Tenfold rise in ADHD meds still insufficient, say experts

The amount of ADHD medication dispensed to Kiwi adults has increased tenfold within 16 years, but most of those with the condition still aren’t receiving treatment, a new study reveals.

The study, published in the New Zealand Medical Journal today, involved almost 70,000 people who were prescribed ADHD medication. It found that rates increased tenfold – from 188 people per 100,000 of population to 819 per 100,000 – between 2006 and 2022.

ADHD, or attention deficit hyperactivity disorder, is a medical condition that affects concentration and/or hyperactivity or impulsivity.

The study also found that the number of children receiving ADHD medication increased threefold, from 566 per 100,000 in 2006 to 1722 per 100,000 in 2022.

The 2022 figures equate to 1.72% of all Kiwi children and 0.56% of adults, but the actual number of people estimated to have ADHD is higher – 5% of children and 2.58% of adults.

While prescriptions for ADHD medications were increasing, there was still a significant treatment gap, the study found.

It authors suggested the gap was caused by a strained mental health workforce, and mostly affected those without the resources to go through the private health sector.

Lead author Ben Beaglehole, a senior lecturer at the University of Otago’s Department of Psychological Medicine, said the study happened after the authors noticed a big upsurge in demand for assessments and treatment of adults with ADHD.

“Māori adults are less likely to receive treatment than Māori children or the overall population, suggesting that access to treatment may not be equitable.”

However, increasing ADHD treatment was not without controversy, and possible issues included having a greater pool of medication for potential misuse, and the medicalisation of distress, he said.

Senior supervising clinical psychologist Dougal Sutherland, of Victoria University of Wellington, said the study was further evidence of increasing rates of ADHD diagnoses in New Zealand, notably for people receiving a diagnosis for the first time in adulthood.

“It also highlights the lack of treatment options that are available for people who have ADHD ... Obtaining a thorough assessment for ADHD is a lengthy and often costly process, with many people going through private healthcare routes to obtain a diagnosis.”

He said it was likely that many people with ADHD were undiagnosed, not only due to affordability reasons but also workforce issues.

“There are many anecdotal examples of people seeking ADHD services being declined access in the public mental health service due to a shrinking workforce focusing only on the most immediate and urgent presentations.”

Royal New Zealand College of General Practitioners medical director Luke Bradford said the paper demonstrated the gains in ADHD diagnosis and treatment rates over the last couple of decades.

“However, it remains below expected levels of prevalence, and it’s clear that serious inequities remain. The burden of undiagnosed and unmanaged ADHD on educational outcomes, employment, mental health and Corrections are well documented.”

Access to services could be sporadic or unaffordable for many, Bradford said.

More work was needed, though, to address concerns about having more ADHD medication out there, such as the risk of drug abuse, he said.