A recent study has revealed a remarkable surge in the number of adults in Ontario beginning treatment with stimulant medications, primarily for attention deficit hyperactivity disorder (ADHD), following the COVID-19 pandemic. This trend highlights a significant shift in the demographics of ADHD treatment, with women emerging as the predominant new consumers of these medications, a stark contrast to their historical association with hyperactive boys.
Dramatic Increase in Prescriptions
The research, published on Monday in the Canadian Medical Association Journal (CMAJ), indicates that over 220,000 adults in Ontario filled prescriptions for stimulants like Vyvanse and Concerta in the four years following March 2020. This figure more than doubles the approximately 107,000 adults who initiated treatment in the preceding four years. Initially, there was a sharp decline in prescriptions when the pandemic first struck, as healthcare services were largely diverted to combat the virus. However, as the situation stabilised, prescriptions surged, particularly among women, who accounted for 59% of new users during this period, compared to only 48% before the pandemic.
Mina Tadrous, a pharmacist and drug policy researcher at the University of Toronto, noted, “We don’t often see this rapid of a growth in a drug class, especially one that has been around for so long. We’re trying to raise the flag to say, ‘We need to look at this.’”
Contributing Factors to the Rise
The CMAJ study aligns with findings from previous research indicating an increase in ADHD prescriptions among adults, especially women. A December study published in JAMA Network Open corroborated similar trends in Ontario, while similar patterns have been observed across various countries, including the United States and the UK.
According to Daniel Myran, a research chair in family and community medicine at North York General Hospital and co-author of the December paper, the rise in adult ADHD diagnoses is still being explored. He noticed a growing number of young adults requesting stimulant prescriptions after receiving ADHD diagnoses from for-profit virtual care clinics. Notably, the study found that 29% of new patients received their prescriptions through virtual consultations after March 2020, a dramatic increase from nearly zero prior to the pandemic when telemedicine was not widely adopted in Canada.
“This can be done very quickly from the comfort of your home,” Dr. Myran explained. “That can make it easier for someone who really has ADHD to get a diagnosis but can also lead to overdiagnosis.”
Overdiagnosis and Its Implications
Concerns surrounding overdiagnosis of ADHD have emerged alongside this increase. Stimulants, which enhance focus, attention, and energy, come with potential side effects, including an elevated risk of cardiovascular diseases with long-term use. In rare instances, inappropriate prescriptions can trigger manic episodes in individuals with other mental health conditions.
The phenomenon has sparked various hypotheses among researchers. Some suggest that the pandemic’s emphasis on screen-based lifestyles has genuinely increased ADHD symptoms, while others point to the influence of social media platforms like TikTok, where ADHD-related content may have heightened awareness and led individuals to self-diagnose. Additionally, there is a growing recognition among clinicians of ADHD in women, who may have masked their symptoms throughout their lives due to societal expectations and behaviours.
Emma Climie, a registered psychologist and associate professor at the University of Calgary, highlighted that some of the highest rates of new ADHD diagnoses are now being observed among women in their 30s and 40s. Climie and her colleague Brandy Callahan are currently conducting a long-term study focusing on adult women with ADHD. “Some women awaken to their ADHD symptoms when their children are diagnosed,” she noted, underscoring the disorder’s genetic aspects. For many, the coping mechanisms that once worked falter under the pressures of career demands and parenting responsibilities. “They’re burned out, they’re exhausted,” Climie said. “They’re really struggling with, ‘Why does it look like everybody else has everything together? And I’m not able to do this?’”
Why it Matters
The rising trend in ADHD diagnoses and stimulant prescriptions among adults, particularly women, raises important questions about mental health awareness, access to treatment, and the potential for overdiagnosis. As more individuals seek help, it is crucial for healthcare providers to ensure accurate diagnoses and responsible prescribing practices. This shift not only reflects a changing understanding of ADHD but also highlights the need for ongoing research and dialogue around mental health, especially as societal pressures continue to evolve in a post-pandemic world.
