Australia has seen a dramatic surge in the number of young people receiving medication for attention-deficit hyperactivity disorder (ADHD), with prescriptions rising more than tenfold over the past two decades, new research shows. At the same time, the demographic profile of those most likely to receive treatment has shifted significantly, with children in the wealthiest postcodes now leading national prescription rates.

The analysis, covering 20 years of national Pharmaceutical Benefits Scheme (PBS) data, indicates that ADHD medication is no longer most prevalent in disadvantaged communities—a reversal of long-standing trends.

What is ADHD?

ADHD is the most commonly diagnosed disorder among Australian children. While symptoms vary from person to person, it's associated with hyperactive and/or inattentive behaviours that cause challenges at home, school or work.

The most common approved treatment for ADHD is psychostimulant drugs.

Sharp rise in prescriptions over two decades

The number of children aged 5 to 17 taking ADHD medication rose from just over 20,000 in 2003—representing 0.5% of the youth population—to more than 246,000 in 2022, or 4.2% of young people.

The steepest increases occurred during the COVID-19 pandemic. Between 2020 and 2022, prescriptions climbed sharply, particularly among older teenagers. Medication use among 15- to 17-year-olds jumped from 3.1% to 5.2% in just two years. Researchers suggest lockdowns played a key role, prompting families to seek assessments or revisit concerns about learning and behavioural difficulties.

Diagnosis becoming more consistent nationwide

In the early 2000s, ADHD treatment varied widely depending on where families lived. States such as Western Australia and Queensland consistently recorded higher prescription rates, while other jurisdictions lagged.

Researchers used a "standardised medication ratio"—with 1.0 representing the national average—to compare postcodes. In 2003, disparities were pronounced across states and territories. Over time, however, the gaps have narrowed substantially.

The study attributes this shift to more uniform clinical practice and national efforts to align diagnostic and treatment guidelines. As more states expand prescribing powers to general practitioners, the authors say consistent training and oversight will be crucial to avoid repeating past inconsistencies.

From poorest to richest: a reversal in who receives medication

For decades, children in the most disadvantaged areas were the most likely to be prescribed ADHD medication. But that pattern has flipped.

In 2003, the wealthiest 10% of postcodes had the lowest prescription ratios—around 0.612, well below the national standard. By 2021, they had surged to the highest levels, reaching 1.245. Meanwhile, the poorest postcodes showed a ratio of 0.708.

Although most areas now cluster close to the national average, the contrast between the richest and poorest regions is stark.

The research suggests that access is a key factor. Diagnosing ADHD often requires multiple specialist appointments, psychological assessments and lengthy wait times—barriers that wealthier families are better placed to navigate. For lower-income households, both wait lists and upfront costs may deter parents from pursuing diagnosis or treatment.

Important limits in the study

The data reflects only prescriptions filled through the PBS, meaning medications dispensed in private clinics—more common in high-income areas—were not captured. This likely means actual rates in affluent communities are even higher.

The research could not account for cultural or ethnic factors because all data was anonymised. Nor could it determine whether some areas are overdiagnosing ADHD, as repeat prescriptions and individual postcode comparisons were not included.

While diagnostic guidelines have shifted over time, including a key change in 2013, the study found no significant prescription spikes linked to those revisions. Instead, growth has been steady, accelerating only from 2020.

Researchers say the findings reflect wider social acceptance of neurodivergence and growing consistency in clinical care. Australia, they argue, is moving away from the “postcode lottery” that once determined whether children were diagnosed or treated for ADHD.

But the widening gap between the richest and poorest postcodes is a reminder that equitable access remains uneven.

(The Conversation)