Andorra Faces ADHD and Opioid Medication Shortages

Andorra is facing ongoing shortages of medications for ADHD and certain opioids for severe pain, forcing doctors to prescribe alternatives and complicating patient care.

The wholesale distributor has been unable to supply Elvanse—containing lisdexamfetamine—in any of its three available dosages to pharmacies, a situation expected to persist until late April. In a late February circular, the Health Ministry notified pharmacies of the issue and instructed doctors to switch to methylphenidate-based options such as Rubifen, Medikinet, or Rubicrono. These alternatives became viable after earlier shortages of methylphenidate products resolved.

The ADHD supply chain has been unstable for months, exacerbated by rising demand for lisdexamfetamine treatments in 2024 and 2025 amid previous methylphenidate disruptions. Patients now face additional hurdles, as pharmacies must inform them of the Elvanse shortage and request new prescriptions from their physicians.

To manage distribution, the ministry has introduced temporary restrictions: these ADHD medications can only be dispensed to Andorran residents and for treatments lasting no more than one month.

Separately, opioid shortages are affecting pain relief options. At the end of January, Actiq in 200 and 400 microgram strengths—used for severe pain—was unavailable, with the Spanish Medicines Agency indicating the issue could last for months. Abstral, an alternative with the same active ingredient fentanyl and also administered orally, was recommended. However, shortages of Abstral began late last month, leaving fewer options for patients.