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The Elephant In The Room – America's Endless Psychostimulant Medication Shortage Crisis

Dr. Shareefah Hamilton Davis is an inspiring leader, visionary, and seasoned veteran in the field of mental health. As the proud owner of Woosah Wellness, a holistic bicoastal psychiatric practice, she is on a powerful mission to end mental health stigma and transform lives through compassionate, quality care.

 
Executive Contributor Shareefah Hamilton Davis

Hello World. This message is overdue—two years, to be exact. Forgive me; I’m no writer, but I have a message that needs to reach some people today. I have to get this one off my chest.

 

Elephant trapped inside the living room

To everyone who knows me, especially my cherished long-time clients, you will see that I am a good person with good intentions within minutes of meeting me. My work is not a job or a chore. It’s my passion. I love interviewing and hearing about peoples’ various life stories and what makes them unique, celebrating their accomplishments and lows. I love every minute of it.

 

What I haven’t loved over the last two years is this unexpected shortage of psychostimulant medications. And for those who aren’t familiar with psychostimulants, I’m talking about Adderall, Ritalin, and Vyvanse, those medications that are first-line treatments for people with ADHD, according to evidence-based research.

 

No matter which side of the fence you stand on, whether you are well-informed with facts or if you are a nonbeliever who thinks ADHD is just a fake diagnosis for someone lazy and unmotivated, the fact remains we are in a state of emergency. This is a crisis. And we aren’t talking about it enough. This changes today. I can’t save the world, but I can use my voice to do what I know best: advocate. You tell your truth because someone hearing that truth may be able to help create a solution. And boy, do I need a solution, fast and quick.

 

Who, what, when, where, why, and how?

How did we get here? I wish I could tell you. Truly. I don’t have the answers. In September 2022 began, the nation’s most extended medication shortage of medications used to treat ADHD. What caused the crisis? I’m not quite sure. It’s become a mystery of sorts. There are no clues, no suspects, no viable solutions. There have been theories suggesting that, somehow, the pandemic influenced a rise in cases of ADHD. I’ve also heard that maybe prescribers such as myself are “overprescribing these drugs.” That is so ludicrous on many levels, and we can discuss it later.

 

But for a moment, can we talk about this approach? It’s as if a lawmaker with zero experience and expertise in diabetes mellitus type I is saying, you know what, I don’t believe in insulin saving lives for people with diabetes, so we’re just going to pull back supply and kind of see what happens. Ummm, what?? I can tell you what will happen. People will die.

 

The struggle is real

While this shortage of ADHD medications negatively impacted the lives of so many people nationwide, I witnessed firsthand how it severely impacted the lives of my clients, some of whom went months with no treatment. My heart goes out to all who had to suffer during this time. However, this crisis also has another side: its adverse impacts on prescribers (Psychiatric Nurse Practitioners, Psychiatrists, Psych PAs, etc), especially those with big hearts like myself, on a mission to save lives.

 

I don’t even have the time to discuss the numerous ways in which this disaster has negatively impacted my boutique practice, my family, my self-care, my anxiety levels, and my consideration of genuinely making a career change. At Woosah, we never have a shortage of clients who want care. We’ve lost clients because we couldn’t keep up with the workload, partly due to the increased demands and pressures placed on me as the sole provider during this crisis.

 

Think about it momentarily, or dare to put yourself in my shoes. I am one provider with over 100 clients. I wasn’t prepared for this drastic increase in workload, medication issues, pharmacy issues, etc. It’s not as if a prophet came to me and said, “Hey girl, hey, just want to put you on to the fact that there’s this stimulant shortage crisis starting next month that will deplete you of your energy, become a draining second job for you with absolutely zero financial rewards, deplete you of your energy, your time, strip you of your motivation, and make you want to leave the profession.” Let’s just say if there was a memo, I didn’t get it.


This crisis has not affected me positively.

 

Gone are the days of seeing a client, sending a script to a pharmacy, and moving happily and uneventfully to your next client. Oh no, no, no. Not if you treat people with ADHD.

 

Enter 2024 and my new world of nonstop pharmacy and prescription issues. Two years into this mess, and I still spend my evenings, early mornings, breaks, and sometimes weekends trying to play prescription magician while wishing upon a star that some pharmacy will have this client’s medication in stock the first time around so that I can quickly move on with my day and be able to sit at my kid’s swim class without the constant worry of solving the next prescription issue.

 

Again, I am one person with over 100 clients, most of whom have prescription issues. I wake up to prescription issues. I go to sleep with prescription issues. I dream of prescription issues. I’ve practiced mindfulness, meditated, listened to affirmations, phoned a friend, and still, I wake up with paralyzing anxiety. If we could only fix this prescription issue, maybe I could return to the life I intended to live before this whole saga began. How do I even answer that dreaded question at every Jamaican Sunday dinner table: “So, how’s business?” Ummm, I think I hear Nat calling me upstairs. I think she needs me. How do you explain this to anyone in five minutes? I haven’t figured it out, so avoid that question like the plague. You would never understand what I’m going through if you’re not walking these shoes.

 

Tips and tricks to navigate for clients

To clients, client advocates, allied healthcare professionals, parents, or anyone else with a dog in this fight, here are some general suggestions to navigate this better together. Pills don’t teach skills, but good habits and planning in advance certainly help.

 

Once I electronically send in any medication or controlled substance, it is truly out of my control what happens with that prescription. I can’t control stock availability. Contrary to popular opinion, I cannot produce Adderall in my apartment. Suffice it to say that if you don’t somehow receive confirmation from your pharmacy, it is not safe to assume this is due to an error on my part. Your pharmacy is your best resource for all things related to medication.

 

If you do not get an alert from your pharmacy regarding medication, please take the initiative to call them and find out why that may be the case. Please refrain from calling me and my part-time assistant at this small boutique practice and asking why you didn’t get an alert. Usually, this is because the medication is either out of stock, somehow unavailable, or any other pharmacy-related reason. It is unsafe to assume that the provider didn’t send the medication. Again, it drains my time and energy, and it is genuinely annoying to tell you what your pharmacy told me. That’s not my job. Once I submit your note, send your medication, and close out our video call, our services are complete.

 

If your pharmacy tells you that your provider indeed sent brand medication instead of generic, it is not safe to assume this was an error on my part. In my 15 years of nursing and working with pharmacies, I’ve learned that pharmacies are also prone to human error.

 

If you are a client expecting me to remember that last month we sent in brand, but this month we should send in generic, and we should send it to Capsule and not Duane Reade, please miss me with the expectations. Not for nothing, but I can’t remember if my kid got his multivitamin this morning. Can we all just meet each other where we’re at?

 

If your pharmacy says, “We didn’t receive your prescription,” please refrain from hunting me down by sending texts, voicemails, or emails, as this slows me down. Also, please do not come at me or my assistant assuming that “Shareefah didn’t send in my script again!” There are such things called timeouts. Did I create them? No. But I see the term on dosespot, so I know it exists. Technology doesn’t always work for us. CrowdStrike anyone?

 

General Prevention: Since this isn’t news to us, let’s all do our best, therapists included, to help mitigate the risk of further challenges during this crisis. Utilize a calendar app and set a reminder for yourself to schedule a visit with me at least ten days before you are expected to run out of medication. Talk to your therapist about creating a disaster plan if you have to go days and months without your medication; refer to the ADHD Treatment Guide I created for tips on nutrition, omega-3 fatty acids, mindfulness coaching, neurofeedback, exercise, and sleep.

 

An attitude of Gratitude can help ground you in the moment. Think about the fact that you had access to medication last month, yet your neighbor may be on his fourth or fifth month of having no access to their medication, which resulted in a loss of housing, no food, losing their car to repossession, you name it. Without an attitude of gratitude, life may feel bleak.

 

Educate yourself. Simply Google "ADHD medication shortage.” The knowledge is at your fingertips—especially if you have a smartphone and have time to spend on TikTok tonight.

 

Take regular breaks off your stimulant medication. What break, you ask? Oh, the evidence-based ones we discussed when we started treatment. It’s all in the guide. Breaks are encouraged. 4-5 days off at least three times a year, hence why research suggests that there are no severely acute withdrawal effects to stopping your stimulant medication while under the guidance of a licensed professional. Breaks are encouraged, and one day off medication is not a crisis.

 

The straw that broke the camel’s back

Quick story I’d like to share, the true catalyst, so to speak, for this public service announcement. A therapist recently reached out to me via my cell phone on not only my Sunday but then again on Monday, my known days off for several years. Anyone who knows me knows I do not work on Mondays. I’ve been doing the four-day workweek before it was a thing. It’s common knowledge at this point.

 

Ms. Entitled, it is not lost on me that the perceived “crisis” you were calling me for became urgent for you on my Sunday sabbath but not on your Saturday sabbath. That one hurt. It was hugely disappointing as the culturally competent mental health providers that we all strive to be in this industry. You hit a nerve, and it stung. It struck me on a deep, visceral, ancestral, soul level. I couldn’t think straight for a few days. Promise you. Your privilege was not only showing; it was shining bright.

 

I see you’re new to the industry, and I was once a beginner, so I know what it's like. I am here to help enlighten, guide, educate, and inform. First, we must establish a few ground rules to maintain our professional relationship with the utmost respect, dignity, and integrity that I’m accustomed to.

 

There is no reason to ever, ever, ever, ever call my cell phone during my off-time with my family and my child, as I do not provide emergency services. My time with my child is my time with my child. Period. Full Stop. And I won’t use this new phrase, “if that makes sense, 'cause it makes perfect sense to me, and I imagine it makes sense to you too, respectfully.

 

Reasons to contact me on my cell phone during my off-hours: This goes for everyone!

 

  1. If you were told that my loved ones and myself are in imminent danger, call me.

  2. If you hit the lottery and want to surprise me with a tiny home and that dream vacation I’ve longed for, call me anytime, day or night.

  3. If you’re on your deathbed and your last wish is to talk to me, make that call.

 

Final words

I don’t call myself the unconventional psych for no reason. I’m here to normalize this whole mental health thing and make it so that it’s not a “thing.” It’s just part of what we do, like

going to the PCP.

 

I’m no writer, but I have a lot to say. If there were ever a reason to leave the profession, this would be it, as this has been the bane of my existence for the last two years. Do you want to talk about task paralysis? I am terrified of the amount of prescription issues waiting for me in my email, my office email, text messages, and voicemails, which leads me to sometimes shut down. I’ve made myself way too available to clients and tapped out. This isn’t healthy, and I didn’t sign up for it.

 

One thing I learned during my short-lived wanting-to-be-an-actor phase circa 2004 was the concept of good, better, and best taught to me by the superb Mary Boyer of MTB Studio. Any actor can make a choice, but the actor who makes the best choice is the one who ultimately books. Good. Better. Best. America, this is not good, and when it comes to mental health in this country, we need to be doing our best. Agreed?

 

Let’s start a healthy conversation based on evidence, facts, personal stories, and experiences because I can assure you that my clients and I have much to say. If you fail to plan, you plan to fail. And if we’ve learned anything about healthcare, prevention is critical. We cannot forget our people, especially our youth.

 

For anyone who does care how I’m doing or how I’d like to be doing, here goes. I love long walks on the beach with my son, studying my birth chart, learning, growing, being a mommy, reading dinosaur books to my baby, walking my son into his preschool, dancing with him, catching up on episodes of Real Housewives, or dreaming about one day having the time to take a virtual dance class at Alvin Ailey or the Steezy App. That’s my idea of a good life. This shortage crisis has taken over my life. I have 99 problems, and the prescription shortage crisis is at the top of my list if that makes sense. Clients, if you are experiencing medication issues, please schedule an appointment. I’m drowning in emails. This is my truth. Peace, love, and light, Reef.


In loving memory of Bridgette May Waldemar


Follow me on Instagram, LinkedIn, and visit my website for more info!

 

Shareefah Hamilton Davis, Psychiatric Nurse Practitioner and Visionary

Shareefah Hamilton Davis is a proud Jamaican-American visionary and a dedicated veteran in the realm of mental health. With over 15 years of experience, she finds immense joy in guiding her clients toward remission and helping them reach their maximum potential. Having navigated the challenges of uncontrolled ADHD for much of her life, Shareefah is passionately committed to eradicating the stigma associated with mental health treatment. She empowers her clients with the belief that “ADHD is a superpower!” and inspires them to embrace their unique strengths.

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