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. 2016 Mar;77(3):e297-304.
doi: 10.4088/JCP.14m09291.

Prescriptions, nonmedical use, and emergency department visits involving prescription stimulants

Lian-Yu Chen  1 , Rosa M Crum, Eric C Strain, G Caleb Alexander, Christopher Kaufmann, Ramin Mojtabai
Affiliations

Prescriptions, nonmedical use, and emergency department visits involving prescription stimulants

Lian-Yu Chen et al. J Clin Psychiatry. 2016 Mar.

Abstract

Objective: Little is known regarding the temporal trends in prescriptions, nonmedical use, and emergency department (ED) visits involving prescription stimulants in the United States. Our aim was to examine these 3 national trends involving dextroamphetamine-amphetamine and methylphenidate in adults and adolescents.

Method: Three national surveys conducted between 2006-2011 were used: National Disease and Therapeutic Index, a survey of office-based practices; National Survey on Drug Use and Health, a population survey of substance use; and Drug Abuse Warning Network, a survey of ED visits. Ordinary least squares regression was used to examine temporal changes over time and the associations between the 3 trends.

Results: In adolescents, treatment visits involving dextroamphetamine-amphetamine and methylphenidate decreased over time; nonmedical dextroamphetamine-amphetamine use remained stable, while nonmedical methylphenidate use declined by 54.4% in 6 years. ED visits involving either medication remained stable. In adults, treatment visits involving dextroamphetamine-amphetamine remained unchanged, while nonmedical use went up by 67.1% and ED visits went up by 155.9%. These 3 trends involving methylphenidate remained unchanged. Across age groups, the major source for nonmedical use of both medications was a friend or relative; two-thirds of these friends and relatives had obtained the medication from a physician.

Conclusions: Trends in prescriptions for stimulants do not correspond to trends in reports of nonmedical use and ED visits. Increased nonmedical stimulant use may not be simply attributed to increased prescribing trends. Future studies should focus on deeper understanding of the proportion of, risk factors for, and motivations for drug diversions.

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Conflict of interest statement

Conflict of Interest Disclosures:

Dr. Alexander is Chair of the FDA’s Peripheral and Central Nervous System Advisory Committee, serves as a paid consultant to IMS Health, and serves on an IMS Health scientific advisory board. This arrangement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policies. Dr. Mojtabai has received consulting fees and research grants from Bristol-Myers Squibb and Lundbeck Pharmaceuticals. Other authors declare they have no conflicts of interest.

Figures

Figure 1
Figure 1
A. Temporal trends in prescription, nonmedical use, and ED visits involving methylphenidate and dextroamphetamine-amphetamine among adolescents (12-17 years). Source: IMS National Disease and Therapeutic Index®, January 2006 to December 2012, IMS Health Incorporated. All Rights Reserved. B. Temporal trends in prescription, nonmedical use, and ED visits involving methylphenidate and dextroamphetamine-amphetamine among adults (18 years old or above). Source: IMS National Disease and Therapeutic Index®, January 2006 to December 2012, IMS Health Incorporated. All Rights Reserved.
Figure 1
Figure 1
A. Temporal trends in prescription, nonmedical use, and ED visits involving methylphenidate and dextroamphetamine-amphetamine among adolescents (12-17 years). Source: IMS National Disease and Therapeutic Index®, January 2006 to December 2012, IMS Health Incorporated. All Rights Reserved. B. Temporal trends in prescription, nonmedical use, and ED visits involving methylphenidate and dextroamphetamine-amphetamine among adults (18 years old or above). Source: IMS National Disease and Therapeutic Index®, January 2006 to December 2012, IMS Health Incorporated. All Rights Reserved.
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Comment in

  • The ABCs of CNS stimulant misuse.
    Waxmonsky JG. Waxmonsky JG. J Clin Psychiatry. 2016 Mar;77(3):e315-6. doi: 10.4088/JCP.15com10102. J Clin Psychiatry. 2016. PMID: 27046316 No abstract available.

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