The message usually arrives through the patient portal, and it is short. The practice is closing. The prescriber is retiring, relocating, or leaving clinical work. Records will be available for some period. Please make arrangements for ongoing care.
For most conditions that is an inconvenience. For someone taking a stimulant for ADHD it is a deadline, because the prescription already in hand cannot be refilled and no pharmacist has the authority to extend it.
This post is about what to do with that deadline.
Why This Lands Harder Than It Should
The stimulants used to treat ADHD are Schedule II controlled substances, and federal regulation is explicit that a Schedule II prescription cannot be refilled.1 A prescriber may issue multiple prescriptions at once totaling up to a ninety day supply, with each prescription after the first carrying the earliest date it can be filled, which is why some people have a small buffer and others have none at all. Which situation applies depends entirely on where the last appointment happened to fall.
That single rule produces most of the difficulty. Someone who loses a prescriber for a blood pressure medication can usually get a bridge supply from an urgent care while they sort out longer term care. Someone who loses an ADHD prescriber often cannot, because most clinicians will not write a Schedule II prescription for a person they have never evaluated. That reluctance is reasonable rather than obstructive, and understanding it early saves a great deal of frustration.
What the Evidence Does and Does Not Say
Two things are worth knowing here, and neither one is a reason to panic.
The first is that stopping ADHD medication is common and is not always a catastrophe. A Danish nationwide registry study followed 23,916 adults for five years after their first ADHD prescription and found five year drug survival of 29 percent in women and 23.5 percent in men.2 Most adults who start ADHD medication are not still taking it five years later. The registry defines discontinuation as a twelve month gap in filled prescriptions, so it cannot separate a planned stop from an abandoned one, and it does not measure how anyone fared afterward.
The second is that at a population level the medication does appear to matter. A Swedish cohort study of 148,578 people with a new ADHD diagnosis found that those who started medication within three months had lower two year all cause mortality than those who did not, with a hazard ratio of 0.79 (95% CI, 0.70 to 0.88).3 The difference was driven almost entirely by deaths from unnatural causes such as accidents and poisoning, hazard ratio 0.75 (95% CI, 0.66 to 0.86). Deaths from natural causes showed no significant difference.
Both of those studies are observational, and the Swedish one compared starting medication against not starting it rather than stopping an established regimen, so neither can tell an individual reader what a gap in treatment will do to them. The absolute differences were also small, roughly nine fewer deaths per ten thousand people over two years. Together they support a modest claim rather than a dramatic one. An unplanned interruption is not an emergency, it is also not nothing, and the useful response is to treat it as a problem with a timeline attached.
Request the Records Before Anything Else
This is the step people skip and then regret two weeks later, when a new office asks for documentation nobody has.
In Washington, a provider who receives a written request for a patient's own health care information has fifteen working days to respond, extendable to twenty one working days if they notify the patient in writing of the reason for the delay.4 A reasonable copying fee is permitted. Separately, Washington Medical Commission guidance says a closing practice should tell patients how records can be obtained or transferred and how long they will be kept before destruction.7
Asking for "my records" tends to produce a thin summary. It is better to ask for specific documents:
The original diagnostic evaluation or intake note. The complete medication history, including doses, dates, and anything that was tried and abandoned. Any psychological or objective testing. Recent vital signs, particularly blood pressure and heart rate. And the visit notes from roughly the last year.
A new prescriber holding those documents is in a completely different position from one holding nothing.
What a New Prescriber Will Want to Do
Expect to be evaluated again. Not because the previous diagnosis is presumed wrong, but because a clinician who takes over Schedule II prescribing is taking on responsibility for that decision and needs an independent basis for it.
In practice that means working through the developmental history, confirming the diagnosis, reviewing what has and has not worked, and checking the state prescription monitoring database. It is a real appointment rather than a formality, and it is what a transfer intake is for, priced as a one time visit rather than a full program.
It also means the regimen may not carry over unchanged. A transfer is a natural moment to ask whether the current dose is actually the right one, particularly when it was set years ago and never revisited. Plenty of people arrive on a medication that was never properly compared against the alternatives, and being on ADHD medication is not the same as being on the right one.
One thing worth saying plainly: a practice that promises in advance to continue an exact regimen sight unseen is telling you something about how it operates, and it is not a reassuring thing.
Where Telehealth Fits
Under current federal rules a DEA registered clinician may prescribe Schedule II medications through an audio and video telemedicine visit without having conducted a prior in person examination.5 This has been the arrangement for several years now, though it has been maintained through a series of temporary extensions rather than settled permanently, and the framework remains under active rulemaking. It is worth confirming rather than assuming, particularly if a gap in care stretches across a change in the rules.
For someone who has just lost a prescriber, the practical advantage of telehealth is availability rather than convenience. Video appointments are usually easier to get quickly, and quickly is the constraint that actually matters. Clarity ADHD keeps a page describing exactly what transferring care here looks like for people in this situation. The clinical case for it is covered separately in what a telehealth ADHD evaluation involves.
If a Gap Is Going to Happen Anyway
Sometimes the calendar simply does not cooperate.
What helps: saying at first contact that the supply is running out, because that changes how the appointment gets scheduled. Asking the closing practice whether anyone is covering patients in the interim. Sending the records request the same week rather than waiting until a new provider asks.
What does not help: taking someone else's prescription, ordering from an online source that does not require an evaluation, or stopping abruptly without telling anyone. Discontinuing a stimulant is not physiologically dangerous in the way that stopping alcohol or a benzodiazepine can be, though an abrupt stop may bring several days of low mood, fatigue, and heavy sleep. The functional consequences at work and behind the wheel are real too, and better planned around than absorbed by surprise.
Several stimulant formulations are also on the FDA drug shortage list at any given time, and that list is public.6 If a transfer happens to coincide with a supply problem, non stimulant options exist and can hold a line temporarily.
If This Just Happened to You
You have less time than you think and more than it feels like.
Put your records request in writing this week, because the fifteen working day clock does not begin until a written request arrives. Book a new evaluation before you know exactly when the supply runs out, since appointment availability is almost always the binding constraint. Bring the medication history, and be straightforward about what you take and how much is left.
And know that being in this position says nothing about you. Practices close, clinicians retire, and telehealth companies fold, usually with very little warning to the people relying on them. You did not do anything wrong here, and you do not need to explain yourself to anyone.
References
1. Refilling prescriptions; issuance of multiple prescriptions. 21 CFR §1306.12. Electronic Code of Federal Regulations. https://www.ecfr.gov/current/title-21/chapter-II/part-1306/section-1306.12
2. Ishøy PL, Johannessen KBE, Houmann T, Levin E, Thomsen PH. Drug survival and risk factors for ADHD medication discontinuation in adults: a Danish nationwide registry based cohort study. Acta Psychiatrica Scandinavica. 2024;150(3):160 to 173. doi:10.1111/acps.13724
3. Li L, Zhu N, Zhang L, et al. ADHD pharmacotherapy and mortality in individuals with ADHD. JAMA. 2024;331(10):850 to 860. doi:10.1001/jama.2024.0851
4. Patient's request for health care information. RCW 70.02.080. Washington State Legislature. https://app.leg.wa.gov/rcw/default.aspx?cite=70.02.080
5. Drug Enforcement Administration. Fourth temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications. Federal Register. 2025;90:61301. https://www.federalregister.gov/d/2025-24123
6. US Food and Drug Administration. FDA drug shortages database. https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm
7. Washington Medical Commission. Retention of medical records. Guideline GUI2017-02. https://wmc.wa.gov/sites/default/files/public/documents/GUI2017-02RetentionOfMedicalRecords.pdf
Clarity ADHD is a telehealth practice focused on adult ADHD care in Washington State that accepts transfers of care from adults whose prescriber has closed, retired, or stopped prescribing, alongside new evaluations and ongoing medication management. Now accepting new patients, and you can start with a free 15 minute consultation to see if it is a fit.
Book a Free 15-Minute ConsultationThe 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.