Rosemary Majerus has been reading about the nation's prescription drug shortages for nearly a year, but the problem suddenly hit home last month when she found herself unable to obtain the medication she requires for a severe sleep condition.
For two weeks in December, Majerus was unable to fill her prescription, with the result that she reported to work late, left early and often nodded off while driving. It was an "absolutely horrible'' period, said Majerus, a working mother of three.
The average adult needs between seven and nine hours of sleep per day; without her medication, Majerus requires 18 to 20.
Majerus is among hundreds of Twin Cities patients reporting a scarcity of Ritalin, Adderall and their generic equivalents -- the latest example of prescription drug shortages that have popped up nationwide and caught the attention of federal regulators and the U.S. Senate.
The latest shortage has affected about 600 patients of the Minnesota Sleep Disorders Center at Hennepin County Medical Center.
Constance Ullevig, a registered nurse at the center, said patients have been frantic for a solution. Without medication, many face sudden daytime sleep attacks and excessive drowsiness.
"We are just people trying to get by," Majerus said.
Majerus said she sometimes spends her Sundays driving pharmacy to pharmacy to plan where she will place her prescription when she runs out of medication, at least until there is a better solution. Filling her prescription at her local pharmacy used to take minutes. Now, she said, she has to plan weeks ahead.
The U.S. Food and Drug Administration website blames the shortages on supply problems with the drug's active ingredient, "uneven product distribution patterns" and increased demand from patients.
Ullevig and Majerus said they believe the scarcity also results from quotas imposed by the U.S. Drug Enforcement Administration -- the drug is a controlled substance sometimes subject to abuse -- and internal industry conflicts that limit the availability of generic drugs in favor of their more expensive brand names.
Majerus' insurance company will cover only the generic versions of the stimulants; her prescription would cost $700 per month if her insurance didn't cover it.
"Who do these big businesses think they are, messing with our lives?" Majerus said.
Local pharmacies have a limited supply of the drugs, which are also used to treat attention deficit hyperactivity disorder for children and teens. Ullevig said the shortage began in October and there has been no indication when it will be resolved.
At a recent forum in the Twin Cities, Sen. Amy Klobuchar, D-Minn., discussed two pending bills to address the problem. One would require drugmakers to alert government regulators sooner when shortages are looming; the other would stop "pay-for-delay'' contracts in which name-brand drug manufacturers pay their competitors to keep generic substitutes off the market for a given period.
Ullevig said most of her patients are scrambling for supplies and living from one refill to another. Many have had to build short "power naps" into their workdays, she said. Others carefully ration medicine to make sure they are able to stay awake during the day. Few, she said, are able to afford more expensive alternative medications on the market -- some as costly as $1,000 per month.
"These people are just trying to fill in the hole so they have a little playing field," she said. "This is a huge, huge issue for them."
Amanda Bankston is a University of Minnesota journalism student on assignment for the Star Tribune.