Early Exposure to Stimulant Medications and Substance-related Problems: The Role of Medical and Nonmedical Contexts

Overview

Journal Drug Alcohol Depend

Publisher Elsevier

Specialty Psychiatry

Date 2016 May 1

PMID 27129621

Citations 8

Authors

Sean Esteban McCabe

Phil Veliz

Carol J Boyd

Affiliations

Soon will be listed here.

Abstract

Background: The age of onset (early vs. late) and context (medical vs. nonmedical) of exposure to stimulant medications for attention-deficit/hyperactivity disorder (ADHD) have been identified as important factors in the addictive potential of these controlled medications. This study examines the role of medical and nonmedical contexts in the association between early exposure to stimulant medications and substance use and substance-related problems among adolescents.

Methods: A Web-based survey was self-administered by Detroit-area secondary school students (N=4755) between the 2009-10 and 2012-13 school years. The sample consisted of 51% females, 62% Whites, 32% African-Americans, and 6% from other racial categories.

Results: During the study period, an estimated 11.7% of respondents were ever diagnosed with ADHD. Approximately 6.7% (n=322) of respondents indicated lifetime medical use of prescription stimulants while 2.6% (n=124) indicated lifetime nonmedical use. The odds of substance use and substance-related problems were significantly lower among those who initiated earlier medical use of stimulant medications relative to later medical initiation. In contrast, the odds of substance use and substance-related problems were significantly greater among those who initiated earlier nonmedical use of stimulant medications relative to later nonmedical initiation.

Conclusions: More than one in every ten adolescents in this epidemiologically-derived community-based sample was diagnosed with ADHD. This is the first investigation to demonstrate that context (medical vs. nonmedical) plays a critical role in the relationship between early exposure to stimulant medications and the subsequent risk of substance-related problems during adolescence within the same diverse youth sample.

Citing Articles

Practice Pearls for Stimulant Treatment of Attention-Deficit/Hyperactivity Disorder in Youth.

Stutzman D, Dopheide J J Pediatr Pharmacol Ther. 2024; 29(3):215-231.

PMID: 38863854 PMC: 11163912. DOI: 10.5863/1551-6776-29.3.215.

Is Early Onset of Nonmedical Prescription Stimulant Use Associated With Cocaine Use During Adolescence? Results From a National Study.

McCabe S, Schepis T, Schulenberg J, Wilens T, Veliz P Subst Use Addctn J. 2024; 45(2):314-324.

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Methylphenidate with or without fluoxetine triggers reinstatement of cocaine seeking behavior in rats.

Lamoureux L, Beverley J, Steiner H, Marinelli M Neuropsychopharmacology. 2023; 49(6):953-960.

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Initiation Patterns and Transitions Among Adults Using Stimulant Drugs: Latent Transition Analysis.

Black J, Burkett H, Rockhill K, Olson R, Dart R, Iwanicki J J Med Internet Res. 2023; 25:e46747.

PMID: 37796607 PMC: 10587808. DOI: 10.2196/46747.

Type of medication therapy for ADHD and stimulant misuse during adolescence: a cross-sectional multi-cohort national study.

Schepis T, Werner K, Figueroa O, McCabe V, Schulenberg J, Veliz P EClinicalMedicine. 2023; 58:101902.

PMID: 36969344 PMC: 10036501. DOI: 10.1016/j.eclinm.2023.101902.

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