Sometimes news is best delivered in the starkness of numbers. From 2003 to 2015, prescription rates for ADHD increased “by 700 percent among women aged 25 to 29, and by 560 percent among women aged 30 to 34.” That’s according to a new study from the Centers for Disease Control and Prevention, reported this week by the New York Times. More numbers: This study included more than 4 million women (all with private health insurance that covered prescription drugs) over a dozen years, tracking only prescriptions — not diagnoses — for medications like Adderall, Ritalin, and Vyvanse.
Reading news reports on studies like these is fascinating but often frustrating, because the CDC only tracked the rise in the use of these medications, and not the reasons for that rise. No doubt, the explanation for this increase is complicated. It could be partially explained by changes in diagnostic criteria, for example, which “extended the criteria to adults who have experienced inattentiveness and restlessness since childhood,” as the Times reports. It could also be partially explained by the fact that plenty of people, young women included, use these prescription drugs to sharpen their focus at work or school. And (or?) it could be due to a newer way of thinking about ADHD, as a disorder that may arise for the first time in adulthood.
And then there’s what could be called the “lost generation” theory. Hyperactivity is usually considered the classic symptom of childhood ADHD, but some researchers argue that this is more true in boys than it is in girls. In girls, ADHD is often more likely to manifest as daydreaming, disorganization, or carelessness, behaviors that are more easily overlooked or misunderstood. “Pressure to perform means many girls internalize their symptoms … as personal flaws rather than medical issues to be treated through medicine and therapy,” science reporter Jenny Anderson wrote for Quartz in 2016. Perhaps some of these young women showed symptoms in childhood that flew under their parents’ and pediatricians’ radars. (Then again, maybe some of these young women with ADHD prescriptions were once young girls with ADHD prescriptions.)
Regardless, much of that CDC report is focused on the fact that these young women are at the age where they might be having children, or thinking seriously about having children. And yet we have very little knowledge about how these medications may affect a pregnancy. “The safety of ADHD medications with regard to risk for birth defects is largely unknown,” the report intones, “with only one sufficiently powered published study.” Only one good study! Yet another striking number.