Stimulant Prescriptions Surge During COVID Pandemic

Important points:

• From 2020 to 2021, stimulant prescriptions increased by more than 10% in certain age groups.
• Most patients prescribed stimulants encountered the ADHD diagnostic code in healthcare.

The proportion of people taking prescription stimulants increased from 2016 to 2021, increasing significantly in the first year of the COVID-19 pandemic, especially among adolescent girls and adult men and women. The data show that.

Melissa L. Danielson, MSPH, CDC statisticians and colleagues have found that in recent decades, prescription stimulant use, particularly for the treatment of ADHD, has increased among US adults and stabilized or declined among adolescents and children. It is written that

“Stimulants are one of the possible treatments that may benefit people with ADHD, but the potential harms associated with these drugs, such as side effects, interactions with other drugs, etc. Risk of Diversion and Misuse Overdose requires judicious prescribing and patient monitoring,” write Danielson and colleagues.

To illustrate trends in prescription stimulant fills before and during the COVID-19 pandemic, the researchers used MarketScan commercial claims data from 2016 to 2021 to find employer-sponsored health Have insurance and at least one dose of prescription stimulants.

Pandemic raises prices

Danielson and colleagues found that in 2016, 3.6% of enrollees took at least one prescription stimulant. In 2021, that figure will rise to 4.1% he. The largest year-on-year increase was from He 2020 to He increased by more than 10%.

The researchers wrote that several factors could have contributed to the increase in prescription stimulant use from 2020 to 2021. Not only has the pandemic exacerbated mental health and may have exacerbated ADHD symptoms, Telemedicine flexibility I could have contributed.

“Future evaluations may determine whether changes in policies and health care system reimbursement enacted during the pandemic contributed to the increase in stimulant prescriptions,” the researchers wrote.

adult ADHD care

Danielson and colleagues further noted that, consistent throughout the study period, most people prescribed stimulants encountered healthcare with an ADHD diagnostic code, receiving an average of seven or more prescriptions each year. ”

“The combination of increased latent needs and reduced barriers to access to prescription stimulants may have led more adults with ADHD symptoms to seek diagnosis and treatment,” they wrote. increase. “Although access to ADHD care has improved, Through telemedicine during a pandemic While it may have benefited some individuals with ADHD symptoms, it may have also resulted in inadequate ADHD assessments and the potential for inadequate stimulant prescriptions.

Daniela and colleagues write that the significant increase in the number of adults taking prescription stimulants during the pandemic “brings attention to the need for clinical practice guidelines for ADHD in adults.” , “The Institute of Clinical Guidelines, similar to those developed for children and adolescents by Pediatric Medicine, will help clinicians provide best-practice care for adult ADHD and help patients achieve better outcomes.” It may help.”

“Well-established professional guidelines exist for diagnostic procedures and treatment algorithms for children and adolescents with ADHD. However, similar diagnostic and treatment guidelines for adult ADHD are not available in the United States.” they write. “Because of the challenges associated with the differential diagnosis of ADHD and the general inadequate access to mental health providers trained in diagnosing and managing ADHD, this gap in guidance for ADHD care in adults is a major concern for the public. It’s a hygiene concern.”

Clinical implications and recommendations

In a related editorial, Dr. Margaret H. Sibley Associate Professor of Psychiatry and Behavioral Sciences at the University of Washington and Seattle Children’s Hospital and colleagues Journal of Attention Disorders The study “underscores the pervasiveness of ADHD as an adult psychiatric condition in routine clinical practice” and “needs a legitimate and more central place for ADHD in adult mental health care.” ”.

“Despite its prevalence, clinicians rarely receive relevant professional training and may be misunderstood or even unaware of ADHD in adults,” they wrote. I am writing. “Experts believe that ADHD is typically chronic and persists into adulthood, but is often associated with sequelae (such as addiction, depression, anxiety, and personality disorders) or non-traditional symptoms (such as women, minorities, and the elderly). ) is often overshadowed.”

Sibley et al. also noted the need for clinical guidelines, writing that “the United States is one of the last developed countries without formal ADHD practice parameters for adults.” However, practice guidelines are currently being drafted by the American Professional Association on ADHD and Related Disorders in collaboration with children and adults with ADHD.

“Additional guidelines and education should address non-ADHD stimulant use (such as narcolepsy, prolonged COVID, and chronic fatigue), including diversion, misuse, and abuse,” they noted.

To “unravel the CDC findings and organize the public health response,” Sibley and colleagues recommend:

• Further analysis of currently available data to answer open questions;
• Funding research on ADHD in adults.
• Be aware of the spread of misinformation about ADHD online.and
• Cross-disciplinary collaboration and support for adult ADHD practice guidelines and educational initiatives for providers.

References: