OBJECTIVES: The objectives of the study were 1) to determine trends of prescription stimulant use over the course of a calendar year, 2) to identify geographic variation in patterns of prescription stimulant use, and 3) to identify the social determinants of health that predict trends in prescription stimulant fills.

METHODS: This study employed a retrospective analysis utilizing 2014 Medicaid claims data from 17 states (CA, GA, IA, ID, LA, MI, MN, MO, MS, NJ, PA, SD, TN, UT, VT, WV, WY). Prescription stimulant fills were identified using NDC codes, and weekly trends were analyzed over the 2014 calendar year at the county level. Known social determinants of health were mapped onto the fill trends to identify predictors of stimulant use.

RESULTS: A total of 29,856,293 eligible Medicaid recipients were included in the study. A total of 5,631,234 prescription stimulants were filled in 2014 within the 17 states by 747,366 individuals (2.50% of total eligible population). The highest prevalence of use was observed in Louisiana (5.93%) and the lowest prevalence was observed in California (0.75%). The maximum number of fills was observed in Pennsylvania (866,927 total fills) and the minimum was observed in Wyoming (25,463 total fills). The maximum number of total fills was observed during week 49 (December 1^st – 7^th) and the minimum was observed during week 27 (June 30^th – July 6^th). The overall trends demonstrated peaks during the beginning and end of academic semesters while fills decreased during academic holidays and summer weeks. Further analyses are still being conducted.

CONCLUSIONS: The weekly trends of prescription stimulant use are in line with expected academic motivations of use. The results present a concern for misuse opportunity due to the high number of fills during certain periods. Further research should be conducted to determine misuse liability.