ADHD medication prescription rates rise tenfold for adults in New ...

The number of adults being prescribed medication for attention deficit hyperactivity disorder (ADHD) in New Zealand has risen tenfold in 16 years - yet many more people are still likely to be missing out on getting help.

A few years ago, psychiatrist Dr Ben Beaglehole started noticing a large number of adult patients coming into his Christchurch clinic with a similar question.

“More and more, I was seeing adults asking me the question, ‘Do I have ADHD?’,” he said.

Many were seeking explanations for why they had struggled over a long period of time. Some had children who had already been diagnosed.

“My clinical suspicion was that treatment for ADHD was increasing,” Beaglehole told the Herald.

He and colleagues at the University of Otago in Christchurch set out to test that theory, focusing on two medications, methylphenidate (better known as Ritalin) and atomoxetine (Strattera).

Their findings, published today in the New Zealand Medical Journal, confirmed Beaglehole’s suspicions.

Between 2006 and 2022, the number of adults being prescribed ADHD medication rose tenfold, from 55 prescriptions per 100,000 people to 556 per 100,000. This compared to a threefold increase in prescriptions for children.

The adult group was made up of both people whose ADHD had persisted since childhood and people who had been diagnosed for the first time as adults.

Beaglehole said this increase did not necessarily reflect growing rates of ADHD in this country, but possibly social acceptance and awareness of the condition.

Around 0.6 per cent of adults were now getting ADHD medication, but this was below the estimated 2.6 per cent of adults who had the condition in New Zealand. This indicated a significant treatment gap for ADHD.

One of the barriers was the special authority required to access medication, which requires sign-off from a specialist.

Mental health workforce shortages meant getting timely access to a specialist was difficult. Many patients end up seeking treatment in the private sector, which raised equity concerns for those who could not afford this option, the NZMJ paper said.

ADHD medications either sped up or slowed down the brain and could help with anxiety.

Beaglehole said not all people with ADHD needed medication, but it was an effective treatment and patients should at least have access to it.

There were potential downsides to having more medication in the community - including over-medicalisation and addiction risks - but he wanted to highlight the treatment gap to prompt further discussion of the subject.

ADHD New Zealand chairman Darrin Bull said there was still a stigma about the condition and reports of a spike in prescribing might alarm some people.

“Many will say it’s just discipline and bad parenting. But it’s not. I celebrate that it’s increased so much, because that means more people are getting the diagnosis, and our scientific understanding is coming along as well.”

Awareness of ADHD had come a long way in New Zealand in the last 10 years, he said. A decade ago, it was considered a “boys’ disease” and was often dismissed as children behaving badly.

This was partly because ADHD symptoms in boys, like hyperactivity, were easier to spot, while girls’ symptoms could be more subtle.

Bull said much of the increased treatment of ADHD was driven by the rising diagnosis rates of women, who often found out they had the condition in their 20s or 30s.

“They don’t suddenly get it, they’ve had it their whole life. It’s just that the medical experience and approach has changed significantly.”

A high-level hui took place at Parliament yesterday, and one of the top items on the agenda was allowing GPs and nursing practitioners to play a greater role in diagnosing ADHD and prescribing treatments.

GPs do not have authority to sign off on ADHD medications because they are Class B drugs. Other hurdles include inexperience or uncertainty among GPs in identifying ADHD, and the time required to carry out detailed assessments.

Bull said there was now broad political agreement on this issue and it was simply a matter of changing laws and regulations to make it happen.

Isaac Davison is an Auckland-based reporter who covers health issues. He joined the Herald in 2008 and has previously covered the environment, politics, and social issues.