Adult ADHD Stimulant Prescriptions Rise Sharply During Pandemic

Prescribing of stimulant medications for adult ADHD increased substantially in several countries during the COVID-19 pandemic, with new patterns emerging in both the volume and method of prescribing.

Between January 2020 and January 2023, England recorded a 91% rise in adults prescribed central nervous system stimulants or ADHD medications, with patient numbers growing from 37,844 to 72,376. In Ontario, Canada, the number of adults starting stimulant prescriptions more than doubled over a similar period, based on data covering over 327,000 adults from January 2016 to June 2024.

In the United States, prescriptions for Schedule II stimulants increased by about 14% during the pandemic, while non-stimulant ADHD medications rose by roughly 32%. The largest increases were observed among adults aged 20 to 39 and among females. A CDC study found that adult stimulant prescriptions in the U.S. rose by more than 10% during the first year of the pandemic.

Telehealth played a major role in the U.S., where nearly 40% of stimulant prescriptions were issued via remote consultations during the pandemic, compared to less than 2% before. Policy changes that relaxed in-person requirements for controlled substances contributed to this shift in prescribing practices.

What the numbers show

• England: 91% increase in adult stimulant prescriptions from 2020 to 2023
• Ontario: Over 327,000 adults received at least one new stimulant prescription between 2016 and 2024
• U.S.: Schedule II stimulant prescriptions rose by 14% during the pandemic
• U.S.: Telehealth accounted for nearly 40% of stimulant prescriptions during the pandemic

In Ontario, the share of new stimulant prescriptions written by nurse practitioners rose from 2% to 10% during the pandemic, while the proportion from psychiatrists declined from 26% to 18%. Just under 29% of adults receiving a new stimulant prescription in Ontario had a prior healthcare visit for ADHD, with a median gap of 2.2 years between the visit and the prescription.

Among new stimulant recipients in Ontario, the proportion with anxiety or depression diagnoses fell from 30.8% in February 2020 to 23.2% in June 2024, though the absolute number of such patients increased. In the U.S., an estimated 15.5 million adults had a current ADHD diagnosis in late 2023, with about one-third using stimulant medication in the previous year. Of those, 71.5% reported difficulty filling their prescriptions due to unavailability.

Institutional reviews have addressed the implications of these trends. The CDC stated that while increased access to stimulants may have benefited some adults, concerns remain about the adequacy of ADHD evaluations and the potential for inappropriate prescribing. Researchers in Canada noted that the rapid rise in adult stimulant prescribing may indicate improved recognition of ADHD, especially among women, but also highlighted questions about diagnostic practices and possible misdiagnoses.

Industry reaction

The CDC has highlighted the lack of clinical practice guidelines for adult ADHD treatment in the U.S. as a public health concern, given the ongoing rise in stimulant prescribing. The agency stated that clearer guidance could help address issues related to evaluation and medication use among adults.

Researchers reporting in the Canadian Medical Association Journal stated that the increase in adult stimulant prescribing may reflect both greater awareness and potential diagnostic challenges. They noted the importance of continued monitoring and assessment of prescribing practices as trends evolve.

* This article is based on publicly available information at the time of writing.