ADHD News & Research

More Young Adults Misuse Stimulant Medications

A study finds that rates of stimulant abuse – particularly with Adderall – are on the rise for young adults, between the ages of 18 and 25, without ADHD.

Misuse of ADHD drugs – and emergency room visits due to overdose – have risen sharply, a new study finds, even as overall prescription rates have held steady.

The study, published Tuesday in the Journal of Clinical Psychiatry, examined three sets of data spanning from 2006 to 2011: the National Disease and Therapeutic Index, a survey of doctors’ office practices; the National Survey on Drug Use and Health, a nationwide survey on substance use among adults; and the Drug Abuse Warning Network, a collection of data focusing on hospital emergency room visits.

During the six-year period studied, prescriptions of Adderall remained steady, while non-medical use increased from 0.73 percent of adults to 1.2 percent. The actual percentage is small, but, researchers note, the rate of misuse increased by 67 percent – a dramatic rise that was seen most prominently in the 18-to-25 age group.

On top of that, emergency room visits due to non-medical use of Adderall increased as well – from 862 visits in 2006 to 1489 in 2011. The causes cited were generally mild (and common) side effects like anxiety, agitation, and insomnia, but more serious cardiovascular events like heart attacks, strokes, and dangerous blood pressure levels were also reported.

Stimulants give a mental boost to non-ADHD adults, increasing focus and energy, while decreasing appetite and the need for sleep. Among those who reported misusing the drugs, most said they were trying to gain an edge at school or work, or giving themselves an extra boost of energy for social events. A prior study found that college students who misused stimulants were mostly uninformed about possible side effects, and also saw nothing wrong with stimulant misuse. “We discovered that these students frame stimulant use as both physically harmless and morally acceptable,” wrote the authors.

The current data refutes the common idea that stimulants are overprescribed, the authors say. “While the mainstream media tend to attribute the increasing abuse rates of these prescription stimulants to physicians’ overprescribing, our data do not support this notion,” said Lian-Yu Chen, M.D., Ph.D., the lead author of the study. “In adults, the abuse rates and ER visits increased significantly, but the prescriptions did not.”

The study also looked at Ritalin and other methylphenidate medications, but it found that the same trends didn’t appear to exist. Amphetamines – whether name- brand Adderall or generic formulations – were more of a culprit, despite the fact that the two drugs work in remarkably similar ways. This may be due simply to word of mouth, researchers hypothesize: “Adderall has gotten a reputation…as a cognitive enhancer,” says Ramin Mojtabai, M.D., MPH, Ph.D., a coauthor of the study. Adderall’s positive reputation “may have contributed to the increased trend of misuse,” he adds.

One possible solution to the misuse, Mojtabai said, is to create a nationwide database of stimulant prescriptions. Such a database already exists for prescription painkillers, and shows doctors if a patient has already obtained the same medication from another doctor. In theory, this should serve as a deterrent to adults with ADHD who are obtaining multiple prescriptions, with the intent of selling or giving away the pills, he said.

It’s also important to educate potential misusers about the dangers, Mojtabai said in a press release. “Many of these college students think stimulants like Adderall are harmless study aids. But there can be serious health risks, and students need to be more aware of them.”