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From attention‐deficit/hyperactivity disorder to medical stimulant use to the diversion of prescribed stimulants to non‐medical stimulant use: connecting the dots
Author(s) -
Poulin Christiane
Publication year - 2007
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2007.01758.x
Subject(s) - methylphenidate , medical prescription , stimulant , attention deficit hyperactivity disorder , amphetamine , psychiatry , medicine , population , attention deficit , attention deficit disorder , pharmacology , environmental health , dopamine
Aims To describe the connections among the likelihood of attention deficit/hyperactivity disorder (ADHD), medical and non‐medical methylphenidate and amphetamine use and the diversion of prescribed methylphenidate in the general adolescent population. Design Cross‐sectional self‐reported anonymous data from the 2002 Student Drug Use Survey in the Atlantic Provinces. Setting The Atlantic provinces of Canada. Participants A total of 12 990 students participated. Measurements The outcomes were a positive ADHD screening test, medical and non‐medical use of methylphenidate, medical and non‐medical use of amphetamine and the giving and selling of methylphenidate medication by students with a prescription. The Ontario Child Health Study Hyperactivity Scale was used to screen for ADHD. Findings The prevalence of a positive ADHD screening test was 6% with no significant gender difference. The prevalence of medical and non‐medical methylphenidate use and medical and non‐medical amphetamine use was 2.0%, 6.6%, 1.2% and 8.7%, respectively. A positive ADHD screening test was independently predictive of these four patterns of use. About 26% of students with prescribed methylphenidate gave or sold some of their medication. Students in a class where at least one student had given or sold some of their prescribed pills had a 1.52‐fold increased risk of non‐medical methylphenidate use than their counterparts in classes where no giving or selling had taken place. Conclusions Connections were demonstrated at the population level between ADHD, medical methylphenidate use, the diversion of prescribed methylphenidate and the non‐medical use of methylphenidate. The appropriate assessment and management of ADHD are essential to minimize both the risk of diversion and of substance use associated with unrecognized or untreated ADHD.