In One Study, One In Four Students Abused ADHD Medications

A study released on Tuesday found that more students in middle and high schools are misusing ADHD medications, as a growing number of children are being diagnosed with the condition.

At some schools, as many as 1 in 4 students reported misusing drugs for attention-deficit/hyperactivity disorder in the previous year -- meaning they used the medications without a doctor's prescription or for nonmedical reasons, according to the study in JAMA Network Open.

Sean McCabe, the lead author of the study and director of the Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, said that the findings "should be a major alarm."

When used correctly, prescription stimulants can be effective and safe.

McCabe stated that the medications "help millions" of people with ADHD. "But it is important to strike a balance between the need to have access to these medications and reducing the risks for misuse."

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The findings of the study were based on results from surveys conducted by more than 231,000 eighth, tenth, and twelfth-grade students at more than 3200 public and privately-run schools in the U.S. Researchers analyzed survey data between 2005 and 2020.

The highest rate of misuse was found in schools where most students were being treated for ADHD. The misuse rates in schools surveyed more recently -- between 2015 and 2020 -- were higher than in those surveyed earlier.

Included in the survey are amphetamines, methylphenidates, Ritalin, Adderall, Concertas, Metadates, Dexedrines, Focalins, and Vyvanse.

Researchers found that the students who attended schools with high rates of ADHD prescriptions were at a higher risk for misusing stimulants.

Middle school students are more likely than high school students to report the misuse of medications. The rate of misuse was higher in schools with high or medium rates of binge drinking.

Researchers also found that schools where there were more white students, or where the parents of those students had a higher education level, had higher levels of misuse.

What are the risks involved?

Dr. Robert Bassett is the associate medical Director of the Poison Control Center of Children's Hospital of Philadelphia. He said there's a misconception that prescription stimulants "can help garner an edge and improve academic performance, memory, or stamina."

Bassett, a researcher who wasn't involved in the study, said that in environments and households where academic performance is highly valued, there could be unintentional stressors that lead to pressures or efforts that may result in a desire to gain an advantage through stimulants.

Stimulants aren't always harmless medications.

He said that long-term, these drugs have many effects on the body. Not the least are cardiovascular problems such as increased blood pressure or heart rate, and they also increase the risk for neuropsychiatric disorders.

Dr. Sam Wang is an emergency medicine physician at Children's Hospital Colorado. He was not involved with the study. However, he noted that misuse of these medications can lead to substance abuse disorders and lower graduation rates.

Some say the problem will get worse over the next few years.

As children's rates of anxiety, depression, and eating disorders rise, the misuse of stimulants may become more prevalent, according to Dr. Nusheen Amieenuddin of the Mayo Clinic, Rochester, Minnesota. She was not a part of the study.

She said, "I believe the tendency to self-medicate has increased."

McCabe, who wrote the study, explained that since the students self-reported, it is possible some misclassified their substance use or underreported it. The study did not include students who had been home-schooled or dropped out, as well as those who were absent the day of the survey.

McCabe suggested that parents of children who have ADHD talk to their children about the proper management of their medication. They should also discuss with their child what to do when someone asks them to use their prescription.

He said that it is important to intervene when children still see these drugs as medicines and not as drugs for misuse.