Differences in patterns of attention deficit/hyperactivity disorder medication use in US children

Abstract Background Understanding attention deficit/hyperactivity disorder (ADHD) medication patterns is crucial for optimizing treatment outcomes. There are limited data on racial, ethnic, gender and socioeconomic treatment differences across longitudinal national samples. Methods Secondary data analysis of baseline through 3rd‐year follow‐up (2016–2020) data from the Adolescent Brain Cognitive Development Study (ABCD) ( N = 11,875). Data were collected from 21 US sites, to reflect national demographic diversity. Complete case panel included 9708 children aged 9/10 at baseline and 12/13 at 3rd‐year follow up. Sociodemographic factors (sex, race, ethnicity, household income), ADHD medication use (stimulants and non‐stimulants), and ADHD severity were examined. Results By the 3rd‐year follow‐up, 13% of children used ADHD medications. Females were more likely to never have received medications compared to males (92% vs. 82%, odds ratio [OR] 2.34, 95% confidence interval [CI] 2.05–2.67, p < 0.001). Females exhibited lower mean ADHD severity scores, though the difference diminished over time. Asian (95% vs. 87%, OR 2.83, 95% CI 1.41–5.38, p < 0.001) and Hispanic children (90% vs. 86%, OR 1.39, 95% CI 1.17–1.64, p < 0.001) were more likely to have never received medications compared to White and non‐Hispanic children. Black children were more likely to discontinue medications (9% vs. 5%, OR 1.84, 95% CI 1.45–2.33, p < 0.001) compared to White children, although this was not significant after adjusting for sociodemographic factors. Children in lower income households were more likely to have clinically significant ADHD but less likely to receive and remain on medications compared to those from higher income households. Conclusions Significant differences exist in ADHD medication use patterns among US children based on sex, race, ethnicity, and socioeconomic status. Addressing these differences is essential to ensure equitable access to treatment.