Adult ADHD stimulant prescriptions more than doubled during the pandemic

Before 2020, a young woman in Ontario who suspected she had ADHD would most likely sit in a psychiatrist's office, answer structured questions, and wait weeks for a diagnosis. By 2022, that same woman could fill out an online assessment, see a nurse practitioner through a virtual platform, and walk away with a stimulant prescription in days. The speed of that transformation is at the center of a new study that tracks how dramatically adult ADHD prescribing changed during and after the COVID-19 pandemic.

More than 327,000 new prescriptions in eight years

Researchers at the Ontario Drug Policy Research Network and ICES analyzed population-level dispensing data from January 2016 through June 2024. Over that period, 327,053 adults in Ontario received at least one new stimulant prescription. The median age was 31, more than half (55%) were female, and 91% lived in urban areas.

The pandemic itself initially caused a brief dip in new prescriptions, as health systems scrambled to adjust. But what followed was a rapid and sustained surge. The largest increases appeared among 18- to 24-year-olds, the age group that also showed the highest absolute rates of new stimulant use.

Before the pandemic, prescribing rates were roughly equal between men and women. After March 2020, rates among women pulled ahead and stayed consistently higher across every age group studied.

The virtual care factor

What drove the spike? The researchers point to several converging forces. Greater public awareness of adult ADHD, amplified by social media, brought more people to seek evaluation. Virtual health services expanded rapidly during lockdowns and made assessments more accessible. And a historical pattern of underdiagnosis in adults, particularly women, meant there was genuine unmet demand.

But the study's lead author, Dr. Tara Gomes of St. Michael's Hospital and ICES, is careful to note that awareness and access alone do not explain the scale of the shift. The data also revealed a change in who was writing these prescriptions. Before the pandemic, psychiatrists initiated 26% of new stimulant prescriptions. By the study's end, that figure had dropped to 18%. Meanwhile, prescriptions initiated by nurses and nurse practitioners climbed from 2% to 10%.

This matters because diagnosing ADHD in adults is not straightforward. Symptoms overlap with anxiety, depression, sleep disorders, and normal variation in attention. A thorough evaluation typically involves clinical interviews, collateral history, and ruling out other conditions. Shorter assessments conducted through virtual platforms may not always meet that standard.

Anxiety, depression, and the question of co-prescribing

One particularly striking detail: roughly 25% of new stimulant recipients carried a diagnosis of anxiety, depression, or both. Stimulants are not first-line treatments for either condition, and in some cases they can worsen anxiety symptoms. Whether these patients had genuine comorbid ADHD or were being prescribed stimulants as an off-label intervention for mood-related cognitive difficulties is a question the study cannot answer directly. But the proportion is high enough to warrant scrutiny.

The pattern is not unique to Canada. Studies from the United States, Australia, the United Kingdom, and Finland have reported similar post-pandemic surges in adult stimulant prescribing. Increased screen time, pandemic-related mental distress, and social media content about ADHD have all been cited as potential contributing factors.

Between catching up and overcorrecting

The tension in these data is real. For decades, ADHD in adults was systematically overlooked, especially in women. The corrective that began during the pandemic has almost certainly helped many people access treatment they needed. At the same time, the speed and scale of the increase, combined with shorter assessment timelines and fewer specialist gatekeepers, raise legitimate concerns about diagnostic accuracy.

Coauthor Dr. Mina Tadrous of the University of Toronto's Leslie Dan Faculty of Pharmacy notes the dual edge of social media in particular. On one hand, it has helped normalize adult ADHD and encouraged people to seek evaluation. On the other, content from influencers, sometimes oversimplified or misleading, may prompt people to self-identify with symptoms that do not actually meet clinical criteria.

The authors call for ongoing monitoring and evaluation to understand the root causes of rising stimulant use and to balance improved access against the risk of inappropriate prescribing.

What the data cannot tell us

This study describes trends in dispensing, not outcomes. It cannot say whether the people receiving these prescriptions are benefiting from them, experiencing side effects, or continuing to use stimulants long-term. It also cannot distinguish between appropriate new diagnoses and cases where the prescribing may have been premature or incorrect.

What it does establish is the magnitude and demographic shape of a prescribing shift that has few precedents. Whether that shift represents a long-overdue correction or an overcorrection with consequences of its own will require the kind of longitudinal follow-up that takes years to complete.

For now, the numbers themselves are the message: something changed fundamentally in how adult ADHD is identified and treated during the pandemic, and the system has not yet caught up to the implications.