An estimated 15.5 million adults in the United States—roughly 1 in 16—have been diagnosed with attention deficit/hyperactivity disorder (ADHD), according to a survey analysis in Morbidity and Mortality Weekly Report. The analysis also found that nearly half of adults with ADHD reported using telehealth and that most who take stimulant medications for their ADHD have had problems filling their prescriptions over the past year.
These findings come at a time of ongoing ADHD medication shortages and uncertainty as to whether COVID-19 flexibilities regarding stimulant prescribing via telehealth will remain in effect after December 31.
“As policies are currently developed and evaluated related to ADHD clinical care for adults, access to prescription stimulant medications, and flexibilities related to telehealth, [our] results can guide clinical care and regulatory decision-making,” wrote Brooke S. Staley, Ph.D., of CDC’s National Center on Birth Defects and Developmental Disabilities, and colleagues.
Staley and colleagues used data from roughly 7,000 adults who completed surveys for the National Center for Health Statistics Rapid Surveys System in October and November 2023. Participants were asked whether they had been diagnosed with ADHD by a doctor or other health professional, and, if so, whether they currently had ADHD. Respondents reporting current ADHD received follow-up questions regarding medication use (categorized as stimulant or nonstimulant medications) and/or other treatments, difficulty obtaining prescription medication, and use of telehealth services for their ADHD care.
According to the researchers’ estimates, 6% of U.S. adults had current ADHD diagnosis, of whom slightly more than half received their diagnosis in adulthood. Furthermore:
- 35.2% were prescribed medication and had received counseling or behavioral treatment in the previous 12 months.
- 15.1% were prescribed medication only.
- 13.3% received counseling or behavioral treatment only.
- 36.5% had not received any treatment.
Among adults who reported taking a stimulant medication, 71.5% reported difficulty getting their ADHD prescription filled during the previous 12 months because their medication was not available.
“Patients experiencing these difficulties might seek medication outside the regulated health care system, increasing their risk for overdose because of the prevalence of counterfeit pills in the illegal drug market, which might contain unexpected substances such as fentanyl,” Staley and colleagues wrote.
Regarding telehealth, the researchers found that among adults with ADHD:
- 46% reported ever receiving telehealth services for their condition.
- 8.9% received their diagnosis via telehealth only.
- 9.5% received their diagnosis through a combination of in-person and telehealth visits.
- 30.5% used telehealth to obtain a prescription for ADHD medication, while 30.8% used telehealth to receive counseling or therapy for ADHD since the start of the COVID-19 pandemic in March 2020.
In October 2023, the Drug Enforcement Administration (DEA) and the Department of Health and Human Services extended COVID-19 flexibilities regarding stimulant prescribing via telehealth without an initial in-person medical evaluation through December 31, 2024. Last Thursday, the DEA sent a nonpublic draft proposal for a third temporary extension of these flexibilities to the White House’s Office of Management and Budget (OMB), but the OMB has not yet made a decision.
For related information, see the Psychiatric News articles “Months Later, Stimulant Shortage Persists,” and “Adult Stimulant Initiations Via Telemedicine Found to Rise at Height of Pandemic.”
(Image: Getty Images/iStock/AntonioGuillem)
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