Prescription surge of ADHD meds across Canada

If your eyes are the windows to your soul and your glasses are the windows to your eyes,

then it's pretty important to find your perfect frames.

That's why at Warby Parker, we've made shopping for eyewear as easy and fun as can be.

Peru's endless styles in our stores, or use our app to virtually try on frames and get personalized recommendations.

To find your next favorite pair of glasses, sunglasses, or contact lenses,

or to locate your nearest Warby Parker store, head over to WarbyParker.com.

That's WarbyParker.com.

This is a CBC podcast.

Hello, I'm Matt Galloway, and this is the current podcast.

For some women with ADHD, social media is a place where they feel seen and where they can share their experience

with ADHD medications like violence.

You know what time it is? It's time to take my 30 milligrams of violence for my ADHD as a recently diagnosed 30-year-old.

This video is going to be about other things that looking back on now.

I was like, oh, yeah, that was definitely an issue.

I started Vivans.

And when I tell you that I feel like the best version of myself I've been in years, it's astonishing.

I took my first dose of Vivans this morning after getting a late diagnosis of attention deficit.

And all I can say is what the f***?

But a new study is rating some concerns about how ADHD medicine is being prescribed in Canada.

The number of adults in Ontario alone who started taking stimulants like Vivans mainly to treat ADHD has doubled since the pandemic

and rates are highest among young women.

Other provinces are seeing similar numbers and we'll talk with one of the study authors in just a moment.

But first, I'm joined by Isabella Hay.

I was diagnosed with ADHD and prescribed Vivans three years ago when she was 23 years old.

She's in Vancouver, Isabella, good morning.

Good morning.

When you were diagnosed with ADHD, what was your reaction?

I was hesitant at first.

I was aware of a lot of the TikTok discourse I was going on and the sentiment of a lot of people being diagnosed with ADHD.

I was definitely, yeah, I was shocked, but it has helped me ultimately the diagnosis.

Did you ever suspect that you might have it?

You're shocked, but do you ever think maybe in the back of your mind something was going on that might lead you to that conclusion?

I remember in high school particularly just struggling with procrastination so much.

And other people around me did as well and so I thought, okay, this is just like how learning works.

You don't really absorb it in school and then when it's homework, it's the first time you're learning it.

And then it's the night before the cramming.

I thought that was all normal, but once I got the diagnosis, I was able to better understand a lot of the symptoms and retroactively relate to a lot of the patterns of behavior that are associated with ADHD.

If you don't mind me asking me, what else was going on in your life at the time that led you to that diagnosis?

I've always had anxiety and so I've been seeing, you know, professionals, counselors, psychiatrists, psychologists.

And I was seeing a new psychologist.

I was describing symptoms to her and also some symptoms of my family members who are not diagnosed.

But she referred me to a psychiatrist and within five minutes, the psychiatrist was like, yeah, I think you have ADHD.

And especially the fidgeting, I told her like, no, I can sit still, I can do all that.

And she said, you haven't stopped moving and fidgeting since you've been in here.

So there was some stuff that I definitely wasn't aware of.

But yeah.

Within five minutes, you were diagnosed.

I mean, well, to be honest, it was longer than five minutes.

But she had a pretty good idea.

In terms of listing off the symptoms, I ticked almost every box.

A lot of them were cognitive symptoms for me.

Like task initiation issues and executive function struggles.

Yeah, just like procrastination, perfectionism paralysis, which was leading to a lot of decision making issues and just emotional overwhelm.

And then also, yeah, sensory sensory issues as well.

But the biggest stuff was I probably said the executive function struggles.

Why do you think your symptoms went unnoticed for so long?

As I mentioned, you were diagnosed and prescribed medication when you were 23.

There are many people, particularly young boys that get diagnosed with ADHD as children.

So what do you think was happening that that would linger for so long?

I think a lot of the symptoms were internal.

And so like you have the classic like inattentiveness.

Sometimes that's very physical and young boys like you know disruptive in the classroom or running around or the stuff like that.

But a lot of the inattentiveness was like noise in my head.

And I think even my physical symptoms, I were I was masking in a way that it felt like it went unnoticed.

I don't know like touching my hair, for instance, like not entirely disruptive behavior.

Like doodling, you know, some teachers could see that as taking notes, stuff like that.

But I think largely it's due to the fact that so many of my symptoms were cognitive.

Do you think there's a stigma or there was a stigma around saying something about that as well?

We've talked a lot about addressing stigma around mental illness, but it doesn't mean that it's gone.

I definitely feel the internalized stigma.

Even to this day, I'm really I totally when I read all the symptoms and I've done a lot of work with psychologists to understand the diagnosis and the disorder better.

But I have a lot of internalized stigma around it.

I totally catch myself in, you know, thought patterns that are like you're late.

You're just it's lazy. This is a crutch is diagnosed. This is a crutch.

And it's yeah, especially there's, you know, a growing discourse like so many people, too many people are diagnosed.

And so it's like maybe maybe I'm I'm one of those people.

But yeah, I definitely felt a lot of shame for a while.

But I also had to like balance that shame with the shame that I was already living with, which was like being so hard on myself and not understanding my behavior and just having these chronic self destructive behavioral patterns.

So it's been it's been better. It's been better, but I still struggle with it for sure.

What is the medication done for you?

The medication has been ultimately super successful. Like for me, like the biggest thing I noticed was mood improvement due to just me being able to complete daily tasks.

Like for instance, like having the cognitive, I don't know, just the wherewithal to get my things in order and break tasks down into manageable steps that just didn't feel like mountains of anxiety to get through.

So just, you know, keeping a clean space, being able to like do my daily tasks, like go to the gym, hygiene, like just basic things that that keep you in a routine that keep your mental health.

They keep your mental health good. I'm able to achieve now. I think that's the biggest thing.

So I would say like, yeah, emotional well-being has been the biggest thing that I noticed.

You mentioned the social media discourse. Let me just ask you briefly about that because we heard that at the very beginning, influencers talking about those people shaking the pills and what have you.

You go on to tech talk. It's filled with posts about signs of ADHD. These are tips to help diagnose yourself, whether you have ADHD, what it's like to take the meds, how the meds might change your life.

Did social media play a role in your diagnosis?

You know, I was aware of all the stuff going on on tech talk and I don't think it played a role in my diagnosis just because I didn't go out of my weight. I wasn't seeking a diagnosis.

I was seeking counseling for, you know, other reasons.

But I was super aware of it. I have mixed feelings because on the one hand, it's amazing that people can have access.

There's a bigger conversation about it and some people that didn't have that information now they do and they can have communities where they can discuss it.

But it's also, yeah, there's some definite, like probably some confirmation bias out there too, like everybody's struggling and then you see these things like, oh, well, I might have that. I might have that.

So it's definitely tricky. I know that I can trace my symptoms back to childhood, but like I had a phone with social media all throughout high school, like while my brain was developing too.

And so it's also like interesting to think about just how technology has probably affected all of our dopamine and our brains.

And so it's hard to say, like I know a lot of people right now are getting diagnosed with ADHD and it's like, is that because there's better diagnostic tools, there's less stigma, there's, you know,

symptoms and women are being better understood or is it, yeah, is it, is it actually being over diagnosed? Like it's hard, it's hard to say.

We're going to talk to the researcher who is looking into this in just a moment. But let me, the last thing I'm going to ask you before I let you go just briefly is you talked a little bit about how your life is different.

Do you see and do you think about yourself differently now that you've had this diagnosis?

I do. I'm still really hard on myself to be honest, but I do. I think it's given me, it is validated a lot of my, a lot of my pain and a lot of the invisible symptoms.

And it's given me a lot of hope to when I see how other people manage and what mitigation strategies there are.

And when I can see that I can relate to other people, that is helped a lot. So yeah, in a way, it's given me more grace with myself, for sure.

I'm glad that you found that grace. This is a tricky thing to talk about with somebody that you've never met on the radio and to an audience all across the country, but it's really important. I'm glad you did it. Isabella, thank you.

Thank you so much.

Isabella, hey, was diagnosed with ADHD when she was 23 years old. She was in Vancouver.

There's one place for the newest drops in wellness and performance and the biggest sale of the year. It's the drop by GNC, curating the best of what's new, handpicked by the pros who know what works.

And right now, get it all by one, get 150% off during the semi-annual live-well sale. From crushing workouts to leveling up to nutrition and everything in between, get the best deals on the latest innovations.

All the newness is all on sale right now during the live-well sale on the drop by GNC.

Hi, I'm Jamie Poisson and I host the Daily News Podcast, front burner. And lately, I'll see a story about, I don't know, political corruption or something and think, during a normal time, we'd be talking about this for weeks.

But then it's almost immediately overwhelmed by something else. On front burner, we are trying to pull lots of story threads together so that you don't lose a plot.

So you can learn how all these threads fit together. Follow front burner wherever you get your podcasts.

As we mentioned, a recent study found the prescriptions to treat ADHD have risen dramatically for adults in Ontario since the pandemic.

Mina Tadros is an associate professor at the Leslie Dan Faculty of Pharmacy at the University of Toronto. It was one of the lead researchers on that study looking into this increase.

Mina, good morning to you.

Hey, good morning. What do you make of what we heard from Isabella? Does that sound familiar in terms of her experience?

Yeah, so first of all, thank you for Isabella sharing the story. I think it really sets up the importance of the work that we're doing really nicely.

I think Isabella's journey is one that a lot of patients that we talked to before we did this study shared with us.

And it's one of those that I think is really important to recognize before we talk about the data that these drugs do for patients who are diagnosed and live with ADHD.

Work and we have lots of evidence around that. I think one of the bigger concerns is that pathway of how you get there.

Isabella highlighted some really important things about having other mental health indications being treated by a specialist, being assessed, thinking about things that happen prior.

And I think all of those are important to set up the proper journey that patients have to go through when they're seeking help or trying to get started on the right treatment.

The study that you published was in the Canadian Medical Association Journal. It looks at prescription rates for ADHD medication for adults in Ontario found that the number of adults taking stimulants more than doubled since the pandemic.

Tell me more about who is being prescribed those drugs.

Yeah, so we looked at the province of Ontario. We were able to look at all prescriptions that happened from prior to the pandemic.

So a few years before it and into 2024. So, you know, four years after 2020.

And what we saw was, you know, an alarming increase that happens right at the end of the first lockdown.

You start to see a really sharp increase in the use, you know, the use of ADHD treatments and adults has slowly been going up over the last decade.

But then there's this doubling in the entire population. But especially amongst young women. So 18 to 34.

We see almost close to a tripling that happens in that age group. It's now around one in 50 of that age group in the province of Ontario are receiving a prescription for stimulants.

Do we know about the medications? Is it just, I mean, I mentioned five ends. Is it, are there other medications that are part of that spike in prescriptions?

Yeah, so this is a whole drug class that most people have heard of, right? So you've heard Ritalin, Adiromal, ViVance, Concerto, those are kind of the brand names for them.

And they all fall into this family of drugs that are called stimulants or, you know, they're anthetamine derivatives.

And they've been around for 60, 70 years, right? These drugs are really old.

But we're only starting to see the emergence of newer formulations over the last 10 to 15 years.

And so why the spike now?

Yeah, and that's the real question that we're trying to answer. So we wanted to first describe it and tell people there's something going on here that we need to look at deeper.

And I hope that the real grounding of our studies to draw further attention to this.

I think for us, you know, we think that there's some good news in here, but there's some concern that we really want to raise the flag for the good news is I think more people are talking about it.

I think the work that we've been doing in mental health and trying to tackle stigma is working.

And I think it's drawing more attention to that issue.

We are concerned that the timing with the pandemic points to a few things.

One, are we spending more time in front of our phones? Is that having an effect on our brains?

There's also the emergence of this virtual care access, right?

So it became relatively much easier to be able to get access to mental health help, which is amazing.

But at the same time, you had the emergence of these clinics while we were doing this study.

You know, I would my algorithm on Instagram started pumping these kind of different pharmacies and clinics.

Let's end get your prescription today. These are for these are for profit clinics.

These are for profit clinics that are are telling people like you need to get assessed.

And they're making it easier to get access, which is an amazing thing.

But if people are being told you might have ADHD get your prescription today.

You know, you're really lower the threshold to people being able to get it.

And is that good or bad?

You know, is it some people are being misdiagnosed or some people getting the right diagnosis?

And I truly believe it's probably both.

You mentioned social media and your algorithm.

And the algorithm is tailored to individuals.

Isabella talked about confirmation bias.

You will have people saying yes, get your prescription today.

But you will also have the algorithm feeding you influencers are saying,

if this is happening to you, if this is happening to you, you may have ADHD.

And you wonder whether those influencers or those content creators are being paid by the companies who create that medication.

Do we know anything about those links?

So there have been some early signals coming out of the United States

that some of those influencers are being paid by some of these clinics and some of the manufacturers.

I don't believe all of them are.

I think some of them are on their own journey.

And I think it's an important place to be talking about.

But you know, there's no transparency in some of that and the involvement.

But there's been a lot of evidence coming out in the last year or two that a variety of different pharmaceutical companies and different health entities are kind of paying for influencers to be to be sharing that information.

They'll argue that they're raising awareness and having those conversations.

But I do think that if you're being told, is your attention span getting shorter?

Are you having an inability to pay attention for a long time?

I think that kind of language resonates with a lot of us.

You know, as we were coming out of the pandemic, spending more time on our phones.

And so this is why it's important to like if you believe that you have these symptoms that you engage with a healthcare provider and go on that journey, knowing that you may not have it, but you also might, right?

And I think that's the important conversation to have, rather than saying you have it, let's start the drugs right now.

Why are young women getting diagnosed and then prescribed stimulants at a higher rate than any other demographic right now?

I think Isabella really nicely hit on some of the issues that come up in this age group.

You know, we don't have all the answers for it.

But a lot of people believe that, you know, in our study, the rates of use and medications between men and women were pretty similar to each other before the pandemic.

I think that there is an ability for kind of clouding of the typical symptoms that young boys get diagnosed with earlier.

You see kind of an earlier phase, but I do think that there's something further happening in the way that they're being communicated to the conversations that are happening amongst young women in themselves and within community.

So I think this is one of those things that we want to, we want to flag like, why is this population, you know, substantially growing at a faster rate than boys.

And now in the younger adults, they do make up more users of these products than they do young men.

There was a line in the study that left out to me that speaks to that.

It says this happens in a backdrop of societal and digital pressures that may influence demand.

We talked about the digital pressures, but what are the societal pressures that would particularly influence that demand among young women?

Yeah, I think there's a lot of research on, you know, the workforce, what's being expected of people and how we work,

spending a lot of time in front of computers and sort of the virtual world that we live in.

But also at the same time, like having these conversations to keep performing better, being able to just do more, I think as we get more tools, we're expected and society to do more.

And, you know, Isabella touched on that really nicely where she, she feels like she's able to be more productive.

And that's kind of the pressure that's placed on one of us continue to be productive, continue to do all these things.

And as you're being asked of more, you know, if we're all honest with ourselves, like we're being asked of more and more things to stay on top of than ever before.

And yet this is a generation Isabella talked about this that has grown up to this marinated in social media.

This has shaped their lives in some ways.

And it can be glib to say you're on tech talk and that's why you have a short attention span is because the app is meant to drive that.

But is there something to that? Is there something about growing up at a time when you, when you live on your phone and you live in that ecosystem that can impact these rates of diagnosis, but also just how people think about attention?

Yeah, absolutely. I think there's a lot of great research around the impacts on how the brain is reshaping.

Now we're even seeing it now with early studies of how using more AI and starting to reshape our cognitive functioning.

So I think to ignore the fact that we have changed in the way that we interact with the world around us.

And that is going to have effects on our brain. It's going to have effects on our neurotransmitters.

It's going to have effects on our social cues and how we interact with each other.

So without a doubt, I think thinking about this next generation that's coming up and maybe reestablishing a new baseline.

What is this new baseline? Can we preemptively be talking about how do you slow down the effects of these tools that are replacing in everybody's hands?

Also, you know, I think a really important thing is that many of the tools that are used to diagnose ADHD were developed in the 70s, 80s and 90s.

And they haven't really been updated or revalidated in the modern era.

And what does that mean? Do we need to have a recalibration?

And I think that's really the purpose of our study here is to raise the flag and say, we better explore this before it gets out of hand.

And let you go, but just very briefly, if somebody is listening and they think they have ADHD, they've been on social media, they've seen those influencers telling them, perhaps they do.

What would your one piece of advice be to them?

I would say go talk to somebody, you know, go talk to a healthcare provider, but be open-minded on the journey that you may not have it.

You might have something else that you're living with or dealing with.

But you know, it's important if you think today that you have something that you're dealing with that you need to talk to somebody.

I think that's really important, but show up with an open mind and go on that journey to see what the best treatment is for you.

It might be medications, but it might not be.

Minotadros, thank you very much.

Thanks for having me.

Minotadros is an associate professor at the Lesley Dan Faculty of Pharmacy at the University of Toronto.

Have you been diagnosed with ADHD? Do you think you might have it?

What your experience has been would be interesting to hear about.

You can let us know, you can email us the current at cbc.ca.

For more CBC podcasts, go to cbc.ca slash podcasts.