Abuse of ADHD Medication in Schools: A Crucial Wake-Up Call

Abuse of ADHD Medication in Schools: A Crucial Wake-Up Call



UJ

A recent study has revealed that approximately 1 in 4 teenagers in certain middle and high schools across the United States have reported abusing prescription stimulants intended for attention deficit hyperactivity disorder within the past year.

“This is the first comprehensive national study examining nonmedical use of prescription stimulants among middle and high school students, and the findings indicate a significant range of misuse,” stated Sean Esteban McCabe, the lead author and director of the Center for the Study of Drugs, Alcohol, Smoking, and Health at the University of Michigan in Ann Arbor.

“In certain schools, stimulant misuse was nearly absent, while in others over 25% of students reported using stimulants in nonmedical contexts,” McCabe noted, who is also a nursing professor at the University of Michigan School of Nursing. “This study serves as a significant wake-up call.”

Nonmedical uses of stimulants typically involve exceeding prescribed doses for recreational effects or combining the medication with substances like alcohol to enhance the high, prior research has shown.

“Students may misuse medications or take pills given to them due to academic pressure, trying to stay awake for studying or completing assignments,” explained Dr. Deepa Camenga, pediatrician and associate director of pediatric programs at the Yale Program in Addiction Medicine based in New Haven, Connecticut.

“We already understand that this issue exists in colleges. A key takeaway from this study is that misuse and sharing of stimulant prescriptions is prevalent not only in college settings but also in middle and high schools,” added Camenga, who did not participate in the study.

Released Tuesday in the journal JAMA Network Open, the study evaluated data from 2005 to 2020 collected by Monitoring the Future, a federal survey that has tracked substance use among secondary school students nationwide since 1975.

In this study, over 230,000 teenagers from eighth, tenth, and twelfth grades participated in a nationally representative sample drawn from 3,284 secondary schools.

The study found that schools with higher rates of teens using prescribed ADHD medications were approximately 36% more likely to report misuse of prescription stimulants in the prior year. In contrast, schools with minimal or no students using such treatments reported fewer cases of misuse, although it didn’t completely eliminate the problem, according to McCabe.

“We have identified that the two primary sources for misuse are leftover medications, possibly from family members, and obtaining pills from peers who attend different schools,” he explained.

The study indicated that suburban schools across all regions of the United States, excluding the Northeast, had elevated rates of ADHD medication misuse among teens, particularly in schools where one or more parents typically held a college degree.

Schools with higher populations of White students and those reporting moderate levels of student binge drinking were also more likely to face issues with stimulant abuse among teens.

The analysis revealed that students who reported using marijuana in the last 30 days were four times more likely to misuse ADHD medications than those who abstained from cannabis.

Furthermore, adolescents who indicated current or past use of ADHD medications were approximately 2.5 times more likely to have misused stimulants compared to peers who had never taken such medications, according to the findings.

“Notably, these results were not exclusively driven by teens diagnosed with ADHD misusing their medications,” McCabe remarked. “We observed a significant correlation even when we omitted students who were not prescribed ADHD treatment.”

While data collection for this study concluded in 2020, recent statistics indicate a 10% increase in stimulant prescriptions in 2021 across various age groups. Concurrently, there has been a nationwide shortage of Adderall, one of the most widely prescribed ADHD medications, leaving many patients unable to obtain or refill their prescriptions.

The consequences are significant: improper long-term use of stimulant medications can lead to stimulant use disorder, which may result in anxiety, depression, psychosis, and seizures, according to experts.

If abused or mixed with alcohol or other drugs, users can face immediate health risks. The Substance Abuse and Mental Health Services Administration notes that side effects may include “paranoia, dangerously elevated body temperatures, and irregular heartbeat, especially with large doses or alternative ingestion methods.”

Research has demonstrated that individuals who misuse ADHD medications are more prone to having multiple substance use disorders.

Experts indicate that stimulant drug abuse has escalated over the last twenty years, as more adolescents are diagnosed and provided with these medications — studies reflect that 1 in every 9 high school seniors report undergoing stimulant therapy for ADHD, according to McCabe.

For children with ADHD who adhere to their medication regimens, stimulants can be effective treatments. They provide essential support for a child’s health, Camenga stated. “Adolescents who receive appropriate diagnosis, treatment, and supervision tend to thrive, facing a lower risk of developing additional mental health issues or substance use disorders.”

What Parents and Caregivers Can Do

Addressing the issue of stimulant misuse among adolescents does not mean restricting access to essential medications for children who genuinely need them, McCabe emphasized.

“Rather, we should thoroughly examine which school strategies are effective or ineffective in reducing stimulant medication misuse,” McCabe advised. “Parents can advocate for safe medication storage and strict dispensing policies in their children’s schools and inquire about local misuse prevalence — that data is readily available for each school.”

Families should also engage their children in conversations about how to respond when peers ask them for ADHD medications for parties or late-night study sessions, he added.

“Many kids are unsure of how to respond,” McCabe noted. “Parents can practice with their children to equip them with responses they can use when they encounter these situations.”

Parents and guardians should always keep controlled medications in a locked box and should regularly count the pills and monitor for early refill requests, he added.

“If parents suspect any misuse, they ought to contact their child’s prescriber immediately,” McCabe stressed. “That child should be assessed without delay.”