A new Canadian analysis finds stimulant prescriptions for adults have surged since the pandemic, shifting who gets diagnosed and who writes the prescriptions, and raising fresh questions about diagnosis practices and telehealth’s role in quick treatment decisions.
Stimulant use among adults climbed dramatically between January 2016 and June 2024, with monthly prescribing reaching 10.4 per 1,000 people by June 2024. That figure represents a more than sevenfold increase since the study began, and prescriptions more than doubled after the pandemic started. The trend tracked similar upticks reported in several other countries.
The makeup of people receiving those drugs changed too. Before the pandemic, 48% of new stimulant recipients were female, a share that rose to 59% during the pandemic, and the fastest growth showed up in adults aged 25 to 34. Researchers also saw that the time from a patient’s first ADHD-related health visit to their first prescription shortened during the pandemic era.
Clinicians on the front lines say that shift feels familiar. “In my practice and that of many of my colleagues, many people, particularly women, have received a new diagnosis of ADHD, usually inattentive subtype, in adulthood,” Dr. Nissa Keyashian, a board-certified psychiatrist and author of “Practicing Stillness,” said. She noted many women had symptoms that were missed in childhood and only become obvious once they’re living independently and responsible for their own routines.
Not every clinician sees the rise as clear-cut evidence of more illness. “Those challenges can resemble ADHD, but they don’t always reflect an actual diagnosis,” Jonathan Alpert, a psychotherapist, explained. He warns that modern life with constant digital demands can mimic attention problems without meeting clinical criteria, and that labeling those struggles as a disorder can be risky.
The study also flagged who is doing the prescribing: psychiatrists’ stimulant prescriptions held steady while primary care providers and nurse practitioners increasingly wrote them. The growth of large telehealth companies during the pandemic likely played a role by offering fast access to evaluations and prescriptions, which may have accelerated treatment for people with genuine need but also made it easier to get medication without a thorough workup.
Experts emphasize the importance of careful assessment before medication is started. “Medication should treat a disorder, not become a performance enhancer,” Alpert said, pointing to concerns about psychological reliance and the risk of turning normal life difficulties into medical problems. Keyashian recommends patients who suspect ADHD seek out a psychiatrist experienced in that diagnosis and ask doctors about their experience and expertise.
Researchers acknowledged limits to their analysis, including not having full access to detailed medical records and uncertainty about how well the trends generalize across all regions. Some stimulants might have been used off-label as adjunctive therapies for depression or anxiety, conditions that also rose during the pandemic, complicating interpretation of prescribing trends.
Clinicians are left balancing two realities: more people are getting help for focus and concentration issues, and the healthcare system now routes many of those patients through faster, less specialized paths. “We’re living in a culture that increasingly pathologizes normal human difficulty, and that should be concerning to everyone,” Alpert said. “Many people today feel mentally scattered,” he added. “The challenge is figuring out whether we’re seeing more [of the] disorder — or simply the cognitive strain of a hyper-distracted world.”
The research was published in the Canadian Medical Association Journal and highlights a mix of gains and concerns: improved access on one hand and the need for rigorous, specialist evaluation on the other. As demand for treatment evolves, clinicians and patients will need to weigh speed of access against the gold standard of careful diagnosis and follow-up care.
