ADHD Medication Shortage in Washington: What to Do When the Pharmacy Is Out

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Quick answer: If a Washington pharmacy cannot fill your ADHD stimulant, there are four legal routes: a partial fill, a one-time transfer of the unfilled electronic prescription to another pharmacy, a new prescription sent to a pharmacy that has confirmed stock, or a planned change in strength, formulation, or medication. A Schedule II prescription cannot be refilled, and a pharmacist cannot swap in a different drug without a new prescription. Clarity ADHD is a cash-pay telehealth practice for adults in Washington led by Lucas Craft, MMS, PA-C.

Pharmacy out and prescriber hard to reach? I see adults across Washington by telehealth, and transferring care starts here: Transfer your care or Book a free consult

It usually happens on the worst possible day. You get to the counter, or you get the text, and the answer is that they do not have it. Maybe next week. Maybe try another store. You have two pills left and a work week ahead of you.

This is not a sign that you did something wrong, and it is not only your pharmacy. As of mid-October 2026, the FDA drug shortage database lists mixed amphetamine salts tablets (generic Adderall), lisdexamfetamine capsules (generic Vyvanse), and extended-release methylphenidate tablets (generic Concerta) as currently in shortage.¹ A listing does not mean the medication has vanished. Each entry is broken down by manufacturer and strength, and many lines are marked available while others are limited or unavailable. That is why one pharmacy can be empty while another across town has exactly what you need.

What you can do about it depends on rules most people never have to learn until the day they need them. Here is how they work in Washington.

Why the Usual Fixes Do Not Work Here

Stimulants are Schedule II controlled substances, and Schedule II prescriptions cannot be refilled. Federal rules say so directly,² and Washington law repeats it, adding that a Schedule II prescription cannot be filled more than six months after it was issued.³ Every fill needs its own prescription.

Washington also requires controlled substance prescriptions to be sent to the pharmacy electronically, with narrow exceptions.⁴ There is no paper copy in your wallet to carry to a different store. The prescription lives at whichever pharmacy it was sent to until it is filled, transferred, or cancelled.

And every controlled substance a Washington pharmacy dispenses is reported to the state prescription monitoring program, no later than one business day after it is dispensed.⁵ That is worth knowing for two reasons. Moving a prescription honestly between pharmacies is normal and visible, so there is nothing suspicious about it. And trying to fill the same medication at two pharmacies at once is not a workaround, because both fills show up.

Route One: Take What They Have

If the pharmacy has some of your medication but not the full quantity, ask about a partial fill. Under federal rules, when a pharmacist cannot supply the full amount, they can fill part of it and supply the rest within 72 hours. After 72 hours, the remaining balance cannot be dispensed without a new prescription.⁶ Washington separately allows a partial fill at the request of the patient or the prescriber, as long as the total never exceeds what was prescribed.⁷ When the patient asks for the partial fill, federal rules allow the rest to be filled up to 30 days after the prescription was written.⁶

The practical question to ask is simple: can you give me what you have today, and when do you expect the rest? Then watch the clock. If the remainder does not arrive in time, the balance is gone, and your prescriber needs to know so a new prescription can go somewhere that has stock.

Route Two: Move the Prescription

Since 2023, federal rules have allowed an unfilled electronic prescription for a Schedule II medication to be transferred between retail pharmacies one time, at the patient's request, pharmacist to pharmacist.⁸ Washington followed with a rule, effective December 2024, that requires a pharmacy to transfer a controlled substance prescription when the patient asks, within three business days or sooner if waiting would disrupt treatment.⁹

There is a catch. Many pharmacy software systems have not been able to send these transfers electronically, and the Washington Pharmacy Quality Assurance Commission acknowledged this in a 2024 policy statement, saying it would not penalize pharmacies whose systems could not yet do it.¹⁰ So if you ask and hear that it cannot be done, that may be a software limitation rather than a pharmacist being difficult. And because the transfer is one time only, if the second pharmacy also runs out, the prescription cannot move again.

Route Three: A New Prescription to a Pharmacy That Has It

In practice, this is often the fastest fix. The work you can do before contacting your prescriber makes it much faster.

Call around first. Some pharmacies are careful about discussing controlled substance stock by phone, so a specific question tends to get a better answer: can you fill this medication, this strength, this quantity, this week? Do not stop at the large chains. I also suggest calling independent pharmacies, hospital outpatient pharmacies, and compounding pharmacies that fill standard prescriptions, because they often serve fewer customers and sometimes have the regular medication in stock when the chains are out. They still buy from the same wholesalers and get limited supply like everyone else, so confirm the exact medication, strength, and quantity, and confirm that they fill Schedule II prescriptions, before your prescriber sends anything. When you find one, send your prescriber the pharmacy's name, address, and phone number, plus the exact product they said they can fill.

Your prescriber will usually cancel the original electronic prescription so two are not active at once. That protects you as much as anyone, because a duplicate sitting at another pharmacy is exactly the kind of thing that looks wrong in the monitoring database later.

Route Four: When Switching Is a Clinical Decision

Sometimes the medication you take is simply not available anywhere nearby, and the question becomes what to take instead. That is a clinical decision, not a pharmacy one, and the options are not equal.

The same medication, a different strength

The simplest change is the same drug in a strength that is in stock, such as two 10 mg tablets in place of one 20 mg. It still needs a new prescription with clear directions, but nothing about how the medication works changes.

The brand-name version

Sometimes the brand-name version is easier to fill than the generic. In the FDA shortage database in mid-October 2026, packages of brand Vyvanse and brand Concerta are listed as available, while many generic versions of the same medications are listed as limited or unavailable.¹ That can change from week to week, so ask the pharmacy about the brand by name. The tradeoff is cost. Brand-name medications usually cost more out of pocket, and insurance plans may not cover the brand when a generic exists, or may want extra paperwork first, so check with your pharmacy and your plan before anything changes. Washington's e-prescribing rules give prescribers an explicit way to indicate whether a generic may be substituted,⁴ so if the brand is the plan, that needs to be marked on the prescription.

The same medication, a different version

Immediate-release and extended-release versions of the same medication are not a swap. They differ in how quickly the medication starts working, how long it lasts, and when you take it, so the dosing has to be rethought.

Generics of the same extended-release product can differ too. In 2014, the FDA concluded that the data for two generic versions of extended-release methylphenidate were insufficient to show they had the same therapeutic effect as Concerta, and changed their rating so they were no longer recommended as automatically substitutable at the pharmacy.¹¹ The broader point is not that generics are bad. It is that if a new manufacturer's version suddenly feels different, that is worth reporting rather than dismissing, and worth tracking for a couple of weeks. A manufacturer switch is one of several reasons a dose can stop feeling right; the others are covered in why ADHD medication can seem to stop working.

An immediate-release version of the same medication can work as a short-term bridge until the extended-release form is back. The tradeoff is more doses per day and more ups and downs, because each dose wears off sooner and the effect is less even across the day. Whether that makes sense for you, and how to dose it, is a decision for your prescriber. It also only helps if the immediate-release form is actually in stock. As of mid-October 2026, mixed amphetamine salts immediate-release tablets (generic Adderall) are themselves on the FDA shortage list,¹ and lisdexamfetamine has no immediate-release version, so a bridge from Vyvanse means a different medication, which is a bigger change. Either way, confirm with the pharmacy that they have the exact form and strength before the prescription is sent.

A different stimulant

Methylphenidate products and amphetamine products are different medications, and doses do not convert one for one. Some people respond well to one family and poorly to the other. Both are standard first-line options for adults. NICE recommends lisdexamfetamine or methylphenidate as first-line medication for adults with ADHD,¹² and the largest network meta-analysis of ADHD medications found that, weighing efficacy and tolerability together, amphetamines were the preferred first choice for short-term treatment in adults.¹³

So a switch driven by a shortage can be completely reasonable. It should still be handled as a new trial: a planned start, a planned check-in, and a decision about whether it is working. For how that process should go, see how to find the right ADHD medication.

A non-stimulant

Atomoxetine and viloxazine are not controlled substances, so the Schedule II rules above do not apply, and neither had an FDA shortage listing when this was written. For some people facing repeated shortages, that stability is a real advantage. They are not a bridge for next week, though. They build up over weeks rather than working the day you take them. The tradeoffs are covered in non-stimulant ADHD medication for adults.

What a Gap Actually Does

Many people go a few days without their medication and notice little more than their ADHD symptoms coming back: harder mornings, more distraction, more things left half done. That is the main cost of a gap, and it matters more than it sounds on a day you need to drive, work, or care for someone, for reasons covered in ADHD treatment and safety.

Some people notice more than that. After long, continuous use, stopping suddenly or dropping the dose sharply can bring a stretch of feeling tired, flat or low, hungrier than usual, or sleeping poorly or too much. The Adderall prescribing information describes these effects after abrupt discontinuation following prolonged use.¹⁴ Not everyone has them, and when they do happen they are usually short-lived. I try to plan time off medication with patients so it goes smoothly, and if you know a gap is coming, whether from a shortage or a planned break, it is worth talking through with your prescriber ahead of time.

Two practical points. Do not cut or crush an extended-release tablet to stretch your supply unless your pharmacist or prescriber has told you that specific product allows it, because some are built to release medication across the day and splitting them defeats that. And when you restart, tell your prescriber exactly how many days you missed. It can change how treatment restarts.

Two Things Not to Do

Do not take someone else's medication, even a partner's or a friend's with the same prescription. In 2023, the FDA required updated warnings on all prescription stimulants, noting that most people who misuse them get them from family members or peers, and that patients should never share them.¹⁵

And do not buy stimulants online without a prescription. In October 2024, the DEA warned that illegal online pharmacies were selling counterfeit pills made with fentanyl and methamphetamine to people who believed they were buying real medications, including Adderall.¹⁶ The sites can look entirely legitimate. A shortage is exactly the situation they are built to exploit.

Making the Next Shortage Smaller

Shortages have come and gone for several years now, so it is worth planning for the next one while things are calm.

Contact your pharmacy several days before you are due, not on the day you run out. Know which strengths of your medication work for you and which combinations would get you to the same dose. Have a second pharmacy in mind. And ask your prescriber whether a 90-day supply written as separate prescriptions makes sense for you. Federal rules allow it when the prescriber judges it appropriate and it does not create undue risk,² though it is a clinical decision rather than something anyone is entitled to.

I would rather plan a backup with a patient during a routine visit than improvise one on the day the bottle is empty. If your current prescriber is hard to reach when this happens, that is worth taking seriously. Telehealth prescribing of controlled substances is currently permitted when federal and Washington requirements are met, and you need to be physically in Washington at the time of each visit. For what ongoing online care looks like, see online ADHD medication management in Washington. If you are switching prescribers entirely, the transferring care page lays out the steps.

A shortage is frustrating, but it is usually solvable. The people who get through it fastest are the ones who know which of these four routes to ask for.

References
1. US Food and Drug Administration. FDA Drug Shortages Database: amphetamine mixed salts tablets, lisdexamfetamine dimesylate capsules, and methylphenidate hydrochloride extended-release tablets, status Current, with package-level availability for brand and generic products (entries updated October 15, 2026). https://dps.fda.gov/drugshortages
2. 21 CFR 1306.12, Refilling prescriptions; issuance of multiple prescriptions. United States Code of Federal Regulations.
3. RCW 69.50.308, Prescriptions. Revised Code of Washington.
4. RCW 69.50.312, Electronic communication of prescription information. Revised Code of Washington.
5. RCW 70.225.020, Prescription monitoring program, duties of dispensers. Revised Code of Washington.
6. 21 CFR 1306.13, Partial filling of prescriptions. United States Code of Federal Regulations.
7. RCW 18.64.265, Schedule II controlled substance, partial fill permitted. Revised Code of Washington.
8. 21 CFR 1306.08, Electronic prescriptions. United States Code of Federal Regulations.
9. WAC 246-945-346, Controlled substance prescription transfers. Washington Administrative Code.
10. Washington State Pharmacy Quality Assurance Commission. Policy Statement P013: Transfer for initial dispensing of an electronic prescription for a controlled substance. Effective December 26, 2024.
11. US Food and Drug Administration. Questions and answers regarding methylphenidate hydrochloride extended release tablets (generic Concerta) made by Mallinckrodt and UCB/Kremers Urban (formerly Kudco). Content current as of November 4, 2016.
12. National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: diagnosis and management (NG87). 2018, updated 2019. Recommendation 1.7.11.
13. Cortese S, Adamo N, Del Giovane C, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2018;5(9):727 to 738. doi:10.1016/S2215-0366(18)30269-4
14. Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate) tablets, prescribing information, Drug Abuse and Dependence section. DailyMed, US National Library of Medicine.
15. US Food and Drug Administration. FDA Drug Safety Communication: FDA updating warnings to improve safe use of prescription stimulants used to treat ADHD and other conditions. May 11, 2023.
16. US Drug Enforcement Administration. DEA issues warning about illegal online pharmacies. October 4, 2024.

Related reading: moving to Washington with ADHD medication, what to do if your prescriber closed their practice, non-stimulant ADHD medication for adults, and pricing.

The content on this website is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.