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The nonmedical use of prescription ADHD medications: results from a national Internet panel.

Novak SP, Kroutil LA, Williams RL, Van Brunt DL - Subst Abuse Treat Prev Policy (2007)

Bottom Line: Most respondents reporting NMU used on multiple occasions.Productivity was the most frequently endorsed reason for NMU.Because most prescription ADHD medications currently are highly regulated, policy options for supply-side reduction of nonmedical use may include identifying those medications with lower abuse liability for inclusion on insurance formularies.

View Article: PubMed Central - HTML - PubMed

Affiliation: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. snovak@rti.org

ABSTRACT

Background: Emerging evidence suggests that nonmedical use (NMU) of prescription attention deficit/hyperactivity disorder (ADHD) medications is rising, but many previous investigations have used clinical or regionally based samples or limited their investigations to stimulants rather than to medications specifically used to treat ADHD. Using an Internet-based epidemiological survey, this paper advances understanding of the prevalence and correlates of NMU of medications used to treat ADHD, sources of diverted medications, motivations for use, and consumption patterns.

Methods: The study used a self-administered Internet survey of civilian, noninstitutionalized adults (N = 4,297) aged 18 to 49 in the United States. National-level estimates were created using propensity scoring methods and weighting procedures using data from three nationally representative probability surveys: a random-digit dialed telephone survey, the current U.S. Census, and the National Survey on Drug Use and Health (NSDUH).

Results: Past-year prevalence of NMU of ADHD medications was approximately 2%, with 4.3% reported among those aged 18 to 25 and 1.3% among those aged 26 to 49. Most respondents reporting NMU used on multiple occasions. Receipt of medications for ADHD was a significant correlate of past-year NMU, though most nonmedical users never had a prescription. Among persons who had never been prescribed medication to treat ADHD, friends or family members were the most common source. Productivity was the most frequently endorsed reason for NMU. Alcohol was the substance most commonly used in combination with ADHD drugs.

Conclusion: Because most prescription ADHD medications currently are highly regulated, policy options for supply-side reduction of nonmedical use may include identifying those medications with lower abuse liability for inclusion on insurance formularies. Patient and physician education programs also may be useful tools to heighten awareness of intentional and unintentional diversion of ADHD medications for nonmedical purposes.

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Related in: MedlinePlus

Sources of diverted adhd medications among past-year nonmedical users. Percentages of past-year nonmedical users of ADHD medications aged 18 to 49 who were never told that they had ADHD or were never prescribed medications specifically for ADHD and who were estimated to have obtained diverted medications in specific ways (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder. * Stolen from friends, family members, or other sources. † Obtained fraudulently by mispresenting symptoms or presenting to a physician who "didn't ask too many questions."
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Figure 1: Sources of diverted adhd medications among past-year nonmedical users. Percentages of past-year nonmedical users of ADHD medications aged 18 to 49 who were never told that they had ADHD or were never prescribed medications specifically for ADHD and who were estimated to have obtained diverted medications in specific ways (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder. * Stolen from friends, family members, or other sources. † Obtained fraudulently by mispresenting symptoms or presenting to a physician who "didn't ask too many questions."

Mentions: Figure 1 presents findings on sources of diverted ADHD medications for the NMUs who reported never having an ADHD diagnosis and prescription. The 95% confidence intervals also are presented to show the precision of the estimates. The most common source among this group was a friend or family member (66%) who gave away some of their prescription. More than 34% of NMUs had taken or stolen medications from friends, family, or other sources. However, physicians also were a significant source of diverted medications for this group, with nearly 20% of NMUs having obtained fraudulent prescriptions by fabricating symptoms or presenting to doctors who were known to "not ask too many questions." An estimated 5% of NMUs without a legitimate need for a prescription procured their medications over the Internet.


The nonmedical use of prescription ADHD medications: results from a national Internet panel.

Novak SP, Kroutil LA, Williams RL, Van Brunt DL - Subst Abuse Treat Prev Policy (2007)

Sources of diverted adhd medications among past-year nonmedical users. Percentages of past-year nonmedical users of ADHD medications aged 18 to 49 who were never told that they had ADHD or were never prescribed medications specifically for ADHD and who were estimated to have obtained diverted medications in specific ways (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder. * Stolen from friends, family members, or other sources. † Obtained fraudulently by mispresenting symptoms or presenting to a physician who "didn't ask too many questions."
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2211747&req=5

Figure 1: Sources of diverted adhd medications among past-year nonmedical users. Percentages of past-year nonmedical users of ADHD medications aged 18 to 49 who were never told that they had ADHD or were never prescribed medications specifically for ADHD and who were estimated to have obtained diverted medications in specific ways (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder. * Stolen from friends, family members, or other sources. † Obtained fraudulently by mispresenting symptoms or presenting to a physician who "didn't ask too many questions."
Mentions: Figure 1 presents findings on sources of diverted ADHD medications for the NMUs who reported never having an ADHD diagnosis and prescription. The 95% confidence intervals also are presented to show the precision of the estimates. The most common source among this group was a friend or family member (66%) who gave away some of their prescription. More than 34% of NMUs had taken or stolen medications from friends, family, or other sources. However, physicians also were a significant source of diverted medications for this group, with nearly 20% of NMUs having obtained fraudulent prescriptions by fabricating symptoms or presenting to doctors who were known to "not ask too many questions." An estimated 5% of NMUs without a legitimate need for a prescription procured their medications over the Internet.

Bottom Line: Most respondents reporting NMU used on multiple occasions.Productivity was the most frequently endorsed reason for NMU.Because most prescription ADHD medications currently are highly regulated, policy options for supply-side reduction of nonmedical use may include identifying those medications with lower abuse liability for inclusion on insurance formularies.

View Article: PubMed Central - HTML - PubMed

Affiliation: RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA. snovak@rti.org

ABSTRACT

Background: Emerging evidence suggests that nonmedical use (NMU) of prescription attention deficit/hyperactivity disorder (ADHD) medications is rising, but many previous investigations have used clinical or regionally based samples or limited their investigations to stimulants rather than to medications specifically used to treat ADHD. Using an Internet-based epidemiological survey, this paper advances understanding of the prevalence and correlates of NMU of medications used to treat ADHD, sources of diverted medications, motivations for use, and consumption patterns.

Methods: The study used a self-administered Internet survey of civilian, noninstitutionalized adults (N = 4,297) aged 18 to 49 in the United States. National-level estimates were created using propensity scoring methods and weighting procedures using data from three nationally representative probability surveys: a random-digit dialed telephone survey, the current U.S. Census, and the National Survey on Drug Use and Health (NSDUH).

Results: Past-year prevalence of NMU of ADHD medications was approximately 2%, with 4.3% reported among those aged 18 to 25 and 1.3% among those aged 26 to 49. Most respondents reporting NMU used on multiple occasions. Receipt of medications for ADHD was a significant correlate of past-year NMU, though most nonmedical users never had a prescription. Among persons who had never been prescribed medication to treat ADHD, friends or family members were the most common source. Productivity was the most frequently endorsed reason for NMU. Alcohol was the substance most commonly used in combination with ADHD drugs.

Conclusion: Because most prescription ADHD medications currently are highly regulated, policy options for supply-side reduction of nonmedical use may include identifying those medications with lower abuse liability for inclusion on insurance formularies. Patient and physician education programs also may be useful tools to heighten awareness of intentional and unintentional diversion of ADHD medications for nonmedical purposes.

Show MeSH
Related in: MedlinePlus