Prescription rates for ADHD medication increase tenfold for adults in New Zealand

The number of adults prescribed medication for attention deficit hyperactivity disorder (adhd) in New Zealand has increased tenfold in 16 years, but it is likely that many more people are still missing out on getting help.

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

“More and more, I saw adults asking me the question, ‘Do I have ADHD?'” she said.

Many were looking for explanations as to why they had struggled for such a long period of time. Some had children who had already been diagnosed.

My clinical suspicion was that the ADHD treatment was increasing, Beaglehole said Herald.

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

Their findings, published today in New Zealand Medical Journalthey confirmed Beagleholes’ suspicions.

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

The adult group consisted of both people whose ADHD persisted from childhood and people who had been diagnosed for the first time as adults.

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

About 0.6 per cent of adults were receiving medication for ADHD, 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 needed to access the medication, which requires a specialist’s signature.

Shortages of the mental health workforce meant that 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 speed up or slow 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 drugs in the community, including the risks of overmedication and addiction, but he wanted to highlight the treatment gap to spur discussion on the issue.

ADHD New Zealand president Darrin Bull said there was still a stigma around the condition and reports of an increase in prescribing could alarm some people.

Many will say it’s fair discipline and bad parenting. But it isn’t. I celebrate that it has increased so much, because it means more people are getting the diagnosis and our scientific understanding is catching up too.

ADHD awareness had come a long way in New Zealand in the past 10 years, he said. A decade ago, it was considered a children’s disease, and children were often considered misbehaving.

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

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

Suddenly they don’t get it, they’ve had it all their lives. It’s just that medical expertise and approach have changed significantly.

A high-level hui took place in Parliament yesterday, and one of the main items on the agenda was to allow GPs and nurse practitioners to play a bigger role in ADHD diagnosis and prescribing of treatments

GPs do not have the authority to sign ADHD medications because they are Class B drugs. Other barriers include inexperience or uncertainty among GPs to identify ADHD and the time required to carry out detailed assessments.

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

Isaac Davison is an Auckland-based journalist covering health issues. He joined the Herald in 2008 and has previously dealt with environmental, political and social issues.