While the number of prescriptions for the stimulant Adderall has remained unchanged among young adults, misuse and emergency room visits related to the drug have risen dramatically in this group, new Johns Hopkins Bloomberg School of Public Health research suggests.
Anecdotal evidence had suggested the most severe problem of Adderall misuse was among older children and adolescents, but the new research – published this week in The Journal of Clinical Psychiatry – finds otherwise.
The study examined trends from 2006 through 2011 and found that it is mainly 18-to-25-year-olds who are inappropriately taking Adderall without a prescription, primarily getting the medication from family and friends and without a physician recommendation or prescription.
“The growing problem is among young adults,” said one of the study co-authors, Ramin Mojtabai, MD, MPH, PhD, a professor of mental health at the Bloomberg School, in a news release. “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.”
Adderall, the brand name for amphetamine and dextroamphetamine, does improve focus, Mojtabai said, 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 behaviors including aggressive or hostile behavior. There is little research on long-term effects. In 2006, the Food and Drug Administration (FDA) put a black box warning on dextroamphetamine and amphetamine due to cardiovascular risks. It is prescribed for conditions such as attention deficit/hyperactivity disorder and narcolepsy.
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, during 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 percent and emergency room visits went up 156 percent. Over the same period, in teens, treatment visits involving Adderall went down, nonmedical use was stable and emergency room visits declined by 54 percent.
It is interesting to note that, 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.
Study first author, Lian-Yu Chen, MD, PhD, recommended that drugs like Adderall should be monitored in the same way that prescription painkillers have started to be monitored in recent years.