Monday, February 8, 2016

Teens Abuse Prescription ADHD Drugs, Too

Regardless of the slang or street names, they're actually stimulants like 'Ritalin' and 'Adderall', which are commonly prescribed to treat attention deficit hyperactivity disorder (ADHD). But like many other prescription drugs, they are getting in the wrong hands for the wrong reasons.

Teens Abuse Prescription ADHD Drugs, Too

They’re known as study drugs ... party drugs ... vitamin R, the smart drug, addy, a-bomb ...
They’re known as study drugs ... party drugs ... vitamin R, the smart drug, addy, a-bomb ...

By Rima Himelstein

They’re known as study drugs ... party drugs ... vitamin R, the smart drug, addy, a-bomb ...

Regardless of the slang or street names, they’re actually stimulants like ‘Ritalin’ and ‘Adderall’, which are commonly prescribed to treat attention deficit hyperactivity disorder (ADHD). But like many other prescription drugs, they are getting in the wrong hands for the wrong reasons. Look on the Internet for a crash course on what our kids may be learning in between classes.

Here’s what a national survey of 8th, 10th and 12th graders in public and private schools found in 2011:

  • 2.1% of these teens reported that they had abused Ritalin
  • 4.1% reported that they had abused Adderall in the past year.
  • Compared with marijuana use at about 25%, these may not sound like high rates, but even 2 children out of 100 are too many.  

Another recent national study found that calls to poison control centers related to teenaged victims of prescription ADHD medication abuse rose 76% from 1998 to 2005, which was faster than calls for victims of substance abuse generally. Scary but true. 

Stimulants are often prescribed for children with ADHD. A common medical condition affecting between 4% and 12% of children, ADHD symptoms include impulsive behavior, difficulty paying attention and following instructions, restlessness, and distractibility.  When used as directed by a doctor, Ritalin, Adderall, and similar medications such as ‘Vyvanse’, ‘Concerta’, and ‘Focalin’, have what are called “paradoxical effects” on patients with ADHD—making them calmer and more focused—so they are better able to learn.

But when someone takes stimulants in high doses or takes them the wrong way, like “snorting,” these drugs are dangerous. Some teens may abuse them as study drugs—to pull all-nighters before tests and then increase their performance on exams. Others may abuse stimulants as party drugs—for the energy, euphoria or “high,” and strong feelings of self-confidence they get from these drugs.  

Teens who abuse ADHD medications know where to get them.  They get them from classmates or friends. Some teens who are abusing ADHD meds that have been prescribed for them legitimately may start asking their doctor for higher doses of their medication. In fact, among high school seniors these drugs are the third most commonly abused illicit drug.

When someone abuses a stimulant, it is a prescription for trouble. Serious side effects include dangerously high blood pressure, irregular heartbeat, difficulty breathing, seizures and tremors, and mood disorders. With repeated high-dose abuse, stimulants can cause a stroke, or cognitive changes such as confusion, hallucinations, delusions, and paranoia. When alcohol is thrown into the mix, as is often the case with party drugs, the combined effects can spiral out of control. Chronic stimulant abuse is as real as heroin addiction.

Some signs of stimulant abuse may include:

  • Problems in school
  • Change in activities or friends
  • Heightened attention, long periods of sleeplessness or not eating
  • Memory lapses
  • Unusual behaviors, including secrecy and isolation, unexplained spending
  • Aggressiveness, irritability, mood swings
  • Weight loss
  • Dilated pupils, dry mouth and nose

The best “treatment” is prevention.  If a teenager needs ADHD medication and is at risk for substance abuse, the use of non-stimulant drugs to treat ADHD may be helpful. Examples include atomoxetine (‘Strattera’) and certain antidepressants, such as bupropion (‘Wellbutrin’). As with all prescription medications, keep stimulant prescriptions in a locked container and monitor the quantities. Parents should be the only ones to dispense a child’s ADHD medication outside of the school.

It’s okay to leave the teaching of reading, writing, and arithmetic to the school, but teaching your child right from wrong—such as in stimulant abuse—is a lesson that starts in the home. For more information about what parents can do to prevent, recognize, and respond to prescription drug abuse, visit Not in My House  sponsored by the Partnership for a Drug-Free America.

Rima Himelstein, M.D., is a Crozer-Keystone Health System pediatrician and adolescent medicine specialist.

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Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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