Nonmedical use of prescription stimulants in the United States

Kroutil, Larry A.; Brunt, David L. Van; Herman-Stahl, Mindy; Heller, David; Bray, Robert M.; Penne, Michael

doi:10.1016/j.drugalcdep.2005.12.011

Cited by 208 publications

(166 citation statements)

References 12 publications

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“…While misusers are more likely to be white, 39 -41 attempted deceivers are more likely to be Hispanic or Native Americans. Also, while use is higher in rural areas, 40,42 attempted deception was not associated with the size of participants' home communities. Deceivers were more likely to be male, as is the case for pharmaceutical misusers more generally, 43 and our income findings mirror a previous study that noted pharmaceutical misuse was lowest within homes earning $40,000 to $75,0000 annually.…”

Section: Discussionmentioning

confidence: 99%

Deception for Drugs: Self-Reported "Doctor Shopping" Among Young Adults

Stogner

Sanders

Miller

2014

The Journal of the American Board of Family Medicine

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Background: Pharmaceutical abuse is a burgeoning problem, and various forms of drug diversion are becoming more common. At present, little is known about those who attempt to deceive physicians to receive medications, and even less is known about those who successfully avoid detection and abuse-related repercussions. The goal of this study is to assess the prevalence of attempted physician deception in a general population, explore common motives, and evaluate risk factors associated with the behavior.Methods: A stratified random sampling technique was used to obtain a locally representative sample of 2349 young adults. The sample was 48.4% male, 68.9% white, 24.4% black, and 2.8% Hispanic. Selected individuals were surveyed using a self-report instrument (80.4% response rate).Results: Of the respondents, 93 (4.0%) self-reported having attempted to deceive a physician to obtain a pharmaceutical. Most of these indicated that they were at least partially motivated by their own abuse. Approximately half reported that selling a portion of the prescription was a motivating factor. Alcohol use, marijuana use, and pharmaceutical misuse each were risk factors associated with attempted deception. Although no traits were definitively linked to the behavior, attempted deception was more commonly reported by men, Hispanics, self-identified lesbian/gay/bisexual/transgender individuals, and those at the lowest and highest extremes of the income spectrum. Logistic regression models of rare events indicated that past substance use along with sexual orientation and family income were related to attempted deception when controlling for other factors.Conclusion: Results suggest that attempted physician deception may be more common than previously believed. Practicing physicians should attempt to use risk factor information presented within this study, albeit very cautiously. This study identifies general characteristics of young people who might divert medications but notes that only a small minority of any patient group will do so. Awareness should not equal bias in the treatment of these patients; instead, it should reinforce the need for careful clinical interviewing and the utilization of prescription drug monitoring programs and local law enforcement databases. (J Am Board Fam Med 2014;27:583-593.)

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Section: Discussionmentioning

confidence: 99%

Deception for Drugs: Self-Reported "Doctor Shopping" Among Young Adults

Stogner

Sanders

Miller

2014

The Journal of the American Board of Family Medicine

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“…Approximately 7% of the students reported using prescription stimulants illicitly in their lifetime, 4.1% within the past year, and 2.1% within the past month. Kroutil et al [2006] analyzed data from the National Survey on Drug Use and Health and reported that 5.9% of persons aged 18-25 years surveyed had misused ADHD prescription stimulants in their lifetime. Substantially higher usage rates were reported by Low and Gendaszek [2002], who found that 35.5% of college students from a small New England college reported using prescription stimulants illicitly.…”

Section: Medication Misuse Studiesmentioning

confidence: 99%

ADHD in college students: Developmental findings

Weyandt

DuPaul

2008

Dev Disabil Res Revs

102

115

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According to the American Psychiatric Association [DSM-IV-TR, 2000], Attention-Deficit Hyperactivity Disorder (ADHD) affects approximately 3-7% of the school aged population and 2-4% of the adult population. Recently, college students with ADHD have begun to receive more attention, largely due to the increase in numbers of high school students with ADHD pursuing higher education, as well as reports of prescription stimulant misuse on college campuses. The purpose of the present article is to summarize major research findings concerning developmental issues facing college students with ADHD. Overall, findings suggest that relative to the general college population, college students with ADHD are at greater risk for academic and psychological difficulties, and misuse of prescription stimulants is indeed a problem on many campuses. Primary treatment strategies include psychostimulant medication, coaching, and educational accommodations; however, very little controlled treatment outcome research has been conducted with this population. These findings are preliminary and are tempered by methodological limitations as well as the small number of studies that have been conducted. Future research using larger sample sizes, rigorous assessment criteria, and employing longitudinal designs is needed to better understand the developmental issues facing college students with ADHD.

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“…However, prescription psychostimulants, such as methylphenidate, are commonly abused among high school students and young adults (Kroutil et al, 2006;Teter et al, 2006). Of these, methylphenidate is the most commonly abused, with up to 25% of college students reporting having used the drug at least once for nonprescription purposes (Kroutil et al, 2006;Teter et al, 2006). Although the most common nonprescription use is to improve academic performance or to improve concentration, 31% of abusers report using the drug to achieve a high (Teter et al, 2006), and overuse may result in dependence (Kollins et al, 2001).…”

mentioning

confidence: 99%

“…Therefore, methylphenidate is commonly used to treat attention deficit/hyperactive disorder (ADHD). However, prescription psychostimulants, such as methylphenidate, are commonly abused among high school students and young adults (Kroutil et al, 2006;Teter et al, 2006). Of these, methylphenidate is the most commonly abused, with up to 25% of college students reporting having used the drug at least once for nonprescription purposes (Kroutil et al, 2006;Teter et al, 2006).…”

mentioning

confidence: 99%

The Effects of Methylphenidate on Knockin Mice with a Methylphenidate-Resistant Dopamine Transporter

Tilley

Gu²

2008

J Pharmacol Exp Ther

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Methylphenidate (Ritalin) is one of the most commonly abused prescription drugs. It is a psychostimulant that inhibits the dopamine and norepinephrine transporters with high affinity. In mice, methylphenidate stimulates locomotor activity, is selfadministered, and produces conditioned place preference, typical properties of an addictive drug. We have generated a knockin mouse line bearing a mutant dopamine transporter that is approximately 80-fold less sensitive to cocaine inhibition than wild type. It is interesting to note that this mutant is also almost 50-fold less sensitive to methylphenidate inhibition, suggesting similarities in the binding site for cocaine and methylphenidate. Because methylphenidate is not effective at inhibiting the mutant dopamine transporter, we hypothesized that it would not stimulate locomotor activity or produce reward in the knockin mice. In these knockin mice, doses up to 40 mg/kg methylphenidate either inhibit or fail to stimulate locomotor activity and do not produce conditioned place preference. Doses up to 40 mg/kg methylphenidate also fail to produce stereotypy in the knockin mice. Nisoxetine and desipramine, selective norepinephrine transporter inhibitors, also reduce locomotor activity in wild-type and knockin mice. These results indicate that enhanced dopaminergic neurotransmission is required for methylphenidate's stimulating and rewarding effects. In addition, we observed that drugs enhancing noradrenergic neurotransmission inhibit locomotor activity in mice, which is consistent with the notion that methylphenidate's ability to inhibit the norepinephrine transporter may contribute to its efficacy in treating attention deficit hyperactivity disorder.

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Nonmedical use of prescription stimulants in the United States

Cited by 208 publications

References 12 publications

Deception for Drugs: Self-Reported "Doctor Shopping" Among Young Adults

Deception for Drugs: Self-Reported "Doctor Shopping" Among Young Adults

ADHD in college students: Developmental findings

The Effects of Methylphenidate on Knockin Mice with a Methylphenidate-Resistant Dopamine Transporter

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