A provider-focused briefing on the amphetamine/dextroamphetamine IR shortage in 2026: timeline, prescribing implications, alternatives, and patient tools.
The amphetamine mixed salts (generic Adderall IR) shortage, which began in October 2022, continues to impact patients and prescribers heading into 2026. While the supply picture has improved compared to the crisis-level scarcity of 2023, clinicians are still fielding calls from patients who cannot fill their prescriptions.
This article provides an evidence-based overview of the current shortage status, its systemic causes, and practical guidance for managing your prescribing workflow during continued supply constraints.
Understanding how we got here helps contextualize current decision-making:
The shortage creates several challenges for prescribers:
Patients who have been unable to fill prescriptions may present with worsened ADHD symptoms, functional impairment, or anxiety about medication access. Some may have self-adjusted doses or borrowed medication. A non-judgmental approach to these conversations is important.
When switching patients to alternative medications (e.g., from amphetamine/dextroamphetamine IR to lisdexamfetamine or methylphenidate), insurance plans may require prior authorization — adding administrative burden at a time when practices are already strained.
Schedule II prescriptions cannot include refills. Each fill requires a new prescription. Electronic prescribing of controlled substances (EPCS) is now required in most states, which has streamlined the process but still requires a new prescription for each 30-day supply.
Following the DEA's post-pandemic rulemaking, telehealth prescribing of Schedule II stimulants has become more regulated. Confirm that your telehealth prescribing practices comply with current federal and state requirements, particularly regarding initial evaluations and in-person visit requirements.
As of early 2026:
Cost is a significant barrier for many patients, particularly the uninsured:
There are no active manufacturer savings programs for generic amphetamine/dextroamphetamine. Patient assistance through NeedyMeds and RxAssist may be available for qualifying patients. Directing patients to discount card programs can meaningfully reduce out-of-pocket costs.
Medfinder for Providers offers tools that can help streamline the medication access process:
For detailed guidance on integrating these tools into your workflow, see our companion article: How to help your patients find amphetamine/dextroamphetamine IR in stock.
Several developments may improve the supply situation through 2026 and beyond:
However, the structural factors that created this shortage — strict DEA production controls, rising demand, concentrated manufacturing — will take time to fully resolve.
The amphetamine/dextroamphetamine IR shortage has placed an extraordinary burden on patients and the clinicians who care for them. As prescribers, the most impactful actions you can take are:
For patient-facing resources you can share, see our articles on how to find amphetamine/dextroamphetamine IR in stock and alternatives to amphetamine/dextroamphetamine IR.
You focus on staying healthy. We'll handle the rest.
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