By Margaret Peters
Diagnosed at the age of 6, first-year Julia Sitz, now an 18-year-old, is struggling to get her medication for ADHD. The disorder is challenging even with treatment and can be debilitating if prescriptions cannot be filled. Facing shortages of Adderall, Sitz recently switched to taking Concerta, a drug that is less effective for her. At times, however, she can find no medications and recalls going days without filling her prescription. During these periods, she struggles to get anything done as she deals with crippling anxiety and impulsiveness. “It feels exactly like it did before I was on medication,” she says.
Other Kalamazoo College students also struggle to fill their prescriptions to address ADHD. Adderall is a common treatment, but in October 2022 the US Food and Drug Administration declared a shortage due to delays in manufacturing. ADHD medication demand spiked in 2020, during the COVID-19 pandemic, with increased need resulting from testing and awareness of the disorder, USA Today reported. According to National Center for Biotechnology Information between 2 and 8 percent of college students in the United States have ADHD.
With high demand and manufacturing delays, supplies fall short, leaving patients without their medication. Pharmacist Avillo Fon of the nearby Walgreen’s on Main Street at the bottom of the hill said, “I’ve had a lot of patients on the medications, and they are frustrated with the medication being on backorder.” He added, “Many have been complaining about withdrawal symptoms and what to do.”
ADHD is a neurological disorder affecting executive functioning, causing difficulty in focusing, impulsivity, and hyperactivity. Most treatment medications are either amphetamine-based, such as Adderall and Vyvanse, or methylphenidate-based, such as Concerta and Ritalin, according to USA Today. Patients may find certain drugs more effective in addressing symptoms. Having to switch among treatment options due to shortages can present difficulties.
Sitz reported that she switched from Adderall to Conerta because it was too difficult and stressful to travel around searching for medication. “It will be like two days of just misery of not being medicated because the pharmacy doesn’t have the pharmaceuticals,” she said. Those without cars—including freshman without special permission because of a job off campus—have additional difficulties finding availability. Students report that alternatives such as Uber, Lyft, the bus system, and friends with automobiles can be helpful, but burdensome.
Lisa Ailstock, Director of Student Health Services at K College, said in an email, “We are dealing with pharmacies who tell students that they will call them when a med comes in and they don’t, so students are having to go without medication while they think they are waiting for a pharmacy.”
Sitz recalls the longest she went without ADHD medication was four days. “After three days, I would be unhinged,” she said. She would feel very ravenous, tired and could not focus on anything, so getting schoolwork done was extremely difficult. The absence of medication caused other problems as well; ADHD medication is a stimulant and can suppress one’s appetite. Consequently, as the drug’s effects wear off it is common to become hungry and feel heightened fatigue.
Eli Van Drie is a freshman at K College dealing with ADHD. He gets his medication shipped to him but sometimes has to go home cause shipment was unable to go through because of the shortage. His ADHD medication, Concerta, is beneficial to him educationally “my thought patterns are a lot different, and it focuses me to actually do things and buckle down.”
Another K College freshman faces additional consequences without Adderall. Alison H. Settles is diagnosed with ADHD and Postural Orthostatic Tachycardia Syndrome (POTS), an imbalance in heart rate and blood pressure causing lightheadedness and, in some cases, fainting. Adderall ameliorates both ADHD and POTS symptoms for Settles. As she is from Nashville, Tennessee, she has added difficulties getting her prescription filled. “My provider can’t provide it to me because I am out of state and it’s a controlled substance,” she said. “So I have to find a whole new provider which sucks cause I don’t have meds so I can’t get it done and so I can’t see anyone.” That is, without the medication she needs, she struggles to give attention to find local medical care.
Sitz has a car in Kalamazoo but not on campus, she said, “I pay a lot of money to park downtown.” Sitz emphasized that the college only lets first year students have a car on campus if they show proof of a job, so when she asked to have her car on campus for the need to search for ADHD medication she was denied. She said, “the Head of Accommodations said to just walk to Walgreens” which has struggled to maintain a supply of ADHD medications.
Ailstock agrees that transportation is a huge issue for students with ADHD. While the Health Center at K College cannot provide controlled substances, they are able send prescriptions to pharmacies for students to retrieve.
For a student out of state, such as Settles, Ailstock suggests, “just come and see us and we will figure it out.” The Health Center has a list of psychiatrists that can test students or prescribe them their medication through Uwill, an online therapist program. She also suggests F.O.C.U.S Intervention, which helps students address attention, concentration and academic performance. The Health Center also works closely with the Counseling Center to coordinate medication and cognitive behavior therapy, which has demonstrated as the most effective treatment for those with ADHD, according to the Mayo Clinic.
When off her medication, Sitz’s describes a feeling of sadness and negative self-talk for the difficulties she faces with ADHD that come a lot easier to others. USA Today notes that self-esteem and grades often suffer for those with untreated ADHD as the struggle to learn and regulate behavior is internalized. Sitz hopes for more conversation about ADHD at K College to improve awareness, and additional support from classmates, faculty, and the community.
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