A new study from the Centers for Disease Control and Prevention confirms suspected trends in attention-deficit/hyperactivity disorder diagnoses in adults and stimulant prescriptions during the COVID-19 pandemic. A paired commentary led by Margaret H. Sibley of the University of Washington School of Medicine charts a post-pandemic path forward.
The study and commentary appear today in the Journal of Attention Disorders.
“I think it’s time that ADHD takes its rightful place as a primary condition in the field of adult mental health,” said Sibley, an associate professor of psychiatry & behavioral sciences at the UW School of Medicine. “I think that for so many years, we saw ADHD as a disorder of childhood that people grow out of. Now that we realize that it’s something that’s a lifespan disorder, we need to catch our adult providers up on the training of what it takes to identify adult ADHD. There are also a lot of patients who are not identified as children and are coming to clinical attention for the first time as adults, and they look a lot different than hyperactive boys who can’t sit still.”
Adult women, in fact, were the primary drivers of new stimulant prescriptions during the pandemic, with a sharp spike of more than 10% in 2020-21, the study found. The increase contributed to Adderall and treatment shortages that affected those with longstanding diagnoses.
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Likely reasons for this are many, Sibley said. The pandemic strain might have disproportionately affected women and led them to feel overwhelmed and seek help. In parallel, the online upsurge in sharing information about ADHD on TikTok may have influenced women to seek help. Sibley said providers also were able to prescribe stimulants online without seeing patients in person due to the suspension of the Ryan Haight Act.
The findings show a great need to meet this new demand, and to scale up the providers who can diagnose adults, said Sibley and her co-authors from SUNY Upstate Medical School, Oregon Health and Science University and Harvard Medical School.
Sibley said professional organizations such as the American Professional Society for ADHD and Related Disorders and Children and Adults with Attention-Deficit/Hyperactivity Disorder are collaborating on new guidelines to effectively diagnose and treat adults. But there simply aren’t enough resources currently to handle the surge.
“I don’t think the health care industry is prepared yet,” Sibley said. “Beyond the guidelines, we need really good provider training because with increased patients seeking treatment for ADHD, we need more providers as well.”
Finding undiagnosed ADHD sufferers is a good thing, the authors suggested, but there’s a need to evaluate ADHD through a modern lens.
“We need to hear from the women who sought stimulant prescriptions for the first time during this time period to understand exactly what led them to seek care and whether the medication that they received helped them,” Sibley said. “There was a lot of off-label prescribing that was found in the CDC report, which means people without a documented ADHD diagnosis received stimulant medications. So we also need to understand exactly what they’re receiving those medications for.”
Download broadcast-ready soundbites featuring Sibley analyzing the CDC study’s findings.
Sibley authored the commentary with Stephen V. Faraone of SUNY, Joel T. Nigg of OHSA and Craig B.H. Surman of Harvard. A disclosure of potential conflicts of interest appears in the commentary.
Written by Chris Talbott – 206-543-7129, [email protected]
