Nonmedical Use of Prescription ADHD Stimulants and Preexisting Patterns of Drug Abuse

Abstract

Multidrug use is well documented among nonmedical users of prescription stimulants. We sought to provide insight into the drug use patterns of those reporting nonmedical use of prescription attention-deficit hyperactivity disorder (ADHD) stimulants in an attempt to discern whether such use is a first step in a pattern of drug-abusing behavior or, conversely, is a later development accompanied or preceded by a history of drug abuse. A cross-sectional, population-based survey of the U.S. civilian, non-institutionalized population aged 12 years and older was analyzed for lifetime nonmedical use of prescription ADHD stimulants, lifetime nonmedical use of another prescription drug, illicit drug use, and drug use initiation patterns. This included 443,041 respondents from the 2002–2009 National Survey on Drug Use and Health. Lifetime nonmedical use of prescription ADHD stimulants was reported by 3.4% of those aged 12 years and older. Of these, 95.3% also reported use of an illicit drug (i.e., marijuana, cocaine/crack, heroin, hallucinogens, inhalants) or nonmedical use of another prescription drug (i.e., tranquilizers, pain relievers, or sedatives), and such use preceded nonmedical use of prescription ADHD stimulants in 77.6% of cases. On average, 2.40 drugs were used prior to the first nonmedical use of prescription ADHD stimulants. These data suggest that nonmedical use of prescription ADHD stimulants is not commonly an initiating factor leading to the nonmedical use of other prescription medications or abuse of illicit drugs. Rather, nonmedical use of prescription ADHD stimulants appears to be adopted by individuals already engaged in broader patterns of drug abuse and misuse.

KEYWORDS:

• Attention-deficit hyperactivity disorder
• amphetamine
• methylphenidate
• psycho- stimulants
• substance abuse and dependence

Acknowledgments

Pinney Associates, funded by Shire Development Inc., wrote and edited this manuscript. Shire Development Inc. was involved in the concept development and fact checking, and approved the manuscript. Any opinions expressed herein are those of the authors, and not necessarily those of Shire Development, Inc.

Dr. Sweeney, Mr. Sembower, Ms. Ertischek and Dr. Schnoll are employees of Pinney Associates. Dr. Shiffman is a paid consultant to Pinney Associates. All authors have consulted for Shire Development, Inc. via Pinney Associates.

Notes

1. The definition of nonmedical use can vary by study but is defined by the SAMHSA and in this article as “use that was not prescribed or that you took only for the experience or feeling it caused.”¹⁷ In cases where the term is used in other published article, we specify the exact definition of the term as used by the study authors.