An Analysis of the Significant Variation in Psychostimulant Use Across the U.S.

By Farasat Bokhari, Rick Mayes, and Richard M. Scheffler | Published May 2004 in Pharmacoepidemiology and Drug Safety | Link to Full Article

Psychostimulants (methylphenidate and ampheta-mines) are primarily used to treat attention deficit hyperactivity disorder (ADHD), which is the most commonly diagnosed behavioral disorder in children, making up more than 50% of all child psychiatric diagnoses. This article seeks to provide a national profile of the area variation in per-capita psychostimulant consumption in the U.S. We separated 3030 U.S. counties into two categories of ‘low’ and ‘high’ per-capita use of attention deficit hyper-activity disorder (ADHD) drugs (based on data from the Drug Enforcement Administration), and then analyzed them on the basis of their socio-demographic, economic, educational and medical characteristics. We found significant differences and similarities in the profile of counties in the U.S. that are above and below the national median rate of per-capita psychostimulant use (defined as g/per 100K population). Compared to counties below the median level, counties above the median level have: significantly greater population, higher per-capita income, lower unemployment rates, greater HMO penetration, more physicians per capita, a higher ratio of young-to-old physicians and a slightly higher students-to-teacher ratio. Our analysis of the DEA’s ARCOS data shows that most of the significant variables correlated with ‘higher’per-capita use of ADHD drugs serve as a proxy for county affluence.