learn more. Check out the list at the end of this blog. The most important thing to know is suicidal symptoms are treatable.
Second, work at maintaining a close relationship with your adolescent and young adult. Can they talk with you about problems as well as achievements? Can you listen without jumping in and making a judgment or trying to fix everything? Sometimes what they need most of all is for us to listen and understand what they are experiencing.

Third, know what the danger signs are:
  • Persistent unhappiness
  • Withdrawal from friends and activities
  • Feelings of sadness and hopelessness
  • Over-reactions to criticism
  • Preoccupation with death and dying
  • Changes in eating and sleeping patterns
  • Self-destructive behavior
  • Suicidal thoughts, plans, or attempts
Fourth, don’t be afraid to talk with your teen or young adult about depression and suicide. Really listen to what he or she is telling you. Let her know you hear how bad she is feeling. Help him understand that you are there to help him get through this. Don’t be afraid to ask directly about suicide—it can open the door. And don’t allow yourself to be sworn to secrecy—you will need to enlist the help of others.

Fifth, if you feel there is a chance your child may be depressed and suicidal, then take action. Make a plan and get help immediately. Call 1-800-273-8255, the National Suicide Prevention Lifeline for immediate guidance. Seek out an appointment with a qualified mental health professional right away. Make sure that any weapons or dangerous substances are locked up and unavailable. And let your teen know that you have heard him or her and are taking these steps to help.

To learn more, here are some great resources:

Ruth Hughes, PhD, is the CEO of CHADD.

Monday, June 25, 2012

Stimulant Medication Shortages Update: You Helped CHADD to Make a Difference

It has been a very long year of dealing with medication shortages across the country. The information you shared with us last winter was often heartbreaking, as you described the incredible steps you were forced to take to obtain medication for yourself or your child, the skyrocketing prices charged by some pharmacies, and the awful consequences of not having medication.

CHADD has worked hard to address the shortages, and we are seeing some real changes take place—both in resolving the immediate shortages and in solving the problem long-term. We have been working closely with legislators, peer associations, government agencies, and pharmaceutical companies to get to the causes and to address them.

The Drug Enforcement Agency appears to have a key role in the shortages. Their mission is to ensure stimulant medications are not abused or misused. Every year they set a quota for each pharmaceutical company, and the company may not manufacturer even a single pill above this limit. If the quota does not accurately reflect the legitimate need, or if medications are diverted for nonmedical use, then a shortage can occur. Until now there has been no mechanism for a shortage to be addressed once it occurs. That is about to change.

Over the last six months, CHADD has been busy addressing this serious problem:
  • CHADD’s survey in January collected more than 5,500 responses. Forty-nine percent of our respondents were having serious difficulty getting prescriptions filled, and eighteen percent were forced to change to a new medication. Your participation in the survey gave us more information on the shortage than anyone else in the country. Thank you.
  • CHADD and the American Academy of Child and Adolescent Psychiatry formed a coalition of concerned associations, which included several pharmacist groups as well as the American Academy of Pediatrics, the American Psychiatric Association, and a number of mental health and ADHD groups.
  • CHADD has been in regular communication with all the major pharmaceutical companies to understand the obstacles to manufacturing sufficient quantities of medication.
  • CHADD leadership has met with staff for every key committee in both the US House of Representatives and the US Senate to make them aware of the seriousness of the problem.
  • CHADD leadership and members of the coalition met with the staff of the Food and Drug Administration to determine their role.
  • CHADD worked with the media to get the story out to the larger community. Literally hundreds of media outlets covered the story.
  • And the coalition repeatedly asked for a meeting with the Drug Enforcement Agency. We are still waiting.
Have we made a difference? You bet we have.
  • In January, the DEA increased the quota for stimulant medications significantly. Because the pharmaceutical companies need time to then manufacture the medications, an increase in the availability of medications did not begin until this spring.
  • The House Energy and Commerce Health Subcommittee is investigating the role of the DEA in the shortage and has not yet released a report.
  • Senator Chuck Grassley from Iowa has asked the General Accounting Office to investigate the DEA’s role and report on their findings. While such a report can take up to a year, the GAO is known for even-handed, nonpartisan reports and good recommendations.
  • The Prescription Drug User Fee Act of 2012 (PDUFA) was approved by the House last week and now faces one last vote in the Senate before going to the President. It instructs the Secretary of Health and Human Services to address medication shortages within thirty days. When the shortage involves a controlled medication, like stimulants, the Secretary has the authority to contact the Attorney General (the Secretary’s counterpart in the Department of Justice, which includes the DEA) and ask that the quota be increased. The Attorney General and the DEA must respond by either taking action or responding with a clear rationale for not increasing the quota. And all of this information must be made public. This is the first time a mechanism has been put in place to address a shortage before it becomes chronic.
But we want to be really, really sure that all of CHADD’s members and all people with ADHD have access to their medication. So we are asking each of you to take five minutes and fill out another survey. It is just as important to know that the problem has disappeared as it is to know whether you are still having difficulty getting prescriptions filled. We will not trust that the crisis has passed until you tell us. Please take a moment to let us know.

Ruth Hughes, PhD

Ruth Hughes, PhD, is the CEO of CHADD.

Tuesday, April 24, 2012

Discrimination in the Ivory Tower

This week's guest blog is by Robert Tudisco, Esq. 

One of the most difficult choices a college student with a disability can make is to embark on a competitive and demanding career that involves postgraduate education, such as attending law school. What makes that decision even more difficult is the fact that the testing process to get into law school requires a standardized test such as the Law School Admissions Test (LSAT), which often provides a barrier to students with ADHD and executive functioning challenges. Standardized high-stakes testing does not effectively show who will be a successful attorney or doctor, but poor scores can be an insurmountable barrier.

Even more unfortunate is that the Law School Admissions Council (LSAC), the organization that administers the LSAT, is among the most difficult to agree to reasonable testing accommodations that are authorized by the Americans with Disabilities Act. Despite the ADA, the LSAC continues to require that students provide an updated evaluation, costing several thousand dollars (which students are required to pay for themselves), and copies of every single IEP or 504 plan that the students have ever had, which requires amassing hundreds of pages of documentation going back fifteen to twenty years or longer. In addition to these stringent requirements, this process can take six months or longer with little or no transparency. As a result, many students decide to forego accommodations that they need based upon their disability, or drop out of the process because of its difficulty.

To add insult to injury, if a student rides out the process and is lucky enough to receive accommodations from the LSAC, the LSAC then flags that student’s test score and reports to the law schools that the student received testing accommodations and that “scores earned under nonstandard time conditions do not have the same meaning as scores earned under standard time conditions, so these scores are identified as nonstandard.” This process flags not only that the student has a disability and hence requires accommodations, but that the student’s scores are essentially invalid. In addition to completely nullifying the accommodations that the student fought so hard for, the practice is highly discriminatory. It is so discriminatory, in fact, that nearly all other high-stakes testing organizations have discontinued the practice of flagging accommodated scores for tests such as the SAT, ACT, GRE, GMAT, etc. Moreover, the practice is so discriminatory that the American Bar Association’s Commission on Disability Rights adopted a formal resolution to urge the LSAC to discontinue this practice and to provide more transparency into the process by which accommodations are requested and to streamline the turnaround time. At each turn, the LSAC has refused to modify their procedures.

California Assemblyman Ricardo Lara recently drafted legislation (AB 2122 Lara) to prohibit the practice of flagging test scores and for the LSAC to adopt a more transparent and streamlined practice to process requests for testing accommodations. This legislation was fiercely opposed by the LSAC. However, students with disabilities have a voice through organizations such as the Edge Foundation, CHADD, and many others who partnered to offer letters of support for this legislation. Initially this support was helpful in the bill receiving unanimous bipartisan support in committee.

On Wednesday, April 18, 2012, the bill was on the California State Assembly floor for a vote and again received opposition from the LSAC. Through the efforts of attorneys, advocates and organizations such as the Edge Foundation, CHADD, and many others, the legislation passed by an overwhelming majority (65-6). The bill now heads to the California Senate Higher Education Committee. It must pass the committee, then pass on the Senate floor, and will then need to be signed into law by the governor. The disability community that has been supporting the bill is expecting renewed opposition from the LSAC, which believes that accommodations give a student an unfair advantage and cannot appreciate that for a student with disabilities, accommodations are not an advantage but a means to level the playing field.

I have been a successful practicing attorney for over twenty years. I am also an adult diagnosed with ADHD. I can say from my own personal experience and that of many of my colleagues that my poor score on the LSAT was not at all reflective of my intelligence, ability, and my passion to advocate for my clients. We in the disability community now have the opportunity, and I believe the obligation, to provide a voice for those students with disabilities who want to become agents of change. This bill and the issue go way beyond ADHD, affecting all students with disabilities who need accommodations to receive the same opportunities that students without disabilities. This right is guaranteed by federal law, and hopefully by state law in California.

Support students with disabilities and show your support for this legislation. We will keep you posted as AB 2122 moves through the Senate.

Robert M. Tudisco, Esq., is executive director of the Edge Foundation.

Tuesday, February 21, 2012

New York Times Bashes ADHD Once Again

One could easily come to the conclusion that someone on the New York Times Opinion Pages staff has had a very negative experience with ADHD and is on a crusade to blame parents. Just weeks after printing a highly misleading article, “Ritalin Gone Wrong” by Alan Sroufe, the front page of the Opinion section now has a philosophical essay by playwright Hanif Kureishi titled “The Art of Distraction.” Once again someone who has no expertise in ADHD is making highly misleading statements about ADHD and Ritalin.
Don’t get me wrong—I am not pushing medication. CHADD strongly recommends that the decision to choose medication is a personal decision between the patient, the family, and the doctor. Thousands of people deal successfully with the symptoms of ADHD without medication, just as thousands find medication an important part of the treatment process. My own son has been on medication and off of medication, depending on the demands of his life and his coping skills. The decision to medicate or not has to be made based upon the individual needs of the person with ADHD. But that decision should be made based upon good information, not claptrap. And that is my problem with the New York Times, which once again is giving front-page status to utter nonsense in the Sunday Review op/ed section.
So let’s be clear about the facts. When an ADHD medication works properly, there is no stupor and no restraint on creativity. Anyone who experiences a stupor should be visiting his or her doctor immediately. ADHD medications should help your brain to work more effectively. This is not a chemical straightjacket, but rather an opportunity to avoid the many negative consequences of untreated ADHD, such as school failure and a miserable childhood.
The author describes his own troubled childhood, the difficulties his own son is having in school now, and a mythical “Ritalin Boy,” and concludes that suffering and a distracted mind can lead to creativity. In his most appalling passage Kureishi states, “Ritalin and other forms of enforcement and psychological policing are the contemporary equivalent of the old practice of tying up children’s hands in bed, so they won’t touch their genitals. The parent stupefies the child for the parent’s good.” Listen up, folks: According to the New York Times, any parent of a child with ADHD has plopped the child in the bathtub without prior warning, thereby disrupting the wiring of the brain (“Ritalin Gone Wrong”); and, if a parent is so misguided to as to use medication, that parent is chemically restraining the child in the most vulgar terms (“The Art of Distraction”).
In another section, Kureishi describes this as “a moral issue rather than a scientific one; values are at stake here—not facts.” This is in fact both a moral issue and a scientific, factual one. Would we deny a child with diabetes access to insulin because the struggle with their health and potential death would be inspiring? Would we refuse to allow a child to see properly with a pair of glasses, because the resulting visual haziness might lead to some artistic creativity? How could the New York Times continue to be so irresponsible? This is so much more than adding insult to injury. This is gross negligence and does irreparable harm. Fortunately the members of CHADD know this is nonsense, but I worry greatly about the family new to ADHD that reads such garbage and assumes that it must be credible if it appears in the New York Times.
In full disclosure please note that following the publication of “Ritalin Gone Wrong,” CHADD sent a letter to the editor and an opinion/editorial article by Max Wiznitzer, MD, a member of CHADD’s Professional Advisory Board. Neither was published.
So what are we to do? Well, there are several things that can be done—and we need your help.
1.       Take a moment to go to the comment section at the end of the article and tell the New York Times what you know about ADHD.
2.       Send an email to the public editor, expressing your dismay at the incredibly irresponsible behavior of the New York Times op-ed staff.
3.       If you are by chance an advertiser in the Times, please take note. Reconsider sending your advertising dollars to a business that regularly spreads highly prejudicial misinformation.
We cannot allow such blatant misinformation and discrimination to continue to thrive. Please take a moment to act on behalf of all those you love who have ADHD.
Ruth Hughes, PhD, is the CEO of CHADD.

Tuesday, February 7, 2012

New York Times Article Blames Parents for ADHD

by Ruth Hughes, PhD

A week ago the New York Times published an article by Alan Sroufe, "Ritalin Gone Wrong," that questions the need for medication in the treatment of ADHD. Even worse, the author claims that parents and environmental stressors are the major causative factor in ADHD. A firestorm of reaction, both positive and negative, has uncovered some deep rifts in our public understanding of ADHD. There are those who are jumping on the bandwagon and decrying families that think a pill is all that is necessary to help a child with problems. (I don’t know any families like this, but I’m sure there must be one somewhere.) And there is the ADHD scientific and advocacy community, who are appalled that information so flawed would appear in the New York Times.

While there is much to be upset about in these claims (and I have been very upset!), there are several assertions that are worth recognizing. There are bad parents in the world, people who do not have the skills, the resources, or the will to be good parents. And the impact on their children, who may or may not have ADHD, is usually negative. Helping these children is one of the major challenges of our society.

I also agree that pills alone rarely are sufficient treatment for ADHD. As the mother of a now-adult son with ADHD, it took a lot more than medication to help him become a productive adult. CHADD always encourages a combination of treatment, parent training and support, school support, and behavioral interventions for any child with ADHD. Medication can help a child focus and be more amenable to learning, but the skills and external supports also need to be put in place.

What is most troubling (and enraging) about this article is that we are back in the dark ages, blaming parents, particularly mothers, for a child’s ADHD. In the article’s most egregious example the author, Alan Sroufe, claims that along with other stressors, ADHD is caused by “patterns of parental intrusiveness that involve stimulation for which the baby is not prepared. For example, a 6-month-old baby is playing, and the parent picks it up quickly from behind and plunges it in the bath. Or a 3-year-old is becoming frustrated in solving a problem, and a parent taunts or ridicules. Such practices excessively stimulate and also compromise the child’s developing capacity for self-regulation.” Excuse me! Does Dr. Sroufe or anyone with a fundamental knowledge of ADHD really believe such nonsense? There is no scientific basis for his claim of “parental intrusiveness” as a factor in the development of ADHD. He is espousing theories that are now decades old and have long since been debunked and surpassed by our research on this disorder.

What is most disturbing, though, is how many people want to believe that it is Mom’s fault. Not so long ago we blamed depression, autism, schizophrenia, and many other mental disorders on parenting. We now know that there are genetic and neurological causes for these disorders just as we know there are genetic and neurological factors in ADHD. Only if we confront this stigmatization and discrimination whenever we see it or hear it, will it disappear once and for all from our culture. Every one of us must confront these beliefs, if we are to set this to rest once and for all. Speak up and speak out. Do not let these beliefs continue to flourish.

CHADD and a number of other ADHD experts responded to the Times article, pointing out the inaccuracies and errors, and countering the claims made by Dr. Sroufe. While they take many different approaches to confronting these issues, all provide great information.

CHADD’s Letter to the Editor of the New York Times

Dr. Edward Hallowell, Response to NY Times Piece “Ritalin Gone Wrong”

Dr. Harold Koplewicz, “Righting the Record on Ritalin”

Time Magazine Columnist Judith Warner, “ADHD: Is Stigma Back in Style?”

In addition, Dr. Max Wiznitzer from CHADD’s Professional Advisory Board has submitted an article to the New York Times as a counter to the article by Dr. Sroufe. We are waiting to hear if it will be published, but will share with all of you in the near future.

Ruth Hughes, PhD, is the CEO of CHADD.

Monday, January 9, 2012

ADHD Medication Shortages: Your Information Needed Today

As you know, CHADD is very concerned about the current shortage of medications to treat ADHD. No one seems to have a good handle on the extent of the shortages. If you would take just a moment to answer a few questions about your personal experience with the availability of your medication, then CHADD will know much more about the extent of the problem, all the medications being affected, and the geographic distribution. It is important that we hear from people who are not having problems as well as those who are. We need both sides of the picture.

Answer this quick, anonymous survey, which includes the following questions:

• What is the name of the ADHD medication you normally use and the dosage?
• Are you having any problems with getting your prescriptions filled?
• What city and state do you live in?
• Have you had to change medications because of the shortages?

As CHADD works in Washington to address the causes and management of the shortage, it is important that we have as much accurate information as possible. CHADD’s mission is to provide its membership with a unified and strategic voice to policymakers. We are also partnering with other organizations to determine the extent of this issue and to amplify our voice in effecting positive change.

We will keep you updated on the results of the survey, our meetings with key policymakers in Washington, and what you can do to advocate for a more effective system of dealing with shortages. And we will keep you informed about CHADD’s concerns about diversion of medication and what you can do to keep medications from being used inappropriately.

If you would like some tips on how to find a pharmacy that can fill your prescription, check out "Shortages of ADHD Medications."

If you want information on what has led to the shortages, read "Why Can’t I Get My ADHD Medications?"

Completing the survey will take you less than a minute. Thank you for your help in this matter, and for your immediate cooperation.

Ruth Hughes, PhD

Robert Tudisco, JD
CHADD Public Policy Committee

Thursday, January 5, 2012

Why Can’t I Get My ADHD Medications?

by Ruth Hughes, PhD

Are you having difficulty getting your prescription for stimulant medication filled? Particularly if you have a prescription for amphetamine mixed salts (the Adderall generics), or more recently for immediate-release methylphenidate (Ritalin generics), you may find that your pharmacy is out and unable to tell you when they will get more.

In a previous blog, CHADD’s Tim MacGeorge developed some guidance on what to do if you are in this dilemma. This blog will explain what is causing the problem and what CHADD is doing to address it.

The shortages began last spring and all parties thought it would be a short-term problem. But now it is six months later and the problem is getting bigger, not smaller. To understand the problem, it helps to understand the process:

• Stimulant medications are considered Schedule II controlled substances and their production comes under the purview of the Drug Enforcement Agency (DEA). The DEA’s mission is to ensure that controlled medications are not used for nonmedical purposes.
• Pharmaceutical companies that manufacture stimulants apply to the DEA for permission to purchase a certain amount of the "active pharmaceutical ingredient" (API). This is the controlled substance within the stimulant medications.
• At the beginning of each calendar year, the DEA approves each company for a certain amount of the API. It is normally less than requested by each company, and the aggregate of all awards is the DEA’s best guess of the legitimate need for the year.
• Once approved, the company purchases the API and begins manufacturing the medications. It usually takes 8 to 12 weeks for the medications to be manufactured.
• And then they go to market.

Where Does It Go Wrong?

It only takes one company that has a problem in delivering its portion of the market share for the dominoes to begin to fall. Because each company is limited to a certain portion of the active ingredient, the companies are unable to step in when another company is having problems. Or if the DEA is wrong in its estimates of the number of legitimate prescriptions that will be written, then a shortfall can occur. Or the amount of medication may be correct, but the geographical distribution of the medications by all the companies involved may not lead to an even distribution across the country. The shortage continues until the original problem is solved.

Companies can go back to the DEA and request more of the API, but the application process is long and cumbersome. If the shortage occurs close to the end of the calendar year, companies are more likely to wait for the new annual award of API.

When all goes well, each pharmaceutical manufacturer has enough inventory to carry over into the new year until spring, when the production started in January actually reaches the market. This year the inventories are very low or nonexistent, raising concerns that there will not be sufficient medications available to make it until spring.

If the shortage continues for a while, as it has for ADHD medications, then other things begin to happen. Over time, physicians begin to change prescribing habits to other medications that are more readily available, such as the short-acting methylphenidate medications. But again, production of these medications is limited by the DEA. As a result, the shortage is spread to a new group of medications.

Some pharmacies or chain store distribution centers may begin to stockpile the medications, in anticipation of the shortages. This then aggravates the shortages in other areas.

Unfortunately, no one agency or manufacturer owns the problem. The Food and Drug Administration has responsibility for addressing medication shortages, but has no authority with the Drug Enforcement Agency. The DEA feels that it has a limited role of ensuring only the amount of medication legitimately needed is manufactured and the possibilities for diversion are reduced. And the manufacturers cannot respond quickly to shortages caused by internal problems or by other manufacturers because their production is limited by the DEA. As a result, there is a fair amount of finger pointing and little problem solving.

What Is the Short-Term Outlook?

Not great. Many of the companies that manufacture the short-acting stimulant medications report they have no inventory left or limited inventory. Given the manufacturing time lag of 8 to 12 weeks, it is unlikely that the 2012 DEA-approved medications will get to market until March at the earliest. No one seems to be able to estimate the amount of medications currently in pharmacies across the country. You should anticipate that getting your prescriptions filled for short-acting stimulants in particular, and all stimulant medications in general, may get more difficult as we move into the new year. So plan ahead.

Work closely with your physician and allow enough time before your current prescription is gone to actively search for a pharmacy that has your medication. Prescribing physicians and patients may need to consider long-acting, time-release medications rather than short-acting medications. If you have been purchasing the less expensive generic medications, you may need to consider the more expensive, name-brand medications. And you might need to consider a different delivery method such as the skin patch or liquid medication. Another option may be to try one of the nonstimulant medications that treat ADHD.

What Is CHADD Doing?

Given the manufacturing time lag, our current shortage seems destined to play out. But we can work to make sure this does not happen again. CHADD has been speaking out about the problems to the media to help raise awareness of the issue. Almost every day we are contacted by a major media outlet covering the story. We have been in touch with all the major and many smaller pharmaceutical manufacturers who make stimulant medications to clearly understand the scope of the problem and what steps might make it better. And we are organizing a coalition of concerned groups with the American Academy of Child and Adolescent Psychiatry. Other groups who have joined with us include patient advocacy, clinician, and pharmacy-related associations. The larger our coalition, the more power we will have to influence the agencies involved and Congress.

In early 2012, we will be meeting again with officials from the FDA and the DEA, and ultimately, with key senators and congressmen who can influence the policy of these agencies. We are determined to make sure this problem is solved. CHADD will continue to keep you informed about the shortages and what you can do to help us address this issue. While we may need to weather this storm, we will do all we can to make sure it does not happen again.

Ruth Hughes, PhD, is the CEO of CHADD.

PHOTO: Wikimedia Commons