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Published online August 24, 2009
PEDIATRICS (doi:10.1542/peds.2008-0931)
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Articles

Adolescent Prescription ADHD Medication Abuse Is Rising Along With Prescriptions for These Medications

Jennifer Setlik, MDa, G. Randall Bond, MDa,b, Mona Ho, MSc

aDivision of Emergency Medicine,
bDrug and Poison Information Center, and
cDivision of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio

Objective We sought to better understand the trend for prescription attention-deficit/hyperactivity disorder (ADHD) medication abuse by teenagers.

Methods We queried the American Association of Poison Control Center's National Poison Data System for the years of 1998–2005 for all cases involving people aged 13 to 19 years, for which the reason was intentional abuse or intentional misuse and the substance was a prescription medication used for ADHD treatment. For trend comparison, we sought data on the total number of exposures. In addition, we used teen and preteen ADHD medication sales data from IMS Health's National Disease and Therapeutic Index database to compare poison center call trends with likely availability.

Results Calls related to teenaged victims of prescription ADHD medication abuse rose 76%, which is faster than calls for victims of substance abuse generally and teen substance abuse. The annual rate of total and teen exposures was unchanged. Over the 8 years, estimated prescriptions for teenagers and preteenagers increased 133% for amphetamine products, 52% for methylphenidate products, and 80% for both together. Reports of exposure to methylphenidate fell from 78% to 30%, whereas methylphenidate as a percentage of ADHD prescriptions decreased from 66% to 56%. Substance-related abuse calls per million adolescent prescriptions rose 140%.

Conclusions The sharp increase, out of proportion to other poison center calls, suggests a rising problem with teen ADHD stimulant medication abuse. Case severity increased over time. Sales data of ADHD medications suggest that the use and call-volume increase reflects availability, but the increase disproportionately involves amphetamines.

Key Words: poison center • teen • ADHD • stimulant abuse

Abbreviations: ED, emergency department

Accepted Mar 17, 2009.


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