Express Scripts, which just released a report titled “Turning Attention to ADHD,” found that almost one in 10 adolescent boys were taking stimulant medication (mostly Adderall) for attention deficit hyperactivity disorder (ADHD).

Moreover, it found “significant geographic differences” in ADHD drug utilization throughout the U.S. According to Express Scripts research.

“The concentration of ADHD medication users in Southern states is higher
than in other regions of the country. In 2012, the proportion of Southerners of any age who were taking ADHD medications was 3.6%, compared with 2.9% for the country as a whole. Boys between the ages of 12 and 18 who live in the South had the highest prevalence nationwide, reaching 10.5% while nationally, 9.3% of boys that age are using ADHD medications.”

Here’s the map showing the prevalence of ADHD medication utilization by state in 2012:

Click on image for enlarged view.

Obviously, the South has an ADHD problem that it is treating with Adderall.

“There are a number of factors that may be driving regional variations in ADHD medication use,” says Express Scripts. “Socio-economics plays a role, with lower-income children more likely to be diagnosed with ADHD.”

Express Scripts does not say how lower-income children pay for their medication, but Medicaid plays a big role in that according to a 2013 report in the NY Times (here). Many doctors in Georgia, for example, are prescribing ADHD medications to help low-income children struggling in elementary school, even when they do not have ADHD (read “It’s Official: Doctors Prescribe Adderall to Help Kids Get Higher Grades at School“). The cost of those (unnecessary) prescriptions come from the state and the federal government via Medicaid. One of the mothers profiled in the article notes that Medicaid pays for nearly every penny of her children’s prescription costs.

Express Scripts also reports that there was a significant uptick in the number of adults prescribed ADHD medication in recent years.

Click on image for enlarged view.

But that may change as many of the same states that use Medicaid funds to pay for Adderall prescriptions for children are choosing not to opt into the Medicaid expansion plan, which would cover adults aged 19 to 65. Mostly, these are GOP states. Here’s the map showing where states stand on Medicaid expansion:

Click on image for enlarged view. Source: