In the United States, we first started experiencing shortages of Adderall, one of the more popular treatments for ADHD in adults, last year. While the shortage of Adderall was initially explained as a pandemic-related supply chain issue, it turns out that the problem is more related to increased demand and a spike in the number of patients accessing treatment using telehealth. Nearly 40 percent of all prescriptions for stimulants last year occurred in the context of telehealth visits, compared to less than 2 percent before the pandemic.
A recent report published by the Center for Disease Control and Prevention (CDC) documented a steady increase in the number of stimulant prescriptions for adults in the United States over the last five years. The most significant increase was observed during the pandemic (between 2020 and 2021), particularly in women.
In a recent editorial published in the Journal of Attention Disorders, ADHD experts, including Craig Surman, MD, Director of the Adult ADHD Research Program at Mass General Hospital, take a closer look at this trend. More specifically, they comment on whether this rapid increase in ADHD treatment-seeking is a cause for alarm.
It could mean that recognition of ADHD in adult women has finally improved and now women are facing fewer barriers to obtaining appropriate care. Many adult psychiatrists and primary care practitioners have received no formal training on ADHD; these data may convince providers to learn more about ADHD in adults and women so that they can help shoulder the growing need for adult ADHD care.
The authors of the editorial note this increase may be medically appropriate. They note that historically women and older adults with ADHD have been less likely to receive treatment for ADHD; stimulant prescriptions increased in women and in individuals over the age of 50. It is also likely that telehealth facilitated access to care for individuals in rural regions and for others traditionally unable to pursue treatment due to other obstacles. Although stimulant prescriptions increased between 2016 and 202, current prescription rates more closely parallels the expected prevalence of ADHD in adults.
Of course, questions remain, and future research will help us to better understand the recent increases in stimulant prescriptions.
Although ADHD occurs in 3% to 5% of adults, clinicians rarely receive relevant training in the treatment of adult ADHD. Many have misconceptions about adult ADHD or may not even consider the diagnosis of ADHD in adults. Provider education is particularly necessary now as professionals join the workforce in order to absorb a growing demand for mental health services. Practice guidelines for adult ADHD are currently being drafted by the American Professional Society for ADHD and Related Disorders (APSARD; https://apsard.org/us-guidelines-for-adults-with-adhd/) in collaboration with Children and Adults with ADHD (CHADD; www.chadd.org).
Craig Surman, MD discusses this editorial in a recent interview published HERE.
Read More
Sibley MH, Faraone SV, Nigg JT, Surman CBH. Sudden Increases in U.S. Stimulant Prescribing: Alarming or Not? J Atten Disord. 2023 Apr; 27(6):571-574.
In The News
A ‘perfect storm’ led to an ADHD medication shortage. Here’s why (PBS News Hour)
Recent Increase in Adult Stimulant Prescriptions for ADHD May Be Warranted but More Research and Education is Needed, Experts Say (Mass General News)
Shortage of ADHD medicines: Advice on coping if you are affected (Harvard Health)
How to Tell the Difference Between Regular Distraction and A.D.H.D. (New York Times)
Craig Surman, MD is the Director of the Adult ADHD Research Program at Massachusetts General Hospital and an Associate Professor of Psychiatry at Harvard Medical School. His research focuses on improving the assessment and treatment of ADHD in adulthood and better understanding the impact of ADHD, as well as its relationship to illnesses that are often comorbid with ADHD.
