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Trends and patterns of medical stimulant use by US adults

Molecular Psychiatry (2026)Cite this article

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Abstract

The authors describe trends in stimulant prescribing to US adults and characterize stimulant-treated adults by use of three modalities: telehealth only, in-person only, or mixed (hybrid) behavioral healthcare. Among US adults in the 2018–2023 Medical Expenditure Panel Survey (n = 119,138), annual stimulant treatment rates are presented with age- and sex-adjusted marginal 2018–2023 differences across sociodemographic and clinical strata. Characteristics of stimulant-treated adults are also presented by reason for stimulant use (attention-deficit/hyperactivity disorder vs. other) and behavioral healthcare modality. Between 2018 and 2023, medical stimulant use increased from 1.8% to 2.2% of adults, including greater increases for adults with household incomes >400% than <100% of the Federal Poverty Level and employed adults than non-employed adults over age 65. However, the percentage of patients receiving ADHD visits who were treated with stimulants declined from 81.6% in 2018 to 74.6% in 2023. In 2021–2023, 48.4% of stimulant-treated patients received all their behavioral healthcare as in-person visits rather than hybrid (30.9%) or telehealth only (20.7%). These three groups did not differ in the percentage who received stimulants for ADHD, the number of stimulant prescriptions they received, or benzodiazepine or opioid prescriptions. In summary, between 2018 and 2023, adult stimulant use increased, particularly among higher-income and employed adults, while the share of ADHD patients treated with stimulants declined. Approximately one-half of stimulant-treated patients received teletherapy, and service modality was not related to ADHD treatment, stimulant prescription counts, or benzodiazepine or opioid prescriptions.

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Data availability

The Medical Expenditure Panel Survey is sponsored by the Agency for Healthcare Research and Quality. The data are available at https://meps.ahrq.gov/data_stats/download_data_files.jsp.

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Author information

Authors and Affiliations

  1. Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Mark Olfson

  2. Agency for Healthcare Research and Quality, Rockville, MD, USA

    Chandler McClellan & Samuel H. Zuvekas

  3. National Institute on Drug Abuse, Bethesda, MD, USA

    Carlos Blanco

Authors
  1. Mark Olfson
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  2. Chandler McClellan
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  3. Samuel H. Zuvekas
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  4. Carlos Blanco
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Contributions

Conceptualization: MO, CB. Study protocol: MO, CM, SHZ, CB. Data curation: CM, MO. Formal analysis: CM. Methodology: MO, CM, SHZ, CB. Writing: original draft: MO. Writing: review & editing: MO, CM, SHZ, CB.

Corresponding author

Correspondence to Mark Olfson.

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Competing interests

Drs. Olfson, McClellan, Zuvekas, and Blanco have no conflicts of interest to declare.

Ethics approval and consent to participate

All methods were performed in accordance with the relevant guidelines and regulations. The Medical Expenditure Panel Survey (MEPS) procedures were reviewed and approved by the Westat IRB, established under a multi-project assurance (MPA M-1531) granted by the Office for Protection from Research Risks, (OPRR). Participation in MEPS is voluntary, and participants are informed about the survey and provide informed consent in accordance with IRB-approved procedures.

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Olfson, M., McClellan, C., Zuvekas, S.H. et al. Trends and patterns of medical stimulant use by US adults. Mol Psychiatry (2026). https://doi.org/10.1038/s41380-026-03519-1

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