ADHD

Updated 13 June 2017

More college students misusing ADHD meds as study aid

Researchers found that from 2006 to 2011 misuse of an ADHD drug jumped 67 percent, and related visits to emergency rooms went up by 156 percent.

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College students aiming for an academic edge may explain a surge in the misuse of a stimulant commonly prescribed for attention-deficit hyperactivity disorder (ADHD), new research suggests.

Cramming for exams

Among U.S. adults, the number of Adderall prescriptions stayed stable from 2006 to 2011, but misuse of the ADHD drug jumped 67 percent and related visits to emergency rooms went up by 156 percent, researchers found.

"The majority of adults who are using Adderall nonmedically are in the age range of 18 to 25," said lead researcher Dr Ramin Mojtabai, a professor of mental health at Johns Hopkins Bloomberg School of Public Health in Baltimore. Most get the pills from friends or relatives who have prescriptions, the study found.

Read: Ritalin abuse runs riot in South African schools     

Mojtabai and his team suspect college students use Adderall to help them stay up all night to cram for exams. Similarly, young working adults may use it to stay sharp and focused on the job, he said.

"It's possible some of this use is recreational," said Mojtabai. "There's a pattern of concomitant use of other substances in about half of these adults."

Whatever the reason, the use of amphetamines, including Adderall, can lead to dependence, sudden death and serious cardiovascular events, according to the U.S. Food and Drug Administration, which requires a "black box" warning on the drug packaging.

Three national surveys

"They are not harmless simply because they are prescribed by doctors," said study co-author Dr Lian-Yu Chen, an attending psychiatrist at Taipei City Psychiatric Centre in Taiwan. Among the possible cardiovascular effects are high blood pressure and stroke, Chen noted.

Read: Teens abusing ADHD drugs 

People with ADHD are often prescribed stimulant drugs and/or behavioural therapy to help them focus, reduce their hyperactivity and curb their impulsivity.

Researchers looked at U.S. trends from 2006 through 2011, spurred by concern about misuse of the stimulants among children and teens. They analysed three national surveys – one on doctor visits, one on drug use and another on ER visits – to track use of the stimulants Adderall (dextroamphetamine-amphetamine) and Ritalin/Concerta (methylphenidate). Ritalin is also commonly prescribed for ADHD.

In adults, the researchers found, treatment visits for Adderall were unchanged, although nonmedical use and ER visits rose significantly.

Concern about stimulant misuse among children and teens did not bear out. In adolescents, treatment visits for stimulants declined, and misuse of Adderall did not increase. Nonmedical use of Ritalin and Concerta declined by about 54 percent over the six-year period, the researchers found.

Read: Long-term safety of ADHD meds not established

The study was published in the Journal of Clinical Psychiatry.

The researchers speculate that college students may prefer Adderall over the other stimulants because it increases two brain chemicals linked with better cognitive functioning and has a reputation for making people smarter.

Dangers of drug sharing

However, stimulant use often causes anxiety, insomnia or agitation, Mojtabai said. In younger children, growth can slow somewhat due to the medication's appetite suppressant effect. Aggressive behaviour and depression may also occur with long-term Adderall use, he said.

The study findings don't surprise Dr Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.

Read: SA has one of the highest prescription rates for ADHD medication

"This study highlights the growing problem of drug diversion as the main factor behind both misused and increased emergency department visits for Adderall," said Glatter.

Doctors need to be aware of this and talk to patients who receive a stimulant prescription about misuse and the dangers of drug sharing, he said.

"Many students mistakenly believe these drugs will make them smarter and more efficient at studying, so in their view the risk is worth the reward," he said. "And because Adderall can improve focus, it may also give some students an unfair advantage, thus constituting academic dishonesty."

For those with legitimate stimulant prescriptions, Glatter recommended locking the drugs away to avoid theft from friends and even family members. "It's important to keep track of pills and do daily pill counts to be assured that no one is removing their medications," he said. 

Read more: 

What is ADHD? 

Causes of ADHD  

Symptoms of ADHD

 

Ask the Expert

ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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