AMNA NAWAZ: Since the pandemic eased, millions of Americans have had to deal with a number of drug shortages.

For those with ADHD, it's been an especially difficult year, as they and their families have struggled to get through ordinary daily routines.

Stephanie Sy has the story.

MAN: Thank you for calling your H-E-B pharmacy.

STEPHANIE SY: Every month, Brett Haile calls all of the pharmacies near his Conroe, Texas, home.

BRETT HAILE, ADHD Patient: Hi.

I'm looking for Vyvanse.

STEPHANIE SY: Searching for the medication both he and his 15-year-old rely on to treat their ADHD.

WOMAN: Most of them are on back border.

Let me see.

STEPHANIE SY: Haile has been scrambling for months.

BRETT HAILE: One pharmacy actually, like, scoffed when I asked, as if I had asked an absurd question.

STEPHANIE SY: That's because, for over a year now, there's been a nationwide shortage of medications, like Vyvanse, Adderall and Ritalin, which treat attention-deficit hyperactivity disorder.

ERIN FOX, University of Utah: Initially, it was a labor issue, but you would expect that would resolve pretty quickly.

STEPHANIE SY: Since then, there have been few answers, says the University of Utah's Erin Fox.

ERIN FOX: The majority of details around drug manufacturing, including the country that it was made in, the factory that it was made in, and how much product that they're actually making, all of that is allowed to be a trade secret.

STEPHANIE SY: Stimulant medications are controlled substances and tightly regulated because of their high potential for abuse.

The Drug Enforcement Administration sets limits for how much the industry can make.

But in an August public letter, the DEA and the Food and Drug Administration called on manufacturers to increase production, saying they weren't making as much as they could.

ERIN FOX: Because we don't have visibility into how much raw material the DEA gives each company, and we don't have visibility into the amount that each company is making, it's very hard to figure out.

STEPHANIE SY: What is clear, demand for stimulants is up.

During the pandemic, the percentage of people who had a prescription filled rose by more than 10 percent among some adults and teens.

And manufacturers haven't kept up.

BRETT HAILE: I stopped taking my medicine entirely.

When Brett Haile couldn't find Vyvanse, he decided to save what medication he had at home for his nonbinary child, Jet.

Since we're on the same medication, the same dosage, I could use my reserves, and they were able to go to school medicated because of that.

Otherwise, they wouldn't have had enough pills to keep going.

JET HAILE, ADHD Patient: If I didn't have my medication, I probably wouldn't be able to pass my classes.

STEPHANIE SY: Without Vyvanse, Jet Haile cannot stay on task.

JET HAILE: Because I wouldn't be able to focus on what the teachers were saying, so I wouldn't be, like, learning any of it.

STEPHANIE SY: Dad Brett did his best without his medicine, but was easily distracted.

BRETT HAILE: When I'm driving down the road, my attention drifts, and I then physically drift into the lane next to me.

And, once, I was only a couple of feet from the car in that lane.

Or I will look up, and the brake lights are on the car in front of me, and I have to slam on the brakes to keep from hitting them.

STEPHANIE SY: Weekends can be tough, when Jet foregoes their medicine.

JET HAILE: I feel like I just can't focus on anything.

It feels hard to move and stuff like that.

BRETT HAILE: Jet is much more irritable.

One of their main responsibilities is just emptying the dishwasher, and that's a small task that doesn't require a lot of energy, but it feels monumental to them when they don't have their medicine.

STEPHANIE SY: About 10 percent of kids and teens have ADHD; 62 percent of them take medication for it.

CR.

CESAR SOUTULLO, University of Texas Health Houston: What the medicines do is, they increase the dopamine availability in parts of the brain that are in charge of focusing and also completing tasks.

STEPHANIE SY: Dr. Cesar Soutullo directs the ADHD outpatient program at UTHealth Houston.

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CESAR SOUTULLO: They also impact the dopamine in parts of the brain that are in charge of stopping you before you act, so, impulsivity.

MARA MOODY: I need my Adderall.

It's a necessity in order to get through day-to-day tasks.

STEPHANIE SY: Nineteen-year-old Mara Moody has been taking ADHD medication since she was 8.

MARA MOODY: I was always fidgeting, and that annoyed a lot of people.

They viewed me as some hyper kid who was really weird.

STEPHANIE SY: She's managed her symptoms with medication, but, in the last year she's gone up to two weeks without it.

MARA MOODY: There was a lot of stress and frustration, and I felt like I couldn't go about my day-to-day activities or behave how I prefer to behave.

ERIN MOODY, Mother: The thing that affects her the most is the emotional regulation.

STEPHANIE SY: Erin Moody is Mara's mom.

ERIN MOODY: When she gets frustrated, she shuts down.

So, then we're at a standstill, and we can't get homework done.

We can't get chores done.

We can't get ready on time.

STEPHANIE SY: When she hasn't been able to take her medication, how do you see that impacting the family as a whole?

ERIN MOODY: Anyone who's having emotional problems affects a family dynamic.

And there are times when we just need to shut everything down and just talk through the situation and kind of take some deep breaths and reset.

STEPHANIE SY: I can see just the fact that you got emotional then, that it's been a tough year with the shortage.

ERIN MOODY: Yes.

STEPHANIE SY: Like, people don't... ERIN MOODY: I think ADHD is a tough condition to deal with even on medications, with therapy, with psychiatric help, with accommodations.

STEPHANIE SY: Without medication, it's that much harder.

Mara started college this fall and hopes the monthly hunt for her prescription will get easier.

MARA MOODY: I used to have a list of probably about 20 different pharmacies that we would have to call around to.

STEPHANIE SY: When patients have to try multiple pharmacies, that means doctors like Cesar Soutullo are scrambling too.

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CESAR SOUTULLO: When I write a prescription, and it's not available in this particular pharmacy, they cannot just transfer the prescription.

I have to write a new prescription, send it to the second pharmacy.

And then, if the second pharmacy runs out, I have to rewrite the prescription, send it to the third pharmacy.

It's a lot of hours that I just waste, I would say waste, writing prescriptions.

STEPHANIE SY: At the start of his day, Soutullo already had a backlog.

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CESAR SOUTULLO: I have like five prescription requests from the pharmacy, eight patient calls, and then another five patient calls requesting a renewal of medications.

STEPHANIE SY: Because the medications are controlled substances, distributors place strict limits on supplies to pharmacies, making them even more difficult to keep in stock, says Fox.

ERIN FOX: There are restrictions related to the opioid settlements that don't let the pharmacies buy as much as they need to fill the prescriptions that they have.

I really feel like the pendulum has swung very far to really limit access, even if you have legitimate prescriptions.

STEPHANIE SY: Mara Moody says some pharmacists have questioned if she has a real need for the prescription.

MARA MOODY: One of the things that has hurt me the most is the amount of people who kind of made me feel like I'm an addict.

And a lot of pharmacists are really distrustful of that, even though I have been on ADHD medications for the vast majority of my life.

STEPHANIE SY: Moody knows people who have even turned to the black market when they could not fill their script.

MARA MOODY: I have definitely had friends who have chosen to buy street Adderall just to kind of get through the days.

STEPHANIE SY: You have friends that have ADHD that, because of the shortage, have had to do that?

MARA MOODY: Yes.

Yes.

And not only is that just incredibly unfortunate and messed up, but it's dangerous.

STEPHANIE SY: As Mara and millions of others with ADHD across the country continue to struggle, Erin Fox says the economics of these medications mean there's no quick end in sight.

ERIN FOX: These are low-cost drugs.

And so when a drug company has a shortage, it doesn't really hurt their bottom line.

And so there's not a tremendous amount of incentive to fix the problem.

WOMAN: Thank you for calling CVS pharmacy.

STEPHANIE SY: And so Brett Haile will likely be calling pharmacies for the foreseeable future.

WOMAN: How can I help you?

BRETT HAILE: Hi.

I'm looking for Vyvanse.

STEPHANIE SY: For the "PBS NewsHour," I'm Stephanie Sy.

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