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. 2017 Mar;56(3):226-233.e4.
doi: 10.1016/j.jaac.2016.12.008. Epub 2016 Dec 25.

Adolescents' Prescription Stimulant Use and Adult Functional Outcomes: A National Prospective Study

Sean Esteban McCabe  1 , Philip Veliz  2 , Timothy E Wilens  3 , John E Schulenberg  4
Affiliations

Adolescents' Prescription Stimulant Use and Adult Functional Outcomes: A National Prospective Study

Sean Esteban McCabe et al. J Am Acad Child Adolesc Psychiatry. 2017 Mar.

Abstract

Objective: To assess the prospective 17-year relationship between the medical and nonmedical use of prescription stimulants during adolescence (age 18 years) and educational attainment and substance use disorder (SUD) symptoms in adulthood (age 35 years).

Method: A survey was self-administered by nationally representative probability samples of US high school seniors from the Monitoring the Future study; 8,362 of these individuals were followed longitudinally from adolescence (age 18, high school senior years 1976-1996) to adulthood (age 35, 1993-2013).

Results: An estimated 8.1% reported medical use of prescription stimulants, and 16.7% reported nonmedical use of prescription stimulants by age 18 years. Approximately 43% of adolescent medical users of prescription stimulants had also engaged in nonmedical use of prescription stimulants during adolescence. Among past-year adolescent nonmedical users of prescription stimulants, 97.3% had used at least one other substance during the past year. Medical users of prescription stimulants without any history of nonmedical use during adolescence did not differ significantly from population controls (i.e., non-attention-deficit/hyperactivity disorder [ADHD] and non-stimulant-medicated ADHD during adolescence) in educational attainment and SUD symptoms in adulthood. In contrast, adolescent nonmedical users of prescription stimulants (with or without medical use) had lower educational attainment and more SUD symptoms in adulthood, compared to population controls and medical users of prescription stimulants without nonmedical use during adolescence.

Conclusion: Nonmedical use of prescription stimulants is common among adolescents prescribed these medications. The findings indicate youth should be carefully monitored for nonmedical use because this behavior is associated with lower educational attainment and more SUD symptoms in adulthood.

Keywords: adolescent; adult; prescription drug misuse; stimulants; substance-related disorders.

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Conflict of interest statement

Conflicts of Interest: Drs. McCabe, West and Ms. Dickinson report no biomedical financial interests or potential conflicts of interest. Dr. Wilens has served as a consultant to Euthymics/Neurovance, Ironshore, Sunovion, Theravance, TRIS, the U.S. National Football League (ERM Associates), U.S. Minor/Major League Baseball, Bay Cove Human Services (Clinical Services), and Phoenix House. He has grant funding from NIH (NIDA), He has published the book, Straight Talk About Psychiatric Medications for Kids (Guilford Press); and has co-edited the books, ADHD in Children and Adults (Cambridge Press) and Massachusetts General Hospital Comprehensive Clinical Psychiatry (Elsevier). He is the co-owner of the Before School Functioning Questionnaire (BSFQ), a copyrighted diagnostic questionnaire- with a licensing agreement with Ironshore (BSFQ Questionnaire).

Comment in

References

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MeSH terms

Substances