The areas in NSW with the most ADHD prescriptions

Exorbitant psychologist fees and year-long wait times for an ADHD diagnosis are forcing desperate Australians to self-medicate with illegal drugs.

Exorbitant psychologist fees and year-long wait times for an ADHD diagnosis are forcing desperate Australians to self-medicate with illegal drugs.

Amid a doubling of prescriptions for attention-deficit/hyperactivity disorder in the past decade, the illegal drug revelation is one in a number of troubling submissions made ahead of a Senate inquiry into the nation’s treatment of the condition which affects at least 1.5 million Australians.

With soaring cases, many psychiatrists have closed their books, prompting year-long wait times for a diagnosis, which comes at a huge cost.

Submissions to the inquiry include reports of psychiatrists charging up to $2500 for a diagnosis alone, and up to $550 for a regular check up to access medication.

ADHD Foundation director Christopher Ouizeman.

Sydney mum Kathryn Lowe said fees had climbed significantly since she was first diagnosed in 2019, and at times she had been forced to choose between paying for appointments and medication, or rent.

“I have had to go off my medication, because I can’t afford my psychiatrist appointment which has climbed hugely (in cost), as well as have enough money for food,” she said.

One sufferer said it was cheaper to “go to a drug dealer and get a bit of speed than pay to go see a psychiatrist and get medication”.

ADHD Foundation director Christopher Ouizeman said he had heard stories like this before, recounting one call to the organisation’s hotline where an anonymous caller said that it was “easier to find meth than get an appointment to secure medication”.

Unable to find treating psychiatrists for many years, the caller had gone down a dark path with drugs.

“When he was effectively treated and properly medicated he got his life back in order and is now an elite sports person making a wonderful contribution to society … without proper treatment and medication, he would likely be dead,” said Mr Ouizeman.

The dramatic spike in prescriptions coincides with a significant increase in awareness around ADHD in Australia, particularly on social media platforms such as TikTok.

Entire online communities have formed around relatable ADHD videos, memes and group chats.

According to Mr Ouizeman, while awareness is a good thing, it has also caused problems.

“One of the problems with TikTok is that people will jump online and self-diagnose,” he said.

“There are a lot of people clogging up the system.”

WHERE THE ADHD HOT SPOTS ARE

Newcastle, Wyong and Penrith are the ADHD medication capitals of NSW, exclusive analysis by The Sunday Telegraph can reveal.

Between 2017 and 2022, the three areas recorded the highest total number of scripts for ADHD stimulants, according to Pharmaceutical Benefits Scheme (PBS) data.

New data provided by the PBS examined the total number of ADHD scripts issued in areas across NSW in the six years between 2017 and 2022.

Newcastle led the way, with the beachside city filling 124,945 prescriptions from 2017 to 2022. Prescriptions surged from 12,814 prescriptions in 2017 to 32,458 in 2022 — an increase of 153 per cent.

Wyong followed closely behind, recording 117,586 prescriptions and a 101 per cent surge in prescriptions, jumping from 13,149 in 2017 to 27,378 in 2022.

Penrith ranked next, with 102,592 prescriptions from 2017 to 2022, reflecting a 141 per cent increase from 10,569 in 2017 to 25,474 in 2022.

The most significant jump in prescriptions was seen in the inner-city region of Marrickville, Sydenham, and Petersham, which increased an almost 300 per cent jump, from 2402 in 2017 to 9547 in 2022. Wollongong and Leichhardt experienced similar explosions, with the areas recording an increase of 258 per cent and 238 per cent respectively.

When considering population size, Maitland topped the list with the highest number of prescriptions. The Lower Hunter Region filled 167 scripts per 1000 people, followed closely by Leichhardt with 164 and Lake Macquarie with 161.

ADHD Explosion

ADHD medication needs have more than doubled in the past decade, forcing many psychiatrists and paediatricians to close their books to new ­patients (see story below).

It’s left those living in hotspot areas like Penrith struggling to access treatment and medication.

Penrith mum Susanne Devine sees herself as one of the lucky ones. Both her teenage children have ADHD, and while she has been able to get them into treatment, it’s sometimes a logistical nightmare.

While her 15-year-old son Callum sees a local paediatrician, securing treatment for her 13-year-old daughter Neveah requires extensive travel, hours away from home.

“It’s becoming harder and harder for families with children to be able to see psychiatrists to be diagnosed … it’s really disappointing because early treatment makes such a difference,” she said.

Susanne Devine with 15-year-old son Callum Hulbert who has ADHD. Picture: Sam Ruttyn

Although the high prescription figures suggest an increase in ADHD diagnoses and medication use, according to leading ADHD researcher and psychiatrist Professor David Coghill, there’s more to the numbers than meets the eye.

According to Prof Coghill, it’s important to note that the number of prescriptions filled does not necessarily reflect the number of patients being treated.

“While you might be able to get a rough estimate of how many people have been prescribed medication in one area, there’s going to be a margin of error,” he said.

“The true number of people being treated for ADHD varies greatly, depending on how many prescriptions one individually gets.

“If somebody, for example, is prescribed two different medications for the same condition, then you run the risk of double counting them. It’s one person but it looks like two.”

Why are some areas higher than others?

When asked why certain areas had such high numbers of scripts compared to others, Prof Coghill said that a number of factors could come into play.

“There are many reasons why one place might prescribe higher than others. The most simple one is access to people who can prescribe and diagnose,” he said.

“If you have an area where there’s a higher concentration of psychiatrists, then those places will diagnose and prescribe more than one would expect in areas with limited access like rural NSW.

“I wouldn’t be surprised to see increases in higher socio-demographic groups, because those are the groups that actually have better access to private health care and services,” he said.

Dr Alison Poulton. Picture: John Feder

A 2018 study by The Australian Atlas of Healthcare Variation that examined rates of ADHD medication dispensing in under-17-year-olds found that regional towns were more likely to have more prescriptions than major cities. Dispensing rates were also higher in lower-socio-economic areas.

Ahead of an upcoming ADHD inquiry, many experts are raising concerns about the impacts of untreated ADHD. The Royal Australian and New Zealand College of Psychiatrists estimates ADHD to be the most common neurodevelopment disorder, costing the Australian economy $20.4 billion in lost productivity and health sector expenditure.

Meanwhile, according to ADHD Foundation Director Christopher Ouizeman, an estimated 25 per cent of juveniles and adults in the judicial system have ADHD.

“Had their condition been effectively diagnosed and treated, they possibly may not have ended up in the system,” said Mr Ouizeman.

One way to solve the issue of long wait times and exorbitant fees was to allow GPS to prescribe medication.

Generally, only paediatricians and psychiatrists diagnose and prescribe ADHD medication, with ongoing specialist visits required.

Specialist ADHD paediatrician and researcher Dr Alison Poulton is a strong advocate for a system overhaul. She the ADHD Professions Association is calling for GPs to be upskilled in ADHD diagnosis and treatment.

Under the proposal, GPs will be trained in ADHD identification and given the same prescribing rights as psychiatrists and paediatricians.

According to Dr Poulton, ADHD treatment is at risk of becoming a class-based system, where only the wealthy have access to treatment.

“By restricting prescribing to specialists you’re basically restricting access … it’s not fit for purpose. The reality is there’s not enough psychiatrists and paediatricians to go around right now,” she said.

“Allowing GPS to see patients alongside their psychiatrist, would solve this bottleneck.”

She also said the substantial growth in prescriptions observed in areas like Marrickville and Leichhardt could be attributed to increased investment in treatment.

She noted that in 2000, southwest Sydney, central Sydney, and the far west of NSW had the lowest prescribing rates in the state. However, since then, there had been significant expansion in the Department of Community Paediatrics within Sydney‘s local health district.

“This expansion could potentially account for the rise in prescribing rates observed in Leichhardt, Marrickville, Petersham, and Sydenham,” she said.

Got a news tip? Email [e-mail]