Recent years’ increased prescribing of stimulants for attention-deficit/hyperactivity disorder (ADHD) in adolescents has not led to rising abuse, according to a study issued yesterday by JAMA.
“These findings are consistent with declines in peer-to-peer diversion among adolescents following COVID-related school closures and findings from adult studies,” said Sean Esteban McCabe, Ph.D., of the University of Michigan, and colleagues.
McCabe and colleagues analyzed responses from 259,623 youth in eighth, 10th, and 12th grade from the national Monitoring the Future survey between 2005 and 2023. Respondents reported on whether they had ever taken or were now taking prescription stimulants for ADHD; nonstimulant medications were excluded. Respondents also answered questions about lifetime and past 30-day use of these medications “without a doctor telling you to take them.”
Researchers noted that following a sharp drop in teens’ medical stimulant use at the start of the pandemic, such use peaked in 2022 at 9.3%. However, over the 18-year study period, teens’ medical use of prescription stimulants for ADHD increased only modestly. While teens’ nonmedical use of the medications was more prevalent than medical use at the study outset (10.03% versus 8.11%, respectively), nonmedical use decreased significantly over time, reaching a low of 4.69% in 2023. Meanwhile, lifetime prevalence of combination medical/nonmedical use of the medications also dropped over time, from 2.05% in 2005 to 1.37% in 2023.
Compared with adolescents in eighth grade, those in 10th and 12th grade had higher misuse of stimulants but greater declines in such use over time. Among adolescents who reported stimulant misuse, about half used stimulants one to two times, one-quarter used them three to nine times, and the remainder used them more than 10 times.
Limitations of the study include lack of information about dose and lack of representation of homeschooled or truant youth, the researchers wrote.
“Despite concerns about increased stimulant prescribing, findings indicate no associated increase in nonmedical prescription stimulant use at this time, although longitudinal research and continued monitoring is necessary,” the researchers wrote. “These findings enable clinicians and policymakers to consider population-level trends in … use patterns when weighing the risks and benefits of prescription stimulants.”
For more information, see the Psychiatric Services article (from McCabe and colleagues) “Attention-Deficit Hyperactivity Disorder Stimulant Therapy and Prescription Drug Misuse During Transition to Young Adulthood.”
(Image: Getty Images/iStock/Ridofranz)
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