Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration

Abstract

In a US national cohort of adult incident stimulant medication users in the Veterans Affairs health-care system, measured from fiscal years 2001 to 2012, comorbid substance use disorders were common and were risk factors for development of an amphetamine use disorder (AUD). Increased mortality risk among incident users of stimulant medications was observed among both those who developed an AUD later and those whose use was defined as off-label.

Analysis of Stimulant Prescriptions and Drug-Related Poisoning Risk Among Persons Receiving Buprenorphine Treatment for Opioid Use Disorder

“…29,30 In addition to ADHD, stimulants are commonly used off-label to treat other conditions, including depression and stimulant use disorders. 31 In fact, as many as 50% of stimulant prescriptions may be written for off-label conditions in adults, 32,33 and the prevalence of stimulant prescriptions has increased over time, particularly among adults. 34 Because stimulants carry the potential for misuse, [35][36][37] clinicians may be reluctant to prescribe them to persons with co-occurring SUD owing to concern that the stimulants may increase the risk of SUD relapse.…”

“…In addition to ADHD, stimulants are commonly used off-label to treat other conditions, including depression and stimulant use disorders . In fact, as many as 50% of stimulant prescriptions may be written for off-label conditions in adults, and the prevalence of stimulant prescriptions has increased over time, particularly among adults …”

Characterizing prescription stimulant nonmedical use (NMU) among adults recruited from Reddit

“…Prescription stimulant NMU is a public health concern that has been associated with physical and psychiatric complications as well as mortality ( Barkus and Murray, 2010 , Cooper et al, 2018 , Hennissen et al, 2017 , Westover and Nakonezny, 2010 , Westover et al, 2008 , Westover et al, 2018 ). Motives for prescription stimulant NMU are poorly understood and are likely different for various populations.…”

D-Amphetamine Exposure Differentially Disrupts Signaling Across Ontogeny in the Zebrafish

“…Although the epidemic of opioid abuse continues to grow rampantly, the population of amphetamine (AMPH) users consistently rises, including the number of individuals prescribed AMPH, as well as with illicit users who often pair other drugs of abuse with AMPH. 1 AMPHs are commonly prescribed to children as young as 3 years old through middleaged adults who experience attention disorders, depression, and binge eating disorder. 2 Between 2005 and 2014, attention disorder diagnoses more than doubled from 6.8% to 14.4%, and were paired with a significant increase in AMPH prescriptions (3.57-8.51%) among children and adults.…”

“…6 Between 2001 and 2009, incident use jumped eight-fold in individuals 18-44 years of age. 1 Although studies have not correlated AMPH use with academic performance, the perception that AMPH use improves study habits and academic ability only strengthens the likelihood of illicit AMPH use among students desperate to succeed. 7 Misuse, especially in this population of neocortexforming and childbearing-aged individuals is not only on a consistent upward trajectory, even incidental exposure introduces changing brain chemistries to artificially inflated concentrations of neurochemicals that alter the establishment of balanced signaling that governs behavior, mood, memory, and learning.…”