An analysis of the significant variation in psychostimulant use across the U.S

Pharmacoepidemiol Drug Saf. 2005 Apr;14(4):267-75. doi: 10.1002/pds.980.


Objective: To provide a national profile of the area variation in per-capita psychostimulant consumption in the U.S.

Methods: We separated 3030 U.S. counties into two categories of 'low' and 'high' per-capita use of attention deficit hyperactivity disorder (ADHD) drugs (based on data from the Drug Enforcement Administration), and then analyzed them on the basis of their socio-demographic, economic, educational and medical characteristics.

Results: We found significant differences and similarities in the profile of counties in the U.S. that are above and below the national median rate of per-capita psychostimulant use (defined as g/per 100K population). Compared to counties below the median level, counties above the median level have: significantly greater population, higher per-capita income, lower unemployment rates, greater HMO penetration, more physicians per capita, a higher ratio of young-to-old physicians and a slightly higher students-to-teacher ratio.

Conclusions: Our analysis of the DEA's ARCOS data shows that most of the significant variables correlated with 'higher' per-capita use of ADHD drugs serve as a proxy for county affluence. To provide a more complex, multivariate analysis of the area variation in psychostimulant use across the U.S.-which is the logical next step-requires obtaining price data to match the DEA's quantity data.

MeSH terms

  • Adolescent
  • Amphetamines / therapeutic use*
  • Antipsychotic Agents / therapeutic use*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Data Interpretation, Statistical
  • Demography
  • Female
  • Humans
  • Male
  • Methylphenidate / therapeutic use*
  • Socioeconomic Factors
  • United States


  • Amphetamines
  • Antipsychotic Agents
  • Central Nervous System Stimulants
  • Methylphenidate