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A new analysis of Canadian prescription data shows a sharp rise in stimulant medications since the COVID-19 pandemic began — a trend with immediate implications for diagnosis, care pathways and public health. The study, covering January 2016 to June 2024, suggests faster treatment starts and changing patient demographics, prompting debate over whether the surge reflects better detection or looser prescribing practices.
What the study measured
Researchers examined prescription records over an eight-year span and found a sustained increase in stimulant dispensing to adults. By June 2024, the monthly prescribing rate reached 10.4 per 1,000 people — a rise the authors describe as more than sevenfold compared with the beginning of their dataset.
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The analysis was published in the Canadian Medical Association Journal and tracked both who received prescriptions and which clinicians wrote them. The paper flags faster time from a patient’s first ADHD-related healthcare visit to their first prescription during the pandemic years.
Key numbers at a glance
| Measure | Finding |
|---|---|
| Study period | January 2016 – June 2024 |
| June 2024 prescribing rate | 10.4 per 1,000 adults per month |
| Female share of new recipients | 48% before pandemic → 59% during pandemic |
| Fastest-growing age group | Adults aged 25–34 |
Who is being treated — and by whom
The demographic picture shifted notably. Women now represent a larger share of new stimulant prescriptions than before the pandemic, and young adults in their late 20s and early 30s show the steepest increase. The study also documents a change in prescribers: while psychiatrists’ prescribing remained relatively steady, primary care clinicians and nurse practitioners wrote many more stimulant prescriptions over the period studied.
ADHD diagnoses in adulthood — particularly the inattentive presentation that can be less obvious in childhood — are a likely part of the explanation, clinicians told the researchers. But other forces may be at play.
Why clinicians say the rise matters now
Dr. Nissa Keyashian, a California psychiatrist and author, noted that many women only receive an ADHD diagnosis later in life because symptoms were missed when they were children. She warns that greater awareness can lead to needed treatment — but that it also requires careful evaluation.
Jonathan Alpert, a psychotherapist in New York and author of a recent book on therapy, emphasized the cultural context: digital overload, relentless productivity pressures and blurred boundaries have increased the number of people seeking help for attention and focus problems. Alpert cautioned that not every concentration difficulty is a chronic disorder and that medication should address a diagnosed condition, not serve primarily as a short-term performance aid.
- Faster prescribing: Shorter intervals between first visit and first stimulant prescription raise questions about assessment thoroughness.
- Telehealth’s role: The expansion of virtual clinics during the pandemic may have increased access — and, in some cases, accelerated diagnoses.
- Off-label use: Some stimulants might be prescribed alongside treatments for depression or anxiety, which also rose during the pandemic.
Keyashian suggested that the growth of large telehealth providers could be a factor in broader diagnostic reach — and in some cases, diagnoses made without in-depth, longitudinal assessment.
Study limits and open questions
The authors acknowledge several caveats: they did not have fine-grained clinical records to evaluate diagnostic rigor, and the findings may not generalize to every region. The data set identifies prescription patterns but cannot definitively say whether every new prescription followed a comprehensive ADHD evaluation.
That uncertainty feeds the broader question clinicians and policymakers must answer: are we seeing improved recognition and treatment of a previously underdiagnosed condition, or a lower threshold for prescribing stimulant medications in a stressed, digitally intense era?
Practical guidance for people who suspect ADHD
If you think you might have ADHD, specialists advise a careful route. Seek an evaluation from a clinician with specific experience in adult ADHD, ask about their diagnostic approach, and consider both medication and nonpharmacologic strategies as part of a treatment plan.
As the debate continues, this study serves as a timely reminder that rapid increases in medication use deserve scrutiny — not to stigmatize care, but to ensure diagnoses are accurate and treatment is appropriate for each patient.
The research was published in the Canadian Medical Association Journal.
