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. 2024 Aug;33(8):2669-2680.
doi: 10.1007/s00787-023-02346-x. Epub 2024 Jan 5.

Impact of COVID-19 pandemic on prescription stimulant use among children and youth: a population-based study

Tony Antoniou  1   2   3   4 , Kathleen Pajer  5   6 , William Gardner  7 , Melanie Penner  8   9 , Yona Lunsky  10   11   12 , Daniel McCormack  10 , Mina Tadrous  10   13 , Muhammad Mamdani  14   10   13   15   16   17 , Peter Gozdyra  10 , David N Juurlink  10   9   18 , Tara Gomes  14   10   13   17
Affiliations

Impact of COVID-19 pandemic on prescription stimulant use among children and youth: a population-based study

Tony Antoniou et al. Eur Child Adolesc Psychiatry. 2024 Aug.

Abstract

COVID-19 associated public health measures and school closures exacerbated symptoms in some children and youth with attention-deficit hyperactivity disorder (ADHD). Less well understood is how the pandemic influenced patterns of prescription stimulant use. We conducted a population-based study of stimulant dispensing to children and youth ≤ 24 years old between January 1, 2013, and June 30, 2022. We used structural break analyses to identify the pandemic month(s) when changes in the dispensing of stimulants occurred. We used interrupted time series models to quantify changes in dispensing following the structural break and compare observed and expected stimulant use. Our main outcome was the change in the monthly rate of stimulant use per 100,000 children and youth. Following an initial immediate decline of 60.1 individuals per 100,000 (95% confidence interval [CI] - 99.0 to - 21.2), the monthly rate of stimulant dispensing increased by 11.8 individuals per 100,000 (95% CI 10.0-13.6), with the greatest increases in trend observed among females, individuals in the highest income neighbourhoods, and those aged 20 to 24. Observed rates were between 3.9% (95% CI 1.7-6.2%) and 36.9% (95% CI 34.3-39.5%) higher than predicted among females from June 2020 onward and between 7.1% (95% CI 4.2-10.0%) and 50.7% (95% CI 47.0-54.4%) higher than expected among individuals aged 20-24 from May 2020 onward. Additional research is needed to ascertain the appropriateness of stimulant use and to develop strategies supporting children and youth with ADHD during future periods of long-term stressors.

Keywords: Adolescent; Central nervous system stimulants; Child; Policy; Prescriptions/statistics & numerical data.

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Conflict of interest statement

Melanie Penner has received consulting fees for unrelated work the Government of Nova Scotia. Mina Tadrous has received consulting fees for unrelated work from Green Shield Canada and the Canadian Agency for Drugs and Technologies in Health. Tara Gomes has received funding from the Ontario MOH and the Ontario College of Pharmacists.

Melanie Penner has received consulting fees for unrelated work the Government of Nova Scotia. Mina Tadrous has received consulting fees for unrelated work from Green Shield Canada and the Canadian Agency for Drugs and Technologies in Health. Tara Gomes has received funding from the Ontario MOH and the Ontario College of Pharmacists.

Figures

Fig. 1
Fig. 1
Impact of COVID-19 (April 2020) on monthly rates of stimulant dispensing among Ontario residents between the ages of 0 and 24, January 2013 to June 2022
Fig. 2
Fig. 2
Impact of COVID-19 on monthly rates of stimulant dispensing among Ontario residents between the ages of 0 and 24, January 2013 to June 2022, stratified by sex
Fig. 3
Fig. 3
Impact of COVID-19 on monthly rates of stimulant dispensing among Ontario residents between the ages of 0 and 24, January 2013 to June 2022, stratified by age
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