Is misuse of drugs that treat ADHD getting better or worse?

Misuse of prescription drugs used to treat ADHD has dropped sharply among American adults, according to a new study published in the Journal of Clinical Psychopharmacology.

The research reports that misuse among adults under 30 has dropped by half since 2016, according to the federally commissioned review of two decades of research.

About 3.7% of adults under 30 misused the medications in 2023, down from 7.5% in 2016, researchers at the Keck School of Medicine of USC found. Among adults of all ages, 1.9% reported misusing the drugs.

The review, which was requested by the U.S. Food and Drug Administration, drew on 64 studies conducted between 2004 and 2024.

"We found a rapid drop in misuse of these medications, largely driven by a decline in Adderall misuse among young adults," Margaret Maglione, the study's first author, said in a news release. She said the lower rates have held steady since 2023.

Researchers said the decline may be tied in part to a nationwide shortage of ADHD medications that began in 2022.

Among adults who took prescription stimulants in the year before a late-2023 survey, 71.5% had difficulty filling a prescription because the drug was scarce, according to the U.S. Centers for Disease Control and Prevention.

Misuse remains most common among younger adults, white adults, city dwellers and college students.

The review found two patterns: One group, mostly adults 18 to 30, occasionally takes the drugs without a prescription to study or concentrate, usually swallowing pills they get free from friends or relatives.

A second group uses seven or more days a month and is more likely to be over 30, to lack a college degree, to be divorced or separated or on work disability, and to obtain the drugs from a dealer or by visiting multiple doctors.

Those users are also more likely to snort, smoke or inject them.

The most common reasons cited by participants were to concentrate, 35%; to stay awake, 31%; and to get high, 16%.

"Most patients do use the medications safely and as prescribed, but these medications are most likely to be misused by those who have a legitimate prescription or those who have access to someone else's medication," said Dr. Jaskanwar S. Batra, a clinical professor of psychiatry at the Keck School of Medicine.

Researchers said they found no long-term U.S. studies on the physical health effects of misusing the drugs.