ADHD medication surges for young women
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Illustration: Aïda Amer/Axios
Stimulant use has spiked in the post-pandemic era, particularly among young adult women.
Why it matters: Demand for ADHD medications is surging, but the drugs may not be reaching the people who need them the most.
Driving the news: The latest data point comes from Trilliant Health, which found a 94% increase in stimulant prescriptions for commercially insured women ages 18-44 between 2018 and 2024.
- Among men the same age, Trilliant found a 65% increase.
The analysis also found a marked change in who prescribes the drugs.
- In 2018, the top prescriber groups were primary care providers (39% of prescriptions) and psychiatrists (24%).
- By 2024, "allied health" professionals like nurse practitioners and physician assistants had risen to the top spot, responsible for 34% of prescriptions.
The big picture: ADHD awareness has coincided with a significant increase in prescriptions for drugs like Adderall and Vyvanse, leading to large spikes in demand that have depleted supplies and led to a yearslong stimulant shortage.
- The rise of telehealth platforms offering prescriptions for such medications was initially lauded as a model for the future and a way to reach underserved populations.
- But that narrative eventually took a darker turn. Last year, two executives of telehealth company Done were convicted for their roles in "a years-long scheme to illegally distribute Adderall over the internet," per the Justice Department.
- "These criminals turned telehealth into a pipeline for addiction, recklessly distributing controlled medications with no regard for safety, science, or the law," the Drug Enforcement Administration's Cheri Oz said in a statement.
Between the lines: Two things are likely true: There are still a lot of people who need stimulants who aren't getting them, and there are also people currently taking ADHD medication who don't need them, said Columbia University psychiatry professor Mark Olfson.
- One particular problem is diagnosis, especially since it's increasingly done by generalists.
- "ADHD is a difficult diagnosis to make for non-specialists, particularly for people who are presenting without a history of being assessed during childhood," Olfson said.
- "We don't yet have well-established, national practice guidelines for the treatment of adult ADHD, and without that it's a lot more complicated to diagnose in an office-based setting if you're a generalist than it is to diagnose, say, depression," he added.
The bottom line: The U.S. is still facing an enormous mental health care shortage. Some of the solutions in place may be having unintended consequences.
