Objective: Recent studies have provided variable information on the frequency and context of diversion and the use of nonprescribed and prescribed stimulant medications in adolescent and young adult populations. The purpose of this systematic review of the literature is to evaluate the extent and characteristics of stimulant misuse and diversion in attention-deficit/hyperactivity disorder (ADHD) and non-ADHD individuals.
Method: We conducted a systematic review of the literature of available studies looking at misuse and diversion of prescription ADHD medications using misuse, diversion, stimulants, illicit use, and ADHD medications as key words for the search.
Results: We identified 21 studies representing 113,104 subjects. The studies reported rates of past year nonprescribed stimulant use to range from 5% to 9% in grade school- and high school-age children and 5% to 35% in college-age individuals. Lifetime rates of diversion ranged from 16% to 29% of students with stimulant prescriptions asked to give, sell, or trade their medications. Recent work suggests that whites, members of fraternities and sororities, individuals with lower grade point averages, use of immediate-release compared to extended-release preparations, and individuals who report ADHD symptoms are at highest risk for misusing and diverting stimulants. Reported reasons for use, misuse, and diversion of stimulants include to concentrate, improve alertness, "get high," or to experiment.
Conclusions: The literature suggests that individuals both with and without ADHD misuse stimulant medications. Recent work has begun to document the context, motivation, and demographic profile of those most at risk for using, misusing, and diverting stimulants. The literature highlights the need to carefully monitor high-risk individuals for the use of nonprescribed stimulants and educate individuals with ADHD as to the pitfalls of the misuse and diversion of the stimulants.
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http://dx.doi.org/10.1097/chi.0b013e31815a56f1 | DOI Listing |
J Anal Toxicol
December 2024
Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway.
Dexamphetamine, lisdexamphetamine, and methylphenidate are central stimulant drugs widely used to treat Attention-deficit/hyperactivity disorder (ADHD), but poor adherence may lead to treatment failure and the drugs are also subject to misuse and diversion. Drug analysis in oral fluid may thus be useful for monitoring adherence and misuse. We measured drug concentrations in oral fluid and urine after controlled dosing to investigate detection windows and evaluate the chosen cut-offs.
View Article and Find Full Text PDFSubst Use Misuse
December 2024
Bicycle Health, Boston, Massachusetts, USA.
Telehealth-only provision of buprenorphine for opioid use disorder was made possible during the COVID-19 pandemic, but policymakers are considering ending this practice. A primary concern is potential diversion of buprenorphine, although it is unknown how many patients enter telehealth-only treatment already using diverted buprenorphine. We performed a retrospective chart review of 500 consecutive newly enrolled patients in our large telehealth-only program in January 2023.
View Article and Find Full Text PDFToxics
October 2024
Medical School, The Grove, Swansea University, Singleton Campus, Wales SA2 8PP, UK.
Introduction: Evidence suggests an increasing misuse of veterinary medicines by humans. This study aims to analyse Adverse Events (AEs) associated with selected veterinary products using the Food and Drug Administration Adverse Events Reporting System (FAERS).
Methods: A descriptive pharmacovigilance analysis was conducted on AEs related to 21 drugs approved for human and/or animal use.
Int J Drug Policy
November 2024
Service Universitaire d'Addictologie de Lyon (SUAL), Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France; Service Pharmaceutique, Hospices Civils de Lyon, Lyon, France; Univ. Lyon, UCBL1, INSERM U1028, CNRS UMR5292, CRNL, PSYR2, Lyon, France; CSAPA, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France.
Background: Pregabalin is a drug approved for neuropathic pain, epilepsy and general anxiety disorder. However, pregabalin is also an increasing cause of diversion and misuse, and, for this reason, the French health authorities have decided in 2021 to classify it as a narcotic drug, requiring secured prescription pads. Our study aimed to evaluate the impact of this measure on pregabalin dispensation patterns.
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