An ongoing shortage of medication for attention deficit hyperactivity disorder is affecting millions—and with no end in sight.
The Food and Drug Administration first announced a shortage of Adderall, the drug most commonly used to treat ADHD, in October 2022. Manufacturing delays, medication withdrawals due to cross-contamination, overprescribing, and unprecedented demand are some of the many reasons behind the shortage.
This June, the shortage was heightened when the Centers for Disease Control and Prevention announced disrupted access to stimulation medications, including Adderall, due to a health care fraud scheme. As a growing number of people with ADHD experience a disruption to their prescriptions, they may seek medication outside the traditional health care system, in turn increasing the risk of injury and overdose, reported the CDC.
There's been a dramatic increase in patients with prescriptions for ADHD over the past decade. Prescribed stimulants, including Adderall, Ritalin, and other drugs, rose by over 50% between 2012 and 2022, according to a 2023 report from the Drug Enforcement Administration. Meanwhile, there are around 6% of adults in the U.S.—roughly 15.5 million individuals—currently have ADHD, according to data from the CDC's National Center for Health Statistics.
As of October 2023, around one-third of adults with ADHD take stimulant medication, with almost three-quarters experiencing problems getting their medicines due to a lack of availability. At the same time, about a third of adults are not receiving any kind of ADHD treatment.
"We are seeing people go without their medications, and those who ration them in various ways to try and deal with the current shortage," Stephen Lassen told Stacker. Lassen has a doctorate in clinical child and adolescent psychology and is a psychologist in behavioral sciences at the University of Kansas Health System.
"Without the medication, many children with ADHD are struggling in school and in social relationships. Adults with ADHD are also struggling at work and with daily life management tasks," he added.
Common ADHD symptoms like inattention, hyperactivity, and impulsive behavior are often managed with medication. But amid the ongoing shortage, many people living with ADHD are considering alternative strategies to mitigate symptoms. Lassen noted that emerging research suggests that some lifestyle interventions produce mild reductions in ADHD symptoms, such as regular exercise, adequate and consistent sleep, and limited screen time.
"In reality, these are good lifestyle habits for everyone and carry no risk, so they should be the foundation of any plan for managing ADHD," he said.
ADHD Advisor compiled evidence-based tactics for managing ADHD as an Adderall shortage continues to plague the U.S. Please note that any treatment changes should be run by a medical doctor, and these tips are not a replacement for medication.
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Identify food sensitivities
While no definitive diet exists for ADHD, some research suggests that eliminating foods that may trigger flare-ups could help manage symptoms in young people. A 2020 literature review published in the Nordic Journal of Psychiatry found that some children and adolescents may benefit from an elimination diet, which involves removing one or more foods over a period of time to identify food sensitivities that exacerbate ADHD symptoms.
A 2021 study published in Scientific Reports found that over 3 in 5 boys aged 8 to 10 experienced a significant reduction in ADHD symptoms when following the few-foods diet, which consists of rice, meat, vegetables, pears, and other foods deemed least likely to trigger reactions. However, patients are advised to be under professional supervision when trying the few-foods diet to avoid nutritional deficiencies.
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Take vitamins
Though there are mixed results on how nutritional supplements affect ADHD symptoms, diet quality and nutrition have been shown to play a role in ADHD's functionality. Vitamin D and magnesium supplements were shown to improve ADHD symptoms among patients deficient in vitamin D, according to a 2022 literature review in the journal Nutrients. The researchers also found that some probiotic supplements improved symptoms of ADHD, but robust evidence is still needed.
"Individuals with ADHD may have vitamin and mineral deficiencies that need to be addressed," Lassen noted. "However, there is limited evidence that specific dietary changes impact ADHD symptoms in children and adults."
The new field of nutritional psychiatry is starting to unpack the general effects of diet on mental health, Lassen added. "A balanced diet that avoids processed food and refined sugar is likely to lead to improved cognitive and physical functioning."
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Exercise regularly
The "natural high" that many people experience from moving their bodies and getting their heart rate up may have a particularly profound impact on people with ADHD.
"According to the broad science, exercise tempers ADHD by increasing the neurotransmitters dopamine and norepinephrine-both of which play leading roles in regulating the attention system," Dr. John Ratey, a Havard professor and ADHD expert wrote in an April 2024 article for ADDitude magazine.
A 2023 meta-analysis published in eClinical Medicine found that exercise improved cognitive flexibility, inhibitory control, and inattention in children and adolescents with ADHD.
Activities like martial arts, ballet, rock climbing, and other technically precise physical activities can help manage ADHD, Ratey added in his article. These activities require skills that engage a number of areas in the brain, notably "evaluating consequences, switching, error correction, fine motor adjustments, inhibition, and, of course, intense focus and concentration."
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Limit screen time
Studies have long shown an association between screen time and heightened ADHD symptoms. Higher amounts of screen time among high school students exacerbated ADHD symptoms, according to a 2023 study in Scientific Reports. The study directly linked social media usage, watching TV, and gaming to ADHD symptoms, with social media use in particular associated with an increase in impulsive behavior.
Limiting screen time can help manage ADHD symptoms, particularly for children and teens with ADHD. Parents can add guardrails, including setting a schedule and giving warnings, being discerning about usage, and incorporating physical activity after screen time to help mitigate symptoms.
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Get a good night's sleep
ADHD has been linked to insomnia, and can increase the chance of sleep disruptions or the time it takes to fall asleep. What's more, because sleep deprivation is known to exacerbate ADHD symptoms, including forgetfulness and a lack of concentration, sleep issues can create a vicious cycle for people with ADHD.
The Sleep Foundation has several tips for improving sleep, including avoiding screen time at least one hour before bed, exercising, getting enough sunlight during the day, and stopping the consumption of sugar, caffeine, and alcohol before bedtime. Developing an enjoyable bedtime routine, which may include taking a warm bath or spending time with pets, can also help patients unwind before bedtime and get a good night's sleep.
Story editing by Alizah Salario. Additional editing by Kelly Glass. Copy editing by Kristen Wegrzyn. Photo selection by Clarese Moller.
This story originally appeared on ADHD Advisor and was produced and distributed in partnership with Stacker Studio.