Rising stimulant use raises red flags for diagnosis quality and long-term member health
Ontario’s surge in ADHD prescribing is reshaping how often plan members show up at the pharmacy counter – especially adult women.
According to CP24, new stimulant prescriptions in Ontario climbed 157 percent between 2015 and 2023, based on a JAMA Network Open study that tracked all Ritalin‑, Adderall‑ and similar stimulant scripts dispensed in the province.
Annual growth in prescriptions ran at about seven percent from 2015 to 2019, then jumped to 28 percent a year once COVID‑19 lockdowns began in 2020.
The sharpest increase came from working‑age women.
Stimulant use rose about 421 percent for females aged 25 to 44 and roughly 369 percent for those 18 to 24.
First author Daniel Myran told CP24 that “in 2023 there are more females age 25 to 44 who’ve used a stimulant in the past year than males.”
He noted that earlier diagnostic criteria focused on hyperactivity – more typical in males – while more recent attention has turned to women’s inattentive symptoms, such as difficulty focusing and setting priorities.
Children also saw higher use, although less dramatic than in adults.
CP24 said new prescriptions rose 191 percent for girls aged 10 to 14 and 67.5 percent for boys in the same age group.
Researchers linked the post‑2020 spike to several overlapping forces.
According to CP24, they pointed to more screen time, greater public awareness and acceptance of ADHD, and the identification of people who had gone undiagnosed.
During the pandemic, private virtual care clinics offering ADHD assessments expanded rapidly, lowering barriers to diagnosis but also raising the risk of misdiagnosis or overdiagnosis.
Myran told CP24 he began seeing patients in his family practice with inaccurate ADHD labels, which helped prompt the study, and warned that “if you have the wrong diagnosis and you pursue the wrong treatment for it, you may never get the right treatment for what you have.”
Those diagnostic concerns matter because the drugs are not benign.
CP24 reported that stimulant side effects can include appetite loss, sleep problems and anxiety, with longer‑term risks such as higher blood pressure and increased risks of stroke and heart attacks.
Myran told CP24 that when severe ADHD symptoms block people from participating in school or work “the risk trade-off is clear,” but he cautioned that as prescribing broadens, “you start getting into groups of individuals who are being prescribed it where the risk-benefit base ratio may not be as favourable.”
The pattern is not unique to Ontario.
Senior scientist Heather Palis of the BC Centre for Disease Control said her Lancet study in British Columbia also found the fastest growth in ADHD diagnoses among females, with an estimated rate of increase more than twice that of males during the pandemic.
She told CP24 this points to a population that now needs services, including prescribers who can monitor patients for adverse effects.
