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

Objective: To provide a county-level profile of the area variation in psychostimulant use in the U.S. Methods: We sepa-rated 3,030 U.S. counties into two categories of “low” and “high” use of ADHD drugs (based on data from the Drug Enforce-ment Administration, DEA), and then compared them on the basis of their socio-demographic, economic, educational, and medical characteristics. Results: We found that there is a significant difference in the profile of counties that are above or below the national median rate of psychostimulant use (defined as grams/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, and higher students-to-teacher ratios. The two sets of counties also differ significantly in their demographic composition. Conclusions: Our analysis of the DEA's ARCOS data shows that area variation in psychostimulant use is large and growing over time. U.S. counties differ significantly not only in their use of psychostimulant drugs, but also in their socioeconomic, demo-graphic, educational, and health system characteristics.