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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

Use of alcohol or selected other drugs in combination with nonmedical use of adhd medications in the past year. Percentages of nonmedical users aged 18 to 49 in the U.S. civilian noninstitutionalized population who used any of the listed drugs at the same time or within a couple of hours of using ADHD medications nonmedically in the past year (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder.* Examples given included painkillers, tranquilizers, or sleeping pills. Use in combination (either at the same time or within a few hours) with ADHD medications could include legitimate prescription use or nonmedical use of other medications.
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Figure 3: Use of alcohol or selected other drugs in combination with nonmedical use of adhd medications in the past year. Percentages of nonmedical users aged 18 to 49 in the U.S. civilian noninstitutionalized population who used any of the listed drugs at the same time or within a couple of hours of using ADHD medications nonmedically in the past year (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder.* Examples given included painkillers, tranquilizers, or sleeping pills. Use in combination (either at the same time or within a few hours) with ADHD medications could include legitimate prescription use or nonmedical use of other medications.

Mentions: Among those who had used ADHD medications nonmedically in the past year, 68% also used alcohol, other prescription medications, or illicit drugs at the same time or within a couple of hours of their nonmedical ADHD medication use (Figure 3). More than half (53%) of past-year NMUs drank alcohol while using these medications, and 26% used marijuana. Nearly one in five past-year NMUs aged 18 to 49, had used ADHD medications in combination with cocaine at least once in the past year.


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)

Use of alcohol or selected other drugs in combination with nonmedical use of adhd medications in the past year. Percentages of nonmedical users aged 18 to 49 in the U.S. civilian noninstitutionalized population who used any of the listed drugs at the same time or within a couple of hours of using ADHD medications nonmedically in the past year (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder.* Examples given included painkillers, tranquilizers, or sleeping pills. Use in combination (either at the same time or within a few hours) with ADHD medications could include legitimate prescription use or nonmedical use of other medications.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Use of alcohol or selected other drugs in combination with nonmedical use of adhd medications in the past year. Percentages of nonmedical users aged 18 to 49 in the U.S. civilian noninstitutionalized population who used any of the listed drugs at the same time or within a couple of hours of using ADHD medications nonmedically in the past year (including error bars). Estimates are not mutually exclusive. Bars represent 95% confidence intervals. ADHD = attention deficit/hyperactivity disorder.* Examples given included painkillers, tranquilizers, or sleeping pills. Use in combination (either at the same time or within a few hours) with ADHD medications could include legitimate prescription use or nonmedical use of other medications.
Mentions: Among those who had used ADHD medications nonmedically in the past year, 68% also used alcohol, other prescription medications, or illicit drugs at the same time or within a couple of hours of their nonmedical ADHD medication use (Figure 3). More than half (53%) of past-year NMUs drank alcohol while using these medications, and 26% used marijuana. Nearly one in five past-year NMUs aged 18 to 49, had used ADHD medications in combination with cocaine at least once in the past year.

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