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In some middle and high schools in the United States, 1 in 4 teens report misusing prescription stimulants to treat attention deficit hyperactivity disorder in the past year, a new study finds.
“This is the first national study to examine nonmedical use of prescription stimulants by middle and high school students, and we found a very wide range of misuse,” said lead author Sean Esteban McCabe, director of the Center for Drugs, Alcohol, Tobacco and Health at the University of Michigan in Ann Arbor.
“In some schools, there was little or no stimulant abuse, while in other schools, more than 25 percent of students had used stimulants for nonmedical purposes,” said McCabe, who is also a professor of nursing at the University of Michigan School of Nursing. “This study is a major wake-up call.”
Nonmedical uses of stimulants can include taking a higher-than-normal dose to get a high, or taking the drug with alcohol or other drugs to enhance the high, previous studies have found.
Students also abuse medications or “take a pill that someone gave them because of a feeling of academic stress — they try to stay up late and study or finish their homework,” said pediatrician Dr. Deepa Camenga, associate director of pediatric programs at Yale’s addiction medicine program. New Haven, Connecticut.
“We know this is happening in colleges. One of the key findings of the new study is that abuse and sharing of prescription stimulant medications is happening in middle schools and high schools, not just in college,” said Camenga, who was not involved in the study.
Published Tuesday in the journal JAMA Network Open, the study analyzed data collected between 2005 and 2020 by Monitoring the Future, a federal survey that has measured drug and alcohol use among high school students nationwide every year since 1975.
In the dataset used for this study, questionnaires were administered to over 230,000 adolescents in eighth, tenth, and twelfth grades in a nationally representative sample of 3,284 secondary schools.
Schools with the highest rates of adolescents using medications prescribed for ADHD Students who use prescription stimulants are about 36 percent more likely to have students who abuse the drugs in the past year, the study found. Schools with few or no students currently using such medications have far fewer problems, but they haven’t gone away, McCabe said.
“We know the two main sources are leftover medications, perhaps from family members like siblings, and requests made to peers, who may attend other schools,” he said.
Schools located in suburban areas of every region of the United States except the Northeast had higher rates of ADHD medication abuse among teens, the study found, as did schools where one or more parents typically had a college degree.
Schools with more white students and those where students had average levels of binge drinking were also more likely to see adolescent stimulant abuse.
At the individual level, students who reported using marijuana in the past 30 days were four times more likely to misuse ADHD medications than teens who had not used pot, the analysis found.
Additionally, adolescents who reported using ADHD medications currently or in the past were about 2.5% more likely to have misused stimulants compared with peers who had never used stimulants, the study found.
“But these results are not just because teens with ADHD are misusing their medications,” McCabe said. “We still found a significant association, even when we excluded students who had never been prescribed ADHD medication.”
Data collection for the study ran through 2020. Since then, new statistics show that stimulant prescriptions increased by 10% in 2021 across most age groups. At the same time, there was a national shortage of Adderall, one of the most popular ADHD medications, leaving many patients without a prescription. unable to fill or renew their prescriptions.
The stakes are high: Taking stimulant medications inappropriately over time can lead to stimulant use disorder, which can cause anxiety, depression, psychosis and seizures, experts say.
When abused or combined with alcohol or other drugs, side effects can be sudden. According to the Substance Abuse and Mental Health Services Administration, side effects can include “paranoia, dangerously high body temperature, and irregular heartbeat, especially if stimulants are taken in high doses or in ways other than swallowing a pill.”
Research has also shown that people who abuse ADHD medications are at high risk for multiple substance use disorders.
Stimulant drug abuse has increased over the past two decades, experts say, as more teens are diagnosed and prescribed the medications — studies have shown that According to McCabe, 1 in 9 high school seniors report receiving stimulant therapy for ADHD.
For children with ADHD who use their medications properly, stimulants can be an effective treatment. They “protect the child’s health,” Camenga said. “Teens who are diagnosed, treated properly, and followed up do very well: They are less likely to develop new mental health problems or new substance use disorders.”
What Parents and Guardians Can Do
The solution to the problem of stimulant abuse among middle and high school teens is not to limit the use of the drugs to kids who really need them, McCabe stressed.
“Instead, we need to look carefully at which school strategies are more or less effective in curbing stimulant abuse,” he said. “Parents can make sure that the schools their children attend have safe storage conditions for medications and strict rules for dispensing. And they can learn about the prevalence of abuse – that data is available for every school.”
Families can also help by teaching their children how to handle peers who approach them asking for a pill or two to party or to spend a night studying, he added.
“You’d be surprised how many kids don’t know what to say,” McCabe said. “Parents can role-play with their kids to give them options about what to say so they’re prepared when it happens.”
Parents and guardians Controlled medications should always be kept in a secure box and not be afraid to count pills and ensure they are replenished promptly, he added.
“Finally, if parents suspect any misuse, they should immediately contact their child’s prescribing physician,” McCabe said. “That child needs to be examined and evaluated immediately.”
