Most parents considering treatment for the children’s ADHD might increase the risk of stimulant dependence and abuse later on. A recent, large, population-based study answers this question.
Attention-Deficit/Hyperactivity Disorder (ADHD) is most consistently treated by stimulant pharmaceuticals such as methylphenidate (Ritalin) and amphetamine salts (a.k.a., amphetamine-dextroamphetamine, Adderall) and their closely-related variants dexmethylphenidate (Focalin) and dextroamphetamine (Dexedrine). All stimulant ADHD medications on the market consist of one of these in spite of the sixty-odd different product names. They are all intended to temporarily (while on board only) stop the rapid jumping of the attentional system of the brain that is the defining characteristic of the ADHD brain.
By doing so, they significantly boost focus, attention span, and (less consistently) control of impulsivity, all of which can greatly impair academic achievement regardless of intelligence. As understanding of ADHD has spread through the medical community and the population, the use of stimulants has increased sharply. (We here address only briefly the improper use of stimulants which has unfortunately also grown.) Against this backdrop 2024 exhaustive investigation asks whether the proper use of stimulants in the teem years leads to a higher risk of abuse of stimulants later. The study examines the experiences of 11,905 US 12th-grade pupils over a span of six years. This study stands out for its scale and its longitudinal design.
The researchers found the following:
Results
There were no statistically significant differences between adolescents who used stimulant therapy for ADHD compared to those who used only nonstimulant medications and population controls in their adjusted odds of nonmedical stimulant use incidence or prevalence during young adulthood, after adjusting for baseline covariates.
Discussion
The findings offer preliminary support that adolescents who use prescription stimulant or nonstimulant medications for ADHD when clinically indicated are not at greater risk for nonmedical stimulant use during young adulthood.
The decision to incorporate stimulation treatments into an individual’s ADHD management plan is made with cautious assessment of advantages and risks.
These results differ from the common and understandable worry do raise the danger of later nonmedicinal stimulant misuse later on.
Addressing Improper Stimulant Utilization
Many studies have demonstrated that the improper use of stimulants early on does increase the risk of continued or later abuse.
Improper use of prescription stimulants, defined as the “unauthorized or recreational consumption of prescription stimulants”, is hazardous, particularly among teenagers and young adults. This kind of abuse usually aims at a euphoric state, which differs from the medication’s intended benefit. This effect, when it occurs (usually at doses that are above its therapeutic use but not always) fades rapidly. To “chase” it requires higher and higher doses which can lead to addiction. The only proper metric for assessing a stimulant’s proper effect is objective output, not subjective feelings they may induce for awhile, whether good or bad. The same is true when stimulants are used to perpetuate their weight-loss effect and their capacity to prolong wakefulness (a common misuse among college students to “cram” for exams).
The Sterling Institute acknowledges the complex realities faced by those living with ADHD. Its professionals adopt a strategy tailored to each person’s unique requirements by closely tracking all responses to stimulants, positive and negative, and insisting on rigorous and regular follow-ups and tightly-controlled prescribing practices.