For students who rely on medication to treat Attention Deficit Hyperactivity Disorder (ADHD), this back-to-school season is particularly stressful. According to the National Community Pharmacists Association, 97% of pharmacists in the US have reported experiencing ongoing amphetamine drug shortages during the past 10 months.

While alternative generic medications have been approved by the U.S. Food and Drug Administration (FDA) to treat ADHD, the current back-to-school season is expected to cause an increased demand for ADHD medication—therefore putting additional strain on supply chains.

The FDA shortages website lists 11 different drugmakers who currently produce Adderall and its generic versions. The medicine has been intermittently available during the last several months, providing inconsistent treatment for those who rely on it daily.

“A lot of the young people that I’ve been treating have had difficulties getting their medications month to month,” Dr. Warren Ng, a professor of psychiatry at Columbia University Medical Center who also serves as president for the American Academy of Child and Adolescent Psychiatry, tells CNN.

Last month, the FDA and the Drug Enforcement Agency (DEA) issued a joint statement addressing the shortage of ADHD medication. They say a manufacturing delay last fall and higher prescription rates are responsible for the delay in production.

“We want to make sure those who need stimulant medications have access,” the FDA and DEA statement reads. “However, it is also an appropriate time to take a closer look at how we can best ensure these drugs are being prescribed thoughtfully and responsibly.”

The US Centers for Disease Control and Prevention has reported that stimulant prescriptions rose particularly quickly among young adults during the pandemic, likely due to the accessibility of telehealth medicine.

Dr. Ryan Marino, an emergency medicine physician at Case Western Reserve University School of Medicine, tells that he’s critical of the role the DEA plays in determining the amount of ADHD medications that go on the market. Because these medications are stimulants, the DEA considers them to be controlled substances. This means that for medications like Adderall, the DEA is in charge of setting “quotas” for how much supply is produced.

Marino feels the agency should raise its quota to meet the current demand amid the manufacturing issues.

“The DEA is not a medical organization — they are law enforcement and prosecutors,” Marino said. “It’s a little strange that they are setting these quotas, and making determinations of what prescriptions are legitimate or not, without having any sort of medical facilities to do so.”

What happens when children can’t get their ADHD medication?

When forced to go without their medication, many children with ADHD fail classes, are held back from going to the next grade, get sent to the principal’s office and have trouble doing homework, Ng told CNN.

He said when students with ADHD receive proper drug treatment, “it can really change a young person’s life overnight. Suddenly they are able to do the work that they want to do.”

When a child with ADHD is taking stimulant medication to treat it, the medication changes the level of dopamine in the child’s brain. Dopamine is a neurotransmitter that plays a key role in the brain’s ability to pay attention and focus. By taking medications like Adderall, Ritalin, and others, it helps to increase the dopamine in the brain to the optimal level, according to the Child Mind Institute. The “optimal level” is a level comparable to kids without ADHD.

Untreated ADHD can cause children to struggle in school, leading to poorer academic performance and socializing than if they were treated properly. Children with ADHD who aren’t treated properly have a notably more difficult time learning impulse control, emotional regulation, and social skills.

Without access to proper ADHD medication, many parents told CNN and they’re worried about their children becoming frustrated, withdrawn, and depressed—a frustrating and stressful situation for families at the very beginning of a new school year.