ADHD Medication Diversion

The pressure to share pills

Forget Red Bull and high-octane coffee drinks. Many teens and young adults are turning to a new energy boost: They’re asking kids with ADHD for their prescription medications. Experts call it “medication diversion” when people diagnosed with ADHD share or sell their drugs. In the last few years, the phenomenon has emerged as a trend among the young. One recent study found that 4 to 6 percent of 18- to 24-year-olds had taken ADHD drugs for non-medical reasons. An epidemic? It’s hard to say, although experts agree on this: Teaching your kids about the potential dangers of medication misuse is the surest path to prevention.

Why the pills are popular
Scott Novak, PhD, senior research scientist at the North Carolina-based research institute RTI International and lead author of the young adult study, explains that the misusers are often college students. “Roughly 75 percent of non-prescribed users are taking the drugs to be more productive for studying and exams,” he says. A less common—but more dangerous—practice, according to Novak, is that kids are pairing the medications with alcohol or marijuana to “keep the party going.”

Laurie Dupar, RN, an ADHD coach in Granite Bay, California, who works with teens and college students, has found that pill sharing is starting earlier. “Kids are being approached for medication at a younger age—9th or 10th grade,” she says. Academic pressures are behind these students’ use, too.

As for the kids with ADHD? Studies show that they typically are not abusing the drugs.

How to prevent the problem
Experts advise that parents talk to their kids early—by junior high—about the possibility that classmates may ask for pills. Some strategies for discussing the issue:

1. Stress the legal risks. Let your child know that selling their medication is a felony. Selling even small amounts of legally obtained ADHD medication is against the law. Even giving away the medication for free to others is unlawful.

2. Warn them about complications. Although kids are misusing the drugs infrequently (perhaps only a few times a year, according to Novak’s study), an occasional hit isn’t necessarily harmless. Interactions with other medications, physical side effects (vomiting, extreme restlessness), and an increased risk for alcohol toxicity are among the dangers for non-ADHD users. Meanwhile, kids with ADHD miss doses when they share or sell their medications. As a result, they may suffer from poor performance or disorder-related behaviors. A single dose of stimulants can be harmful to someone with certain heart conditions or seizure disorders. It is never a good idea to share prescription medications with friends or school mates.

3. Be the “fall guy”. Dupar says that parents can play a role in easing peer pressure for kids in junior and senior high school. Explain that it’s okay to “blame” you, as in: “My mother counts my pills, and she’d kill me if any were missing.” Likewise, time the dosage so that your child doesn’t need to bring medication to school. You also can lock up the pills.

4. Place a premium on privacy. Without making ADHD seem like a shameful secret, encourage your child to only share information about the diagnosis or prescriptions with trustworthy friends. For a college freshman, says Dupar, this may mean temporarily keeping pills locked up or taking them in private. “The medications are for social and academic success,” she says. “Kids need to protect that until they know the lay of the land.”

References

1. Sherman, C. (n.d.). ADD drugs on campus. Retrieved May 14, 2008, from http://www.additudemag.com/adhd/article/861.html
2. Richardson, W. (1997). AD/HD and stimulant medication abuse. Retrieved May 14, 2008.
3. Minerd, J. (2006, March 31). ADHD patients susceptible to stimulant abuse identified. Medpage Today. Retrieved May 14, 2008, from http://www.medpagetoday.com/Psychiatry/ADHD-ADD/tb/2973
4. L. Dupar (personal communication, February 26, 2008)
5. Novak, S.P., Kroutil, L.A., Williams, R.L., & Van Brunt, D.L. (2007). The nonmedical use of prescription ADHD medications: Results from a national Internet panel. Substance Abuse Treatment and Prevention Policy, 2, 32.
6. S. Novak (personal communication, February 25, 2008)
7. Smith, K. (2006, February 2). Dangers of stimulant abuse. The University Daily Kansan. Retrieved May 14, 2008, from http://www.kansan.com/stories/2006/feb/02/drugs/
8. The Nemours Foundation/KidsHealth. (2006, June). Stimulant abuse among college students a concern. Retrieved May 14, 2008.
9. Sherman, C. (n.d.). Stimulants: Not quite an epidemic. Retrieved May 14, 2008, from http://www.additudemag.com/adhd/article/1688.html
10. ScienceDaily. (2006, March 30). Study examines risk for misuse of ADHD stimulant medications. Retrieved May 14, 2008, from http://www.sciencedaily.com/releases/2006/03/060330162120.htm
11. B. White (personal communication, February 26, 2008)