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

Figures & data

TABLE 1 Prescription Stimulants for ADHD Reported in the NSDUH and Used in the Calculation of Lifetime Nonmedical Use of Prescription ADHD Stimulants

Drug-specific question and open-ended responses	Open-ended responses only^a
• Dexedrine (drug-specific question, open-ended responses)	• Biphetamine
• Dextroamphetamine (drug-specific question, open-ended responses)	• Dextrostat
• Ritalin/methylphenidate (drug-specific question, open-ended responses)	• Concerta
• Adderall (drug-specific question from 2006 through 2009, open-ended responsesprior to 2006)	• Metadate CD
	• Dexmethylphenidate, Focalin
	• Methylin
	• Dexamyl
	• Adderall XR
	• ADHD/ADD medication; otherwise      unspecified
Abbreviations: ADHD = attention-deficit hyperactivity disorder; NSDUH = National Survey on Drug Use and Health.
^aTwo recently approved stimulants for the treatment of ADHD (Daytrana, approved in 2006, and Vyvanse, approved in 2007) were not included in this analysis because they were not available throughout the entire time period of study. However, an examination of NSDUH data revealed no reports of nonmedical use of Daytrana in response to open-ended questions in 2006–2009; <0.01% of respondents reported nonmedical use of Vyvanse in both 2009 and 2008 in response to open-ended questions, although there were no reports of nonmedical use in 2007.

TABLE 2 Prescription ADHD Stimulants Used to Calculate Lifetime Nonmedical Use (N = 443,041)^a

	Nonmedical use of prescription	Other nonmedical
	ADHD stimulants	use or illicit use	No drug use
Characteristic	(n = 21,465) (3.4%^b)	(n = 187,519) (42.9%^b)	(n = 234,057) (53.7%^b)
Age, y
12–17	8.5 (8.1, 8.9)	6.1^‡ (6.0, 6.2)	13.7^‡ (13.6, 13.8)
18–25	33.9 (32.8, 35.0)	15.6^‡ (15.4, 15.8)	10.1^‡ (10.0, 10.3)
26–34	16.6 (15.6, 17.7)	18.1^§ (17.8, 18.4)	11.4^‡ (11.2, 11.6)
35 or Older	41.1 (39.5, 42.6)	60.2^‡ (59.8, 60.5)	64.8^‡ (64.4, 65.1)
Female	42.6 (41.3, 43.9)	46.9^‡ (46.6, 47.3)	55.8^‡ (55.4, 56.2)
Caucasian, non-Hispanic	87.0 (86.0, 88.0)	72.8^‡ (72.3, 73.3)	64.5^‡ (63.9, 65.0)
Married	31.0 (29.6, 32.5)	50.7^‡ (50.2, 51.2)	55.9^‡ (55.4, 56.4)
Education:
12–17 years old (current students)	8.5 (8.1, 8.9)	6.1^‡ (6.0, 6.2)	13.7^‡ (13.6, 13.8)
Less than high school	11.3 (10.5, 12.1)	12.1 (11.8, 12.3)	17.2^‡ (16.8, 17.6)
High school graduate	23.8 (22.7, 24.9)	28.6^‡ (28.3, 29.0)	28.2^‡ (27.8, 28.6)
Some college	30.1 (29.0, 31.2)	26.4^‡ (26.0, 26.8)	19.2^‡ (18.9, 19.5)
College graduate	26.4 (25.1, 27.7)	26.8 (26.3, 27.2)	21.8^‡ (21.4, 22.2)
Unemployed	7.6 (7.0, 8.3)	5.2^‡ (5.0, 5.4)	3.3^‡ (3.2, 3.4)
+1 million individuals	50.1 (48.6, 51.7)	50.7 (50.1, 51.2)	48.5^§ (48.0, 49.1)
Abbreviations: ADHD = attention-deficit hyperactivity disorder.
^aReported sample sizes are unweighted; percentages displayed in the table are weighted.
^bTable heading percentages are weighted percentages based on the total sample and summed to 100%.
§ P<0.05; † P<0.01; ‡ P<0.001.
P values are determined by x^2 tests vs. nonmedical use of prescription ADHD stimulants (i.e., nonmedical use of prescription ADHD stimulants).

TABLE 3 Age of First Nonmedical or Illicit Drug Use Among Those Reporting Nonmedical Use of Prescription ADHD Stimulants (n = 21,465)

			Other drug use among	Other drug use	Average number of drugs
			those reporting nonmedical	preceding nonmedical	used prior to nonmedical
	Mean age, y	95% CI	use of prescription ADHD	use of prescription	use of prescription ADHD
Drug^a	(SE)	for age	stimulants (%)	ADHD stimulants (%)	stimulants (95% CI)
Any prescription ADHD stimulants	19.45 (0.13)	19.19–19.72	—	—	—
Any other drug use^b	15.69 (0.09)	15.52–15.86	95.3	77.6	2.40 (2.35–2.45)
Marijuana	15.92 (0.08)	15.76–16.08	90.6	58.7	—
Inhalants	17.48 (0.14)	17.20–17.75	47.2	19.4	—
Hallucinogens	17.95 (0.08)	17.80–18.11	68.2	24.9	—
Prescription pain relievers	19.37 (0.15)	19.07–19.66	66.1	17.6	—
Prescription sedatives	19.72 (0.19)	19.34–20.10	26.8	4.4	—
Cocaine	20.03 (0.12)	19.80–20.27	61.4	13.8	—
Prescription tranquilizers	20.17 (0.14)	19.89–20.44	52.2	10.4	—
Heroin	21.49 (0.30)	20.89–22.09	12.6	1.5	—
Crack	24.59 (0.34)	23.91–25.26	20.5	1.9	—
Abbreviations: ADHD = attention deficit hyperactivity disorder; SE = standard error; CI = confidence interval.
^aIndividual drugs are sorted by increasing age of onset
^bStatistics for any other drug use take into account all other drugs used by each individual: (1) age of first nonmedical use is the minimum age of first nonmedical use among all of the other drugs a person used; (2) any individual who used at least one of the other drugs listed here is included as a yes in the percent other drug use calculation; and (3) any individual who used at least one of the other drugs listed here prior to initial nonmedical use of prescription ADHD stimulants is included as a yes in the percentage of other drug use preceding nonmedical use of prescription ADHD stimulants calculation.