More Stimulants, More Risks

Balancing the risks of stimulant treatment at the population level

STUDY: Hankin M et al, Internal Medicine Journal 2026;1–4

STUDY TYPE: Viewpoint

FUNDING: Independent

Background

Amidst pressure to expand access to ADHD medications in Australia, a psychiatrist calls for caution. Here’s why:

• Short-term trial data understate the cumulative risks of stimulant treatment.
• Swedish national cohort data found cardiovascular disease risk rose 4% for each additional year of stimulant use, with hypertension 80% higher after five or more years.
• New-onset psychosis occurred in up to 2.83 per 1000 people per year.
• A recent meta-analysis found 22.6% of patients misused prescribed stimulants, and 18.2% diverted them.
• The authors highlight the medical cannabis “script mill” experience as a warning. Telehealth platforms are emerging in Australia that act as stimulant pill-mills (similar problems happened in the US, resulting in a $100 million fraud case and a shortage of meds for patients who need them)

Practice Implications

1. When used to treat ADHD, stimulants have lasting benefits, even increasing longevity. When used in people who don’t have ADHD, the benefits wear off and the risks build up.