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Monitor Your Child For ADHD Medication Abuse

by Sue Hubbard, M.D.

I read an interesting, albeit somewhat alarming article in an issue of Pediatrics. The article is entitled “Adolescent Prescription ADHD Medication Abuse is Rising Along with Prescriptions for these Medications”. In a retrospective study of calls to the American Association of Poison Control Center’s National Data System, for the years 1998 – 2005, the authors noted a sharp increase in calls related to prescription ADHD medication abuse, out of proportion to other poison center calls.

While attention-deficit/hyperactivity disorder (ADHD) is thought to affect between eight to 12 percent of children, there continues to be a significant increase in the diagnosis and treatment of ADHD with stimulant medications. Over the 8 year study period, estimated prescriptions for teens increased 133 percent for amphetamine products (one trade name Adderall), 52 percent for methylphenidate products (trade names such as Concerta, Ritalin, Metadate, Focalin), and 80 percent for both together. With the increase in prescriptions there is potentially greater use of these drugs for non-medical purposes. The Office of National Drug Control Policy and National Institute on Drug Abuse found that next to marijuana, prescription medications are teenagers drugs of choice for getting high.

A study by The Partnership for Drug Free America found that nearly one in five (19 percent) of teenagers reported abusing prescription medications, at least once, that were not prescribed to them. In another study, nearly 30 percent of adolescents reported having a friend that abuses prescription stimulants.

In the study in Pediatrics the authors found that amphetamine exposures and calls to Poison Control rose faster than amphetamine sales. In contrast, methylphenidate calls fell as sales rose. Amphetamine exposures were more frequently classified as moderate to severe than methylphenidate calls. It is inferred that there may be a shift toward amphetamine abuse and more severe side effects, with the greater availability of this medication. It is also noted that 42 percent of amphetamine stimulant ingestion cases presenting to the ER are girls, while the ratio of ADHD diagnosis is three to one boys to girls.

All of these statistics are disturbing, alarming and plain scary. While stimulant medications do have a place in the treatment of ADHD, over diagnosis and availability of these medications may be leading to more abuse of these medications by teenagers. These drugs are used to produce a high, or to help with concentration or increase alertness. These drugs are also being taken with alcohol, which compounds the danger.

The topic of abuse of prescription drugs among teens who have not been prescribed a medication seems to be another dinner table conversation. The consequences for taking another person’s medication are real. If your child takes a stimulant prescription there also needs to be a conversation regarding “sharing” medication. Parents should also monitor their child’s medications and refills. With increased availability there may continue to be a problem with abuse of these medications.

That’s your daily dose, we’ll chat again tomorrow.

Send your question or comment to Dr. Sue!

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