New ADHD prescriptions rose 157% in nine years, fastest in women aged 25 to 44

A study published in JAMA Network Open on 11 December tracked every ADHD medication prescription issued in Ontario, Canada, from 2015 through 2023 — a population of 15,084,455 people, mean age 42.3 years, 50.7% female [s1]. It is a repeated cross-sectional design covering an entire province, not a sample, which removes most of the usual worries about who is represented.

The headline number: the rate of incident (new) ADHD medication prescriptions rose from 275.2 per 100,000 in 2015 to 708.0 per 100,000 in 2023 — a relative increase of 157.2% [s1].

The inflection point

The increase was not steady. Annual percentage change was 7.4% per year (95% CI, 4.9 to 9.9) over 2015–2019, then 29.2% per year (95% CI, 24.9 to 33.6) over 2020–2023 [s1].

That is roughly a fourfold acceleration, and the break falls at the start of the pandemic period. The study is descriptive and does not attribute causation. Several plausible contributors sit in that window at once — the rapid expansion of telehealth prescribing, direct-to-consumer ADHD assessment services, changed working and schooling conditions, and rising public awareness of adult ADHD — and this dataset cannot separate them.

Who the new patients are

By 2023, 2.6% of the entire Ontario population had filled an ADHD prescription in the past year [s1].

The largest relative increases from 2015 to 2023 were in adult women [s1]:

• Women aged 25–44: +421.3%
• Women aged 18–24: +368.7%
• Women aged 45–64: +188.3%
• Men aged 25–44: +219.7%

Prevalence in 2023 was highest among males aged 10–14, at 7.8%, and among females aged 18–24, at 6.7% [s1].

The pattern is the important part. ADHD was historically diagnosed and treated as a condition of boys, and the diagnostic criteria were validated largely in that population. A prescribing curve rising fastest among women in their twenties, thirties, and forties is consistent with a long-standing under-recognition being corrected. It is also consistent with over-diagnosis in a group newly targeted by a diagnostic pipeline. The data cannot distinguish these, and anyone claiming they can is going beyond the study.

The limitation the authors name

The study has no data on whether the prescriptions were appropriate [s1]. It counts dispensed medications; it does not observe the assessment that preceded them, the diagnostic criteria applied, the clinician's training, or the outcome.

That gap is not incidental — it is the entire question. A 157% rise in prescribing is good news if it represents people who met criteria and were previously missed, and a problem if it represents diagnostic drift. Administrative prescribing data can size the phenomenon precisely while saying nothing at all about which explanation is right.

Two further constraints apply. This is Ontario, under a single-payer system with its own referral pathways, prescribing rules, and drug coverage; the trajectory need not match jurisdictions with different access structures. And the analysis runs to 2023, so it does not describe what has happened since.

Why it matters beyond ADHD

Stimulants are controlled substances with real potential for diversion and misuse, and the supply chain for them has been strained in several countries in recent years. A prescribing base growing at nearly 30% a year has consequences for shortages, for monitoring systems, and for the clinicians left managing long-term treatment in a population that did not exist as a treated group a decade ago.

There is also a follow-on question this study raises but does not answer: what happens to adults started on stimulant medication in their thirties over the subsequent decades. The long-term evidence base for ADHD pharmacotherapy is strongest in children and adolescents. Adults newly started in the 2020s are, in evidence terms, ahead of the literature.

What to watch

Whether comparable analyses in other health systems show the same 2020 inflection — which would point away from anything specific to Ontario. Whether the adult-onset prescribing curve flattens as a backlog of previously undiagnosed people is cleared, or keeps climbing. And whether any study manages to attach appropriateness or outcome data to prescription counts, which is the piece this literature is missing.

This article describes population prescribing data. It is not medical advice, and it is not a statement about whether any individual should or should not take medication for ADHD.

Sources

1. Population-Level Trends in Attention-Deficit/Hyperactivity Disorder Medication Prescribing — JAMA Network Open, 11 December 2025