Urgent Action Needed: The Growing Crisis of Adult ADHD Medication MisuseFor years, attention deficit hyperactivity disorder (ADHD) was primarily viewed as a childhood condition. However, recent trends show a significant increase in adult diagnoses, leading to more people over 18 being prescribed stimulant medications—predominantly amphetamines like Adderall and Vyvanse—and subsequently developing dependencies on these drugs.
Despite the generally safe nature of these medications for extended use and their lower risks compared to opioids, alarming statistics have emerged. A recent study of 84,000 adults aged 18-64 revealed that one in four misused their stimulant medications. This misuse included taking medicines without prescriptions, exceeding recommended dosages, or using them outside medical guidance. Shockingly, nearly 10% developed what researchers call prescription substance use disorder (PSUD), where the use of these stimulants caused significant problems in their lives.
The research, published in JAMA Psychiatry in March 2025, included both people with legitimate prescriptions and those obtaining the drugs through unofficial channels—typically from friends or family members. PSUD occurred in both groups, with 90% of cases involving amphetamine medications. Notably, adult stimulant prescriptions have jumped by 34% between 2019 and 2022.
Understanding the Surge
Several factors contribute to this dramatic increase. The relaxation of telehealth regulations during COVID-19 may have played a part, though the upward trend began before the pandemic. Increased marketing and public awareness about ADHD have also contributed, as pharmaceutical companies have emphasized how disabling the condition can be and promoted available treatments.
Perhaps most significantly, medical understanding of ADHD has evolved. Longitudinal studies confirm that most people diagnosed with ADHD in childhood continue experiencing symptoms as adults. Additionally, the condition was previously seen primarily as affecting boys. Still, medical professionals now recognize that girls and women experience ADHD as well. Between 2019 and 2022, women aged 35-64 saw the most significant increase in stimulant prescriptions.
Is This a Crisis?
Opinions differ on whether stimulant misuse constitutes a genuine crisis. Some experts point out that the definition of misuse in the study is quite broad and might include behaviors that some wouldn't consider problematic. Furthermore, nearly two-thirds of those with PSUD had relatively mild cases, and most hadn't misused stimulants in the month before the study—suggesting that daily or weekly misuse isn't the norm.
Understanding the Risks: The Potential Dangers of Stimulant Misuse
Regulation is Key: the Need for Comprehensive Guidelines in Adult ADHD Medication UseA key issue is that the increase in adult stimulant prescriptions hasn't been matched with detailed clinical practice guidelines. Medical professionals need clear guidance to address serious problems, including misdiagnosis, overdiagnosis, overprescribing, and psychosis associated with high doses of prescription amphetamines.
This need is particularly urgent given the diversity of healthcare providers now prescribing ADHD medications. From 2019 to 2022, prescriptions by nurse practitioners and physician assistants more than doubled, increasing by 110%. Internal and osteopathic medicine doctors increased their prescriptions by 26.5%, family and general practice doctors by 16.2%, and psychiatrists by 10.3%.
Medical professionals require additional education about adult ADHD, which presents diagnostic challenges. Unlike childhood ADHD, adult diagnosis involves navigating through potentially complicated medical histories that might include depression, anxiety, PTSD, or substance abuse. Proper diagnosis requires establishing that symptoms begin in childhood, which demands careful assessment.
Demographics and Risk Patterns
The study revealed notable demographic differences in stimulant misuse and addiction. While women ages 35-64 were most likely to receive new prescriptions, they were least likely to misuse their medications or develop dependencies. Young adults aged 18-25 showed the highest rates of misuse, followed by those aged 26-34.
It remains unclear how many adults have been taking medications like Adderall or Ritalin continuously since childhood. Older studies suggest people typically phase out of their prescriptions as they age, but more recent trends of college students using stimulants to maintain focus may have altered this pattern.
Recognizing Warning Signs
It's crucial for individuals with ADHD prescriptions, especially those taking amphetamines, to be vigilant about recognizing addiction warning signs. These signs include spending excessive time obtaining or using prescription stimulants or recovering from their effects. Withdrawal symptoms can consist of extended sleeping periods, depressed mood, irritability, and overeating. While no FDA-approved medications exist specifically for stimulant addiction, treatment approaches typically focus on cognitive behavioral therapy and careful medication management.
Support resources are available for those experiencing addiction or withdrawal symptoms, including the Suicide & Crisis Lifeline (988) and the Substance Abuse and Mental Health Services Administration helpline (800-662-HELP).
Reducing Risks
Maintaining a strong relationship with your healthcare provider is essential. Patients should plan ahead for prescription refills to avoid running out of medication and experiencing withdrawal. Additionally, being careful about who knows about your stimulant prescription can prevent potential diversion, particularly in environments like college campuses where sharing these medications is common.
The concern extends beyond individual misuse to the broader issue of medication diversion—when prescribed drugs are shared with others. This practice introduces serious risks when potent medications are used without proper medical supervision.
MEDICAL DISCLAIMER: The information provided is for educational and informational purposes only and is not intended as medical advice. This information does not create a doctor-patient relationship and should not be used as a substitute for professional diagnosis and treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here. The author and publisher are not responsible for any adverse effects resulting from the use of any information contained herein
