Study finds sharp rise in misuse of Adderall among young adults

Adderall, a drug often prescribed for the treatment of attention deficit and hyperactivity disorder (ADHD) and narcolepsy, is increasingly being misused by 18-to-25-year-olds to aid studying, a new study has found

Researchers from Johns Hopkins Bloomberg School of Public Health say that while anecdotal evidence previously suggested that the most severe problem of Adderall misuse was among older children and adolescents their study suggests otherwise. Having examined trends from 2006 through 2011 they found that it is mainly older students who are inappropriately taking Adderall without a prescription, primarily getting the medication from family and friends and without a physician recommendation or prescription.

In college, especially, these drugs are used as study-aid medication to help students stay up all night and cram. Our sense is that a sizeable proportion of those who use them believe these medications make them smarter and more capable of studying. We need to educate this group that there could be serious adverse effects from taking these drugs and we don’t know much at all about their long-term health effects.

says study co-author Ramin Mojtabai, MD, MPH, PhD, a professor of mental health at the Bloomberg School.

Adderall, the brand name for dextroamphetamine-amphetamine, does improve focus, Mojtabai says, but it can also cause sleep disruption and serious cardiovascular side effects, such as high blood pressure and stroke. It also increases the risk for mental health problems, including depression, bipolar disorder and unusual behaviours including aggressive or hostile behaviour.

In 2006, the US Food and Drug Administration (FDA) put a ‘black box’ warning on dextroamphetamine-amphetamine due to cardiovascular risks.

The sharp rise in the misuse of Adderall is reflected in a rise in emergency room visits.

The number of prescriptions for Adderall has fallen and yet we are seeing more medical problems from its use. This suggests that the main driver of misuse and emergency room visits related to the drug is the result of diversion, people taking medication that is legitimately prescribed to someone else. Physicians need to be much more aware of what is happening and take steps to prevent it from continuing.

says Lian-Yu Chen, MD, the study’s first author.

For their study, the researchers examined three separate sets of data: the National Survey on Drug Use and Health – a population survey of substance use; the Drug Abuse Warning Network – a survey of emergency department visits; and the National Disease and Therapeutic Index – a survey of office-based practices including prescribing.

They found that in adults, over the six-year study period, treatment visits involving Adderall were unchanged, while non-medical use of Adderall (that is, taking the drug without it being prescribed) rose 67 per cent and emergency room visits went up 156 per cent.

Over the same period, in adolescents, treatment visits involving Adderall went down, non-medical use was stable and emergency room visits declined by 54 per cent. The trends for methylphenidate, sold under the brand name Ritalin among others, and another prescription stimulant prescribed for attention-deficit/hyperactivity disorder, were unchanged over the period.

Meanwhile, the major source for non-medical use of Adderall was family or friends; two-thirds of those family or friends obtained it by prescription. The researchers found that of all Adderall non-medical use, from age 12 and up, 60 per cent of it was among those aged 18-25.

The study’s authors are recommending that drugs like Adderall should be monitored in the same way that prescription painkillers are and say it would be helpful to institute informational campaigns for young adults explaining the adverse effects associated with the drug.