In some US schools, 1 in 4 children reported misusing ADHD medication

By Amy Norton HealthDay Reporter

WEDNESDAY, April 19, 2023 (HealthDay News) — American schools that have a lot of students with ADHD drug prescriptions also tend to have a lot of students who misuse the drugs, according to a new study.

Researchers found that among nearly 3,300 US middle and high schools, some had a serious problem with students who abused prescription stimulant drugs. In some schools, more than a quarter of students reported having abused drugs in the past year.

And the problem loomed larger in schools where a high percentage of students had legitimate stimulant prescriptions — a sign that some of those kids are sharing the drugs with their peers.

At issue are the drugs most commonly used to treat ADHD, or attention deficit hyperactivity disorder, including well-known brand names like Ritalin (methylphenidate), Adderall (amphetamine/dextroamphetamine), and Concerta (methylphenidate).

When kids actually have ADHD, medication can help them focus, control themselves better, and do better in school. But the drugs are also commonly abused, often by children or college students who get pills from their friends with prescriptions.

“Often there are multiple motivations for misuse,” said Sean Esteban McCabedirector of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan.

Some children, he said, mistakenly believe that stimulants will make them sharper and improve their academic performance. Other times they use the drugs to “get high”, to lose weight or just to experiment.

“But these drugs shouldn’t be taken lightly,” said McCabe, who led the new study.

According to the US National Institutes of Health, stimulant abuse poses a risk of overdose and side effects such as irregular heartbeat, dangerously high body temperature and seizures. Over time, it can also lead to substance use disorder.

In an earlier study, McCabe and colleagues found that US colleges vary widely in student abuse of stimulants: it’s barely present in some and a major problem in others.

However, little is known about what happens in high schools and colleges.

So, for the new study, the researchers analyzed data from an annual government survey of students in schools across the country. They had information from over 230,000 students surveyed between 2005 and 2020.

Overall, the study found the image closely resembled that seen on college campuses.

“The abuse of stimulants was as low as zero in some schools and as high as over 25% in others,” McCabe said.

And that difference depended, in part, on whether the schools had a high percentage of students taking a stimulant to treat ADHD.

Children who attended schools with a high rate — 12% or more of students on ADHD medication — were 36% more likely to say they abused stimulants, compared to children in schools where no students used ADHD medications.

That wasn’t the whole story, McCabe said. Stimulant abuse still occurred in some schools, and few children were taking ADHD medication.

He also pointed out that no one is saying drugs should be withheld from children who need them.

But, McCabe said, these children need to be prepared if they are pressured by classmates to share their medication.

“A lot of them just don’t know what to do,” he said. “So they need to have something ready to say.”

Parents, McCabe added, can help them understand this.

Linda Richtervice president of prevention research and analysis for the nonprofit Partnership to End Addiction, made similar remarks.

“It is very important for parents to have conversations with their children about prescription drugs from an early age and for them to be a credible source of information about the risks of using drugs that don’t have you. not specifically prescribed,” said Richter, who was not involved in the study.

Children “should understand that sharing their prescribed medication with a friend could put that friend at risk,” she said.

Beyond those discussions, McCabe also suggested parents store their children’s medication in a safe and consider counting their pills to detect any sharing or misuse of medication.

As for red flags that your child might be abusing stimulants, Richter said any sustained changes in a child’s behavior, relationships, sleep, or eating habits could be a sign.

“But,” she says, “the best way to know if your child is abusing a drug is to have an open and honest relationship, to spend time together regularly, and to monitor their whereabouts and activities.”

SOURCES: Sean Esteban McCabe, PhD, professor, nursing and director, Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan, Ann Arbor; Linda Richter, PhD, vice president, prevention research and analysis, Partnership to End Addiction, New York; Open JAMA Network, April 18, 2023, online

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