ADHD

Updated 17 July 2017

Kids who take ADHD meds more likely to be bullied

Bullying by peers is a risk associated with stimulant treatment for ADHD, especially if the teens sell, trade or share their medicines, according to a new study.

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Teenagers who take drugs like Adderall and Ritalin to treat attention-deficit/hyperactivity disorder (ADHD) are twice as likely to be bullied as their peers who don't have ADHD, a new study suggests.

Frequent taunting

The risk of being bullied is even greater if the teens sell, trade or share their medicines, researchers found.

However, the research also raises questions about why these kids are targets of frequent taunting or aggression by their peers.

Is it teens' access to drugs that eggs on bullies, or something else?

Read: ADHD linked to bullying

"I think it's fair to say that bullying is a potential risk that's associated with stimulant treatment for ADHD," said Quyen Epstein-Ngo, a research assistant professor at the University of Michigan Institute for Research on Women and Gender, and the study's lead author.

But Linda Cottler, chair of the epidemiology department at the University of Florida, suggested that it's the teens' behaviour, not their medication use, that causes the bullying.

"They're not being stigmatised because they have ADHD and use meds," said Cottler, who led the first national study examining teens' and preteens' prescription stimulant use, published in 2013. "They may have behaviours that other kids are not tolerant of."

Riskier situations

In the study, teens with ADHD faced about the same risk of being bullied whether they had a recent prescription (in the past 12 months) for stimulant medications, or not.

Read: ADHD signs may be evident by preschool

"We're not quite sure exactly what's going on there," said Epstein-Ngo.

The research team was unable to tease out whether kids were being bullied for their medicines or for other reasons.

"They may be putting themselves into riskier situations where they're more likely to be victimised," Epstein-Ngo speculated. Maybe they're being coerced to share their medications, she reasoned.

The study was published in the Journal of Paediatric Psychology.

Because of their "calming effect", stimulant medications are often prescribed to kids who are severely inattentive, hyperactive or impulsive, according to the U.S. National Institute of Mental Health.

Those pills are often bartered, sold or shared with peers who misuse the stimulants to gain a competitive edge in school, the study authors pointed out.

Read: ADHD in the classroom

"There's growing concern around stimulant misuse and abuse. We also know that peer victimisation, bullying, in schools is a big issue," Epstein-Ngo said.

To see whether those issues could be related, researchers surveyed nearly 5,000 middle and high school students over four years about their use of stimulant medications for ADHD and self-reported bullying.

Surprising findings

Of those taking ADHD medicines, 20 percent had been approached to sell or share their medicines, and about half of them did, the study found.

Teens with ADHD who sold, traded or shared their meds were 4.5 times more likely to be bullied than kids without ADHD, and five times more likely than kids with ADHD but no recent prescription, the findings showed.

Dr Wendy Moyal, a child and adolescent psychologist at the Child Mind Institute, a New York-based nonprofit dedicated to improving mental health care for children, was surprised by the findings.

Read: Ritalin abuse runs riot in South Africa schools

"I don't think they addressed the known fact that kids who have ADHD are at greater risk of bullying [to start with]," she said.

She finds that kids with ADHD who take stimulant medications have better impulse control and do better socially. "Maybe they still have social impairments that don't go away with the stimulants. It's very unlikely that they're caused by the stimulants," she added.

As for the heightened risk of bullying faced by teens who sell or share their medicines, Moyal said those kids may be more troubled or use their meds as "social currency" to lift themselves from an already disadvantaged position.

Parents who are concerned that their teen is being bullied or having trouble socially should first have a conversation with their child to glean more information, she said.

"It's too early to assume that the bullying is related to the medication," Moyal said. "I would recommend parents always speak to their doctor about any concerns they have about their child's medication."

The authors said their work received support from multiple funding sources, including grants from the U.S. National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. 

Read more: 

Many ADHD teens internet addicts  

ADHD may affect boys and girls in different ways  

The dark side 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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