Healthcare providers should be very concerned about the boom in adult stimulant prescribing. Unfortunately, this deeply concerning trend has been made worse by the lack of strong, clear clinical practice guidelines to counter it. The rise in these prescriptions, particularly among women aged 35 to 64, highlights a shift in understanding Attention Deficit Hyperactivity Disorder (ADHD) beyond childhood. The number of adult diagnoses is still skyrocketing, as is the trend of prescription stimulants being abused and causing addiction.
From 2019 to 2022, women ages 35 to 64 had the greatest increase in stimulant prescriptions. This demographic surge is part of a larger societal acknowledgment that ADHD does indeed continue into adulthood for a large proportion of those diagnosed in childhood. Studies show that most people diagnosed with ADHD during their youth still experience its effects well into their adult lives.
The adults being diagnosed with ADHD these days is increasing. This trend has produced more adult patients prescribed stimulants who subsequently developed an addiction. This increasing worry extends past the diversion of prescription drugs by those that are legally prescribed them, either intentionally or through theft. It includes the diversion of these drugs to people who have not acquired them through legitimate means.
Data on the misuse of stimulants is still very limited, creating difficulties for clinicians and policymakers as well. Recent research suggests that close to 10% of people using prescription stimulants will go on to develop prescription substance use disorder (PSUD). Misuse prevalence appears to be highest among younger adults aged 18 to 25, painting an important picture of a demographic that should be the focus of targeted interventions.
“Be mindful about with whom you share the fact that you have a stimulant prescription, especially in college.” – Wilson Compton, MD
It’s not surprising then that researchers have found this definition of misuse in these studies to be very expansive. Such a broad interpretation could encompass actions that many would contend don’t even amount to misuse. This added complexity adds an additional layer to deciphering and solving this growing problem.
Dr. Brooke S.G. Molina pointed out, “One of the things that is tricky about diagnosing in adulthood,” referring to the challenges that healthcare providers face in accurately identifying ADHD in older patients. She called attention to the need for more education and more resources for physicians who might be less familiar with adult ADHD.
“We need to give some guidance to these doctors so they can sort through it or refer to a psychiatrist.” – Brooke S.G. Molina, PhD
Additionally, prescription stimulants are less addictive and fatal than opioids. Their likelihood for abuse makes it a dangerous enough prospect to warrant alarm. Adult stimulant prescriptions have dramatically increased. Comprehensive, evidence-based clinical practice guidelines have not caught up, leaving health care providers without clear recommended management strategies.
Wilson Compton, MD, acknowledged the shift in societal views on ADHD treatment, stating, “We’ve seen marketing to individuals to remind them that ADD [attention deficit disorder] can be quite disabling, and that there are effective treatments.” This new visibility could lead to increased demand for stimulants prescriptions. It exposes significant gaps in our understanding of the sufficiency of existing guidelines and education.
While the number of stimulant prescriptions for adults has broadened dramatically in recent years, little data exists on the potential for adult stimulant misuse. The lack of clarity regarding key definitions and conduct related to misuse adds to the challenge, making it difficult to address this emerging crisis rightly and effectively.
According to the National Institute of Health, women ages 35-64 were less likely to misuse or be addicted than women ages 18-35. This demographic trend may reflect differing life experiences, social pressures, or levels of awareness regarding the risks associated with stimulant use. Despite this, the risk for abuse still poses a serious concern for health care providers of all ages.
It is thus the responsibility of doctors and other medical professionals to close this gap through increased education surrounding ADHD, especially as it pertains to adulthood. More adults than ever are getting treated for their ADHD symptoms. Healthcare providers need the best knowledge and tools available to diagnose and treat these issues effectively, but in a manner that prevents misuse.
“There’s a reason why these drugs are prescription and are classified as controlled substances,” – Wilson Compton, MD
Leave a Reply