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Misuse of Prescription Stimulants in Young Adults

In This Video

  • In this video, Timothy Wilens, MD, co-director of the Center for Addiction Medicine at Massachusetts General Hospital, discusses his research into the misuse and diversion of stimulant medications in young people
  • He notes patterns and prevalence of stimulant misuse and discusses why this is a matter of concern
  • 10-15% of young people who are prescribed stimulant medication are diverting or misusing these medications, and recent data has shown that stimulant use at a young age is predictive of substance use disorders later in life

Timothy Wilens, MD, is chief of Massachusetts General Hospital's Division of Child and Adolescent Psychiatry and co-director of the Center for Addiction Medicine. His research examines the appropriate use of stimulant medications and, in particular, the misuse and diversion of stimulant medications in adolescents and young adults. In this video, he discusses that work and the patterns and prevalence of stimulant misuse his group has identified.


Much of the recent focus of the research that myself and our laboratory's been involved in is looking at the appropriate use of stimulant medications and, in particular, looking at misuse and diversion of stimulant medications in typically young people. That would include adolescents and young adults.

Some of the findings that we have that make it important to understand stimulant misuse is number one, the vast majority of people in whom they're prescribed, those are people who have attention deficit hyperactivity disorder, use their medicines appropriately, and they use it as directed. However, there's a small percentage, probably 10-15% that are either selling or giving away their medicine, which is called diversion, or they're misusing them themselves.

We also are very concerned about people who are misusing these medicines, often referred to as non-medical use, who are in the general population, often college-age kids and not only college-age kids, kids in college. By the way, the misuse prevalence goes up based on the competitiveness of the school. So, the more competitive the school, the more misuse or non-medical use of stimulant medications in the general college population.

How often does it occur? Anywhere from 5-20%, so in some colleges, almost a quarter of the kids have used stimulants in a non-medical way.

So, why do we care? What do we care if a college student uses a stimulant medicine once or twice? These are safe medicines and probably it's not a big issue if they use it once or twice. But the problem is, they don't use it once or twice. Data from our group and others are showing that 10-15% of college students actually have a stimulant use disorder. They actually get hooked on the stimulant and 40-50% of kids who use stimulants are using them pretty frequently.

Another really scary statistic: if you look at the immediate-acting stimulants, those are the short-acting stimulants, in those who misuse them, 40%, 4-0 percent, are snorting them. They're grinding them, and they're sniffing them. Insufflation, it's called. That's problematic.

We also know that many don't even know what they're using and they use what we call supratherapeutic doses. They don't use 10 or 20 mg. of Adderall as prescribed. They use 60 or 100 mg. because they don't know the dose.

We think that all college-age students should be screened to see, "Are you misusing stimulants or, by the way, any other prescription medicine?" We think it's important because if you hear, "yes," our data shows that 50% of them have a substance use problem. That is, they are drinking too much, using marijuana too much, or they've got problems. They've got other issues. 50% is half. That's a real marker.

We also know that 25% of that group have ADHD, or attention deficit hyperactivity disorder, and an almost equal amount have what we call executive function problems. The secretary of the brain is not working right. They have neuropsychological impairment.

Some recent data that was published, again collaboratively between Massachusetts General Hospital and University of Michigan, is if you look 15 years later at people who misuse stimulants, even once, it predicts in young adulthood that these individuals will have a substance use disorder and will be functioning occupationally significantly worse than those individuals who have, let's say ADHD, who are treated and using their medicines appropriately.

Learn more about the Center for Addiction Medicine

Learn more about the Division of Child & Adolescent Psychiatry

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