ADHD medication prescriptions have significantly increased in recent years, with a particularly sharp rise among middle-aged and older women. A recent study highlights not only this surge but also notes that these women are the least likely to misuse their prescription stimulants.
By the end of 2022, 1.7 million women aged 35 to 64 had been prescribed stimulants such as Adderall and Ritalin for ADHD, up from 1.2 million in 2019. The overall rise in prescriptions can be attributed to the pandemic’s impact and the increased accessibility of telehealth services. This new research, published in JAMA Psychiatry, also examined the misuse of these medications—defined as taking more than prescribed, using them at unapproved times, or consuming someone else’s prescription.
The study, using data from over 83,000 adults ages 18 to 64 who participated in the 2021-2022 National Surveys on Drug Use and Health, found a notable disparity in misuse. Among women aged 35 to 64, only 13.7% misused prescription stimulants compared to 22% of men in the same age group. This group also misused the drugs less than younger women, where 36.8% reported misuse.
There are three types of stimulants approved for ADHD treatment: amphetamines (Dexedrine, Adderall), methamphetamines (Desoxyn), and methylphenidates (Ritalin). The study found that around a quarter of all individuals with ADHD prescriptions reported misuse, with 9% suffering from prescription stimulant use disorder, or addiction. Those using amphetamines or methamphetamines were more likely to misuse their medication than those taking methylphenidates.
Researchers are still uncertain about why there has been such a sharp increase in ADHD prescriptions for older women. Dr. Wilson Compton, a study co-author and deputy director at the National Institute on Drug Abuse, expressed surprise over the growth in this demographic. Aaron Brinen, an assistant professor of psychiatry at Vanderbilt University, also noted that the number of older women being diagnosed is striking. This may reflect increased awareness, with women feeling more empowered to discuss their needs and struggles.
ADHD symptoms in girls are often subtler than in boys, leading to missed diagnoses. Girls are more likely to be overlooked due to their ADHD symptoms being less overt than those typically seen in boys, such as hyperactivity or impulsiveness. As Brinen points out, many women may have realized their ADHD went undiagnosed as children and, for the first time in their 50s, were able to seek treatment and find relief. This late diagnosis, however, can be a lifelong challenge, with untreated ADHD often leading to feelings of failure and depression.
Brinen suspects that women with ADHD are less likely to misuse stimulants because the medications help them feel more normal, rather than inducing a high. For many women, ADHD becomes increasingly difficult to manage as life circumstances change. Mariely Hernandez, a clinical psychologist and ADHD specialist, explains that women often cope until family responsibilities, such as managing young children, exacerbate symptoms. Hormonal changes, such as those experienced during menopause, can also worsen ADHD symptoms. Estrogen deficits can lead to a dopamine imbalance, which impairs attention and focus.
This surge in ADHD diagnoses and medication prescriptions among older women reflects a broader societal shift toward acknowledging and treating ADHD, especially in populations where symptoms were previously underrecognized. With greater awareness and treatment, these women are finding ways to live more fulfilling lives, although challenges remain.
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