This article investigates geographic variation in stimulant medication use by youth with attention-deficit/hyperactivity disorder (ADHD) served by public mental health and/or drug and alcohol programs in San Diego (n = 790) during 1997—1998 and in Puerto Rico ( n = 726) during 1998.Youth were stratified into four groups: (a) ADHD, (b) ADHD—not otherwise specified (ADHD-NOS), (c) other DSM-IV diagnoses, (d) no diagnosis. Reported rates of stimulant use were as follows: ADHD, 32.9% (Puerto Rico) and 38.8% (San Diego), and ADHD-NOS, 20.2% (Puerto Rico) and 17.8% (San Diego).Youth in San Diego were more likely to use other psychotropics and to have experienced residential or inpatient care compared with youth in Puerto Rico. A regression model indicated that predictors of stimulant use at both sites included ADHD, ADHD-NOS, male gender, and younger age. Despite sociodemographic and cultural differences, both settings demonstrated similar patterns of stimulant use, suggesting these medications are not over-used in public sectors.
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