In recent years, there has been a marked increase in prescriptions for Attention Deficit Hyperactivity Disorder (ADHD) medications, particularly among women aged 35 to 64. This trend, highlighted in a new analysis conducted by researchers at the National Institute on Drug Abuse, shows a significant rise in stimulant prescriptions such as Adderall and Ritalin for middle-aged and older women. The study, published in JAMA Psychiatry, also delved into patterns of misuse, revealing that this demographic is among the least likely to misuse these medications.
According to the analysis, 1.7 million women in the 35 to 64 age bracket were prescribed stimulants by the end of 2022, a substantial increase from 1.2 million in 2019. This escalation in prescriptions aligns with a broader uptick in ADHD diagnoses and treatment since the onset of the COVID-19 pandemic, a time when telehealth services became more widespread and accessible. The pandemic-induced shift in healthcare delivery likely facilitated easier access to diagnosis and prescriptions for adults who may have previously gone undiagnosed.
To better understand the scale and nature of stimulant use, the researchers examined data from over 83,000 adults aged 18 to 64, gathered through the 2021-2022 National Surveys on Drug Use and Health. Additional prescription data was sourced from the 2019-2022 IQVIA Total Patient Tracker and National Prescription Audit New to Brand databases. This comprehensive dataset allowed the team to assess not only prescription trends but also misuse patterns among different age and gender groups.
Misuse of prescription stimulants was defined as taking a higher dose than prescribed, using the medication at different times than directed, or taking medication that was prescribed to someone else. The study found that misuse was considerably lower among older women compared to their male counterparts and to younger women. Specifically, 13.7% of women aged 35 to 64 reported misuse, compared to 22.0% of men in the same age range and a striking 36.8% among younger women. Despite concerns about addiction, only about 9% of individuals with prescriptions were found to have prescription stimulant use disorder.
The study also observed that individuals prescribed amphetamines or methamphetamines were more likely to misuse their medication than those prescribed methylphenidate. This distinction underscores the importance of careful medication selection and monitoring, especially for adults newly diagnosed with ADHD.
One of the more puzzling aspects of the findings was the sheer magnitude of the increase in prescriptions among middle-aged women. Dr. Wilson Compton, deputy director at the National Institute on Drug Abuse and a co-author of the study, acknowledged the difficulty in explaining the dramatic rise. While increased awareness and improved access to healthcare may be factors, the exact reasons remain unclear.
Experts suggest that many women may have lived with undiagnosed ADHD for years, especially since symptoms in girls and women often manifest differently than in boys. Girls are less likely to display the hyperactivity and impulsiveness commonly associated with ADHD in boys, and instead may experience inattentiveness or internalized symptoms that are harder to recognize. As awareness grows about the presentation of ADHD in females, more women are seeking evaluations and receiving diagnoses later in life.
Ultimately, while the rise in stimulant prescriptions among older women is notable, the relatively low rates of misuse in this group offer reassurance. Continued monitoring and research will be crucial to understanding the long-term implications of this trend and ensuring that those with ADHD receive safe and effective treatment.
