Doctors are dishing our powerful ADHD drugs at 10-times the rate in some parts of England than others, a MailOnline analysis suggests, as experts warn over-diagnosis and ‘mass-prescribing’ could be putting public health at risk.
NHS data shows one in 100 people in some areas are now taking ADHD medications, compared to one in 1,000 in nearby regions.
World-leading experts told MailOnline the most likely reason for the wide variation were differences in the way ADHD is diagnosed.
Our investigation adds to growing concerns that Brits are being wrongly labelled with ADHD by private clinics, which charge hundreds of pounds for an appointment.
They are then prescribed simulant medication to treat the problem, which the NHS has to supply — potentially risking side effects without reason — it has been claimed.
MailOnline’s analysis shows Wirral topped the charts as the area in England where people are most likely to be prescribed ADHD medication.
One in every 100 people in the region was prescribed the tablets in April this year, the latest data available.
This was 10-times higher than Rotherham, which recorded only one ADHD drug prescription for every 1,000 people.
Higher rates were also recorded in areas like Brighton and Hove, were seven in every 1,000 people were on ADHD drugs as well as the NHS-region of North East Essex where three in every 500 residents were taking the stimulants.
Commonly taken ADHD drugs include methylphenidate (Ritalin), lisdexamfetamine (Elvanse) and dexamfetamine (Amfexa).
MailOnline’s analysis used the number of ADHD prescriptions recorded in each NHS sub-region of England in April this year and the health service’s patient population data for that area.
University College London psychiatrist Professor Joanna Moncrieff, a vocal critic of medication over-use, said the data demonstrated how some medics were more eager to diagnose ADHD than others.
‘This confirms just how incredibly subjective ADHD diagnosis is,’ she said.
‘One psychiatrist in one service can think almost everyone has it while another psychiatrist in another service thinks very few people have it.
‘The criteria for ADHD are subjective and we all have the symptoms of ADHD to one extent or another.’
She said some psychiatrists, particularly in the independent sector, were very quick to diagnose people with ADHD, whereas others were far more cautious.
‘You’re more likely to get a diagnosis if you go to a private clinic than if you go to the NHS,’ she said.
ADHD is defined as a persistent pattern of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning.
However, there are no clear definitions as to what this constitutes meaning that a patient with the same symptoms can get a different diagnosis from two psychiatrists.
But Professor Moncrieff said patients were increasingly demanding an ADHD diagnosis as the ‘answer’ to problems they are experiencing in areas like their work.
‘This concept of ADHD has got out there and everyone is reinterpreting their difficulties in the light this new idea, “I’m not bored and don’t like my job, I have ADHD”,’ she said.
‘Stimulants make people feel good, they make them feel confident, they make people feel a little bit euphoric, energetic, so of course people are going to be rating themselves as doing better.’
Fascinating graphs show how ADHD prescriptions have risen over time, with the patient demographic shifting from children to adults with women in particular now driving the increase
She added there was no medical reason why ADHD rates should differ so much across the country and was evidence of how variable diagnosis was.
‘There’s no evidence that there is a medical reason for variation in ADHD rates, as in, that there’s a biological reason why people in one area would be more likely to have ADHD than in another area,’ she said.
But Professor Moncrieff did add the figures could, in part, also be explained by demographic factors.
She highlighted how people in more deprived areas are more likely to experience mental health issues in general and how, overall, younger groups were more likely to seek out an ADHD diagnosis than older Brits.
However, she said the risks of people taking ADHD medications were real.
‘ADHD drugs are stimulants, they include amphetamine which is a well recognised recreational substance,’ she said.
She said they are associated with an increased risk of serious health issues like heart attacks, strokes and there was some evidence they also increase the risk of conditions like Parkinson’s and even potentially psychosis.
Professor Moncrieff said most of the data on these risks came from sporadic or occasional use of stimulants and medics were still largely ignorant of the consequences of taking them for life as ADHD patients are advised.
‘It’s petrifying that we don’t know what the long term consequences of this are,’ she said.
‘We’ve launched into this mass prescribing exercise without really good evidence on the long term consequences.’
She called for NHS England to investigate ADHD diagnosis and the prescription variance across the country to prevent Brits suffering potentially dire consequences.
‘There needs to be a proper investigation into what’s going on at the moment or else we are heading to a scandal,’ she said.
‘There’s going to be a large proportion of the general population taking stimulants, we’re going to see more and more adverse effects coming up, cardiovascular effects, psychosis, increased risk of Parkinson’s. There’s got to be a review of this.’
An NHS spokesperson said: ‘The NHS is committed to improving the lives of those with ADHD and we know there is much more work to do so that more people can get the medical care they need.
‘An NHS taskforce with independent experts has started important work investigating challenges in ADHD service provision so that we can support more patients and to help local services to manage increased referrals.’
Rising interest in ADHD diagnoses are thought to have been partly fuelled by celebrities such as model Katie Price, Love Island star Olivia Attwood and actress Sheridan Smith talking about their own ADHD journey.
An NHS spokesperson said: “The NHS is committed to improving the lives of those with ADHD and we know there is much more work to do so that more people can get the medical care they need.
“An NHS taskforce with independent experts has started important work investigating challenges in ADHD service provision so that we can support more patients and to help local services to manage increased referrals.”
Attwood previously explained how the condition ’caused myself and people around me a lot of stress’ during her teens and early 20s ‘when it wasn’t managed’.
Price also discussed how her adult ADHD diagnosis explains why she has never felt there would be ‘consequences’ for her actions.
Former Bake Off host Sue Perkins last year shared that she had been diagnosed with ADHD and that ‘suddenly everything made sense – to me and those who love me’.
Social media has also been blamed for encouraging people to seek out ADHD drugs with videos from users boasting how taking them has helped calm them down, control their fidgeting and boost their concentration.
NHS data, for the 2022/23 financial year, shows a massive surge in year-on-year ADHD drug prescriptions in women between their late 20s and early 30s, with rises of almost 60 per cent.
Overall figures have doubled in six years, with 230,000 in England taking the drugs last year.
The biggest rise has been in young adults, with treatment increasing five-fold among those aged 25 to 39 since 2015.
This increase has prompted NHS England to launch a dedicated taskforce earlier this year to explore exactly how many people are affected and how to improve their care.
These experts will investigate ‘the rate of growth within the independent sector and the potential variation in the service models and thresholds being used’, and collect data to ‘fully understand the size of the challenge’.
ADHD diagnosis is also driving a surge in the number of children and young adults claiming disability benefits.
Some 1.6million children are reported as disabled, a figure that has doubled in little more than a decade and jumped by more than a third since Covid. Claims for behavioural disorders such as ADHD make up a fifth of all claims.
Furthermore, more than 52,000 adults who receive personal independence payments from the government list ADHD as their main condition, with most of these being 16 to 29-year-olds who have been transferred from disability allowance when they reached adulthood. This number is up from 38,000 in 2022.
Former Bake Off host Sue Perkins (left) last year shared that she had been diagnosed and that ‘suddenly everything made sense – to me and those who love me’. Love Island’s Olivia Atwood (right) said ADHD made her ‘constantly overwhelmed’
Estimates of how many people in the UK actually have ADHD vary.
For example, The National Institute for Health and Care Excellence (Nice) estimates one in twenty children (5 per cent) and one in 29 adults (3 to 4 per cent) have the condition.
But charity, the ADHD Foundation say as many as one in 20 adults in Britain could have the condition.
Some NHS trusts have also reported that waiting lists for an ADHD assessment in their area exceeds 10 years, a factor which may be driving people to seek help privately.
A damning BBC investigation earlier this year found patients could get diagnosed with ADHD and offered powerful drugs through unreliable video call assessments with private clinics.
What exactly causes ADHD to appear in some people is unclear, but it’s thought to involve genetic mutations that affect a person’s brain function and structure.
Premature babies and those with epilepsy or brain damage are thought to be more at risk.
ADHD is also linked to other conditions like anxiety, depression, insomnia, Tourette’s and epilepsy.
There is no cure, but a combination of drugs and therapy is usually recommended to relieve symptoms and make day-to-day life easier.
MailOnline analysis of data has limitations as it covers prescriptions, not patients, which means in theory a single patient may count for more than one prescription, for example, if they lost their medication and needed a new script.
