ADHD Meds Surge: Wealthy Kids First? | Prescription Crisis

The number of young people in Australia prescribed medication for attention-deficit hyperactivity disorder (ADHD) has increased more than tenfold in 20 years, according to new research, and the trend is no longer most prevalent in poorer areas.

ADHD Prescription Trends in Australia

Children living in the lowest socioeconomic postcodes previously had the highest rates of ADHD prescriptions. However, this has reversed, with children from wealthier families now most likely to be prescribed the medication.

What is ADHD?

ADHD is the most commonly diagnosed disorder among Australian children. Symptoms vary, but it’s generally associated with hyperactive and/or inattentive behaviors that create challenges at home, school, or work. Psychostimulant drugs are the most common approved treatment for ADHD.

Research Methodology

Researchers analyzed two decades of national data from 2003 to 2022, examining official prescription records from Australia’s Pharmaceutical Benefits Scheme (PBS), which subsidizes medication costs. The study aimed to determine how prescription rates have changed and differed between states and territories, and whether socioeconomic status plays a role in access to prescriptions.

To compare ADHD prescriptions by postcode, researchers used a standardized medication ratio, where a score of 1.0 represents the national average prescription rate. Scores above 1.0 indicate higher-than-average prescriptions, while scores below 1.0 indicate lower-than-average prescriptions.

Key Findings

Between 2003 and 2022, the number of children aged 5-17 on ADHD medication rose from 20,147 people (0.5% of the youth population) to 246,021 young people (4.2%).

The most significant increase occurred in 2020 and 2021 during the COVID-19 pandemic, with prescriptions spiking, particularly for older teens (15-17 years), increasing from 3.1% in 2020 to 5.2% in 2022.

Lockdowns may have contributed to this increase, potentially prompting more families to seek help or pay closer attention to neurodivergence and learning issues.

Historically, access to ADHD medication in Australia depended on location and parental income. In the 1990s, prescription rates varied significantly between states, with Western Australia and Tasmania having higher rates in 2003.

Over time, these differences have narrowed, suggesting clinicians are becoming more consistent in their diagnosis and treatment of ADHD. This is attributed to efforts to standardize best practices nationwide and reduce variations.

The Role of Wealth

For a long time, children in the most disadvantaged areas of Australia were more likely to be prescribed ADHD medication, potentially because behavioral symptoms are more noticeable when schools and families have fewer resources.

However, this pattern has shifted. Currently, children in the wealthiest postcodes – the top 10% – are most likely to be prescribed medication.

In 2003, wealthier areas had the lowest rates of ADHD medication, with a ratio of 0.612. By 2021, they had the highest rates, with a ratio of 1.245. Meanwhile, the lowest 10% of postcodes had a ratio of 0.708.

Reasons for the Shift

The change likely relates to access. Twenty years ago, the health system could largely meet the demand. Now, obtaining a diagnosis can require multiple specialist appointments, psychological assessments, and lengthy waiting lists. Families with fewer resources may face longer waits or may not pursue diagnosis and medication if it feels inaccessible.

However, most postcodes now have prescription rates close to the national average, indicating that the shift is primarily affecting the most affluent and disadvantaged income groups.

Study Limitations

The data used in the study only includes prescriptions filled through the PBS system, excluding prescriptions from the private medical system. This means the trend in the wealthiest postcodes may be even more pronounced. The study also could not analyze the influence of culture or ethnicity due to the anonymous nature of the data.

While stimulants are primarily prescribed for ADHD, a small number are used to treat other conditions, such as narcolepsy. Changes in diagnostic guidelines, including those implemented in 2013, did not result in a significant jump in prescriptions.

The study did not examine repeat prescriptions or compare individual postcodes to the national rate, so it does not determine whether ADHD is being overdiagnosed or overmedicated in certain areas.

Implications

The findings suggest increasing acceptance of ADHD and a greater willingness to seek help. This indicates improved acceptance of neurodivergence, more consistent care, and a society focused on supporting all children. Standardized practices and consistent care are moving Australia away from a “postcode lottery” effect, where treatment depends heavily on location.

However, the shift in diagnosis ratios from the poorest to the wealthiest postcodes highlights the need to address access and equity of treatment.

Brenton Prosser is a Government & Public Sector Partner and a Providence / Honorary Fellow at the Australian National University.

Yogi Vidyattama is an Associate Professor in the Faculty of Business, Government and Law at the University of Canberra.

This article is republished from The Conversation under a Creative Commons licence.