Disrupted Access to Prescription Stimulant Medications Could Increase Risk of Injury & Overdose

The CDC issued a Health Alert Network Health Advisory to inform public health officials, clinicians, and affected patients, their families, and caregivers about potential disrupted access to care among individuals taking prescription stimulant medications and possible increased risks for injury and overdose. On June 13, 2024, the U.S. Department of Justice announced a federal health care fraud indictment against a large subscription-based telehealth company that provides attention-deficit/hyperactivity disorder (ADHD) treatment to patients ages 18 years and older across the United States. Patients who rely on prescription stimulant medications to treat their ADHD and have been using this or other similar subscription-based telehealth platforms could experience a disruption to their treatment and disrupted access to care.

This potential disruption coincides with an ongoing prescription drug shortage involving several stimulant medications commonly prescribed to treat ADHD, including immediate-release formulation of amphetamine mixed salts (brand name Adderall®). Patients whose care or access to prescription stimulant medications is disrupted, and who seek medication outside of the regulated health care system, might significantly increase their risk of overdose due to the prevalence of counterfeit pills in the illegal drug market that could contain unexpected substances, including fentanyl. Given the national drug overdose crisis and threats associated with the illegal drug market, individuals struggling to access prescription stimulant medications are urged to avoid using medication obtained from anyone other than a licensed clinician and licensed pharmacy.

Recommendations for clinicians:

• Help patients who have lost health care access to find new licensed clinicians and pharmacies
• Avoid stigmatizing patients affected by a disruption in care
• Educate all patients about the health risks of using drugs or medications obtained from sources other than licensed clinicians and pharmacies, including family, friends, and social media contacts
• As a safety precaution, in case a patient obtains medication outside the regulated health care system, prescribe naloxone and overdose prevention education to any patient who has difficulty accessing their stimulant medication or tell patients where they, their caregivers, or families, can access naloxone
• Ensure that patients requesting care continuity for ADHD receive appropriate assessments and best-practice treatments
• Discuss with patients, their caregivers, and families the possibility of difficulty filling a prescription due to current drug shortages and work with them to ensure they are able to fill prescriptions
• Offer other FDA-approved treatment options for ADHD if a prescribed medication is unavailable when needed or facilitate a rapid referral to a clinician who can provide such treatment
• If you believe a patient might have a stimulant use disorder or needs immediate mental health support, provide referrals and information about how to access treatment services, including hotlines: #988 or 800-662-HELP (4357)
• Contact Poison Control (call 800-222-1222 or use the webPOISONCONTROL tool) for help with a poisoning emergency or for questions related to an unknown substance

See the full Health Advisory for more information.