More US adults relying on ADHD meds

Dr Muzina

Attention deficit hyperactivity disorder (ADHD) prescriptions for US adults have more than doubled from 2008 to 2012, according to a report by Express Scripts.

The report, Turning Attention to ADHD, indicated a 53% increase in ADHD prescriptions for adults and a 84% increase in ADHD prescriptions for young adults during the five-year study. In 2012, 2.6 million adults and 640,000 young adults received ADHD prescriptions. Additionally, 5.7% of all children age 4 to 18 years were being prescribed medications for the disorder in 2012, according to the report.

Between 2008 and 2012, the number of Americans who used medication to treat ADHD rose 36%, totaling more than 4.8 million privately insured individuals in 2012. Most surprisingly, the greatest increase in use over the 5-year period was among adults, with the largest gains seen in women aged 26 to 34, climbing 85%. Another surprising finding was that more college-age women are taking these drugs than girls aged 18 and younger, which is just the opposite of what is seen among men, whose use of these drugs drops sharply when they reach aged 18 years.

ADHD awareness

“Awareness of ADHD overall has likely led to an increase in the use of the medications,” said David Muzina, MD, a psychiatrist and Express Scripts’ vice president of specialist practice.

Among adults, part of the increase is fueled by the fact that 30% of Americans carry the condition into adulthood, according to Dr Muzina.

“Among young adult and adult women, there are a few potential drivers, including the possibility of a missed diagnosis in childhood,” he said. “Girls tend to present the inattentive form of ADHD, and the lack of hyperactive behavior may mean their condition goes unnoticed until they become an adult and recognize the symptoms and consult a physician. Also, as women try to do it all both at home and in their careers, achievement demands and expectations in college may possibly fuel the increase [in utilization] in adult women experiencing ADHD-like symptoms.”

“While we now know that ADHD is not just a childhood disease, the rapid increase in the use of ADHD medication among adults is striking given that little research has been done on how these treatments affect an older population,” said Dr Muzina. “Stimulants are most commonly used, and while effective at treating the symptoms of ADHD, do have risks associated with their use. There are safety concerns for people with heart conditions, and they may cause interactions with other medications and conditions.”


Prescribing ADHD medications should never be done lightly, according to Dr Muzina.

“Physicians should do a thorough psychosocial assessment of the patient before making an ADHD diagnosis and prescribing drug treatments,” he said. “Also, managed care should seek to implement clinical safety programs that can help protect patients against adverse reactions, and help identify and prevent fraud and misuse of these controlled medications.”

With ADHD medication abuse being a growing problem, Express Scripts specialist pharmacists are also on the lookout for any suspicious use of these medications that could indicate potential abuse of the drugs. If abuse is suspected, Express Scripts’ Fraud, Waste and Abuse program can investigate and, when necessary, will refer to the proper legal authorities.  

In its 2013 Drug Trend Forecast, Express Scripts noted that medication to treat ADHD was 1 of only 2 traditional therapy classes expected to see increases in utilization over the next 5 years.