HealthDay News — There are wide variations in the use of stimulants to treat attention-deficit/hyperactivity disorder (ADHD) at both the state and the county level, according to research published online Aug. 2 in Psychiatric Services.

Douglas C. McDonald, PhD, and Sarah Kuck Jalbert, from Abt Associates in Cambridge, Mass., analyzed records of 24.1 million stimulant prescriptions dispensed to insured and uninsured patients obtained from approximately 76% of U.S. retail pharmacies. Data were weighted for all U.S. states and counties.

The researchers found that approximately 2.5% of children ≤17 years of age (3.5% of males and 1.5% of females) and 6% of persons >17 years of age were being treated with stimulants as of March 2008. There was wide variance in treatment prevalence among states, and the variation among counties was even wider.

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Supply of physicians, socioeconomic composition of the population, and, among children, funding for special education explained two-thirds of the variation among counties in treatment prevalence. There was a high correlation between county prevalence rates of any stimulant use and rates of treatment among children and adults.

“Wide variations in treatment prevalence signal disparities between established clinical practice guidelines and actual practice, especially for primary care, where most patients prescribed stimulants are managed,” the researchers wrote.


  1. McDonald DC, Jalbert SK. Psychiatric Services. 2013; doi: 10.1176/