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Did your Beauvoir ADHD kid get into STA / NCS?
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Anonymous
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Meta-analysis of abuse issues: interesting paper
J Am Acad Child Adolesc Psychiatry. 2008 Jan;47(1):21-31. Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature. Wilens TE, Adler LA, Adams J, Sgambati S, Rotrosen J, Sawtelle R, Utzinger L, Fusillo S. Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. twilens@partners.org Abstract OBJECTIVE: Recent studies have provided variable information on the frequency and context of diversion and the use of nonprescribed and prescribed stimulant medications in adolescent and young adult populations. The purpose of this systematic review of the literature is to evaluate the extent and characteristics of stimulant misuse and diversion in attention-deficit/hyperactivity disorder (ADHD) and non-ADHD individuals. METHOD: We conducted a systematic review of the literature of available studies looking at misuse and diversion of prescription ADHD medications using misuse, diversion, stimulants, illicit use, and ADHD medications as key words for the search. RESULTS: We identified 21 studies representing 113,104 subjects. The studies reported rates of past year nonprescribed stimulant use to range from 5% to 9% in grade school- and high school-age children and 5% to 35% in college-age individuals. Lifetime rates of diversion ranged from 16% to 29% of students with stimulant prescriptions asked to give, sell, or trade their medications. Recent work suggests that whites, members of fraternities and sororities, individuals with lower grade point averages, use of immediate-release compared to extended-release preparations, and individuals who report ADHD symptoms are at highest risk for misusing and diverting stimulants. Reported reasons for use, misuse, and diversion of stimulants include to concentrate, improve alertness, "get high," or to experiment. CONCLUSIONS: The literature suggests that individuals both with and without ADHD misuse stimulant medications. Recent work has begun to document the context, motivation, and demographic profile of those most at risk for using, misusing, and diverting stimulants. The literature highlights the need to carefully monitor high-risk individuals for the use of nonprescribed stimulants and educate individuals with ADHD as to the pitfalls of the misuse and diversion of the stimulants. PMID: 18174822 [PubMed - indexed for MEDLINE] Publication Types, MeSH Terms, Substances, Grant SupportPublication Types: Research Support, N.I.H., Extramural Review MeSH Terms: Adolescent Adult Amphetamines* Attention Deficit Disorder with Hyperactivity/drug therapy* Attention Deficit Disorder with Hyperactivity/epidemiology* Attention Deficit Disorder with Hyperactivity/psychology Central Nervous System Stimulants* Child |
Anonymous
13:32 again. Actually, I've got 3 kids and never noticed anything I ate had any effect on the baby in the womb. Assuming your assertion that fetal heart rate increases with sugar intake is factual, what does that have to do with hyperactivity? You're comparing apples to oranges. What does it tell us other than a baby in utero baby responds to its environment. |
Anonymous
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Pediatrics. 2009 Sep;124(3):875-80. Epub 2009 Aug 24.
Adolescent prescription ADHD medication abuse is rising along with prescriptions for these medications. Setlik J, Bond GR, Ho M. Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, Cincinnati, OH 45229, USA. jennifer.setlik@cchmc.org Abstract OBJECTIVE: We sought to better understand the trend for prescription attention-deficit/hyperactivity disorder (ADHD) medication abuse by teenagers. METHODS: We queried the American Association of Poison Control Center's National Poison Data System for the years of 1998-2005 for all cases involving people aged 13 to 19 years, for which the reason was intentional abuse or intentional misuse and the substance was a prescription medication used for ADHD treatment. For trend comparison, we sought data on the total number of exposures. In addition, we used teen and preteen ADHD medication sales data from IMS Health's National Disease and Therapeutic Index database to compare poison center call trends with likely availability. RESULTS: Calls related to teenaged victims of |
Anonymous
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Adolescent prescription ADHD medication abuse is rising along with prescriptions for these medications.
Setlik J, Bond GR, Ho M. Cincinnati Children's Hospital Medical Center, Division of Emergency Medicine, University of Cincinnati, Cincinnati, OH 45229, USA. jennifer.setlik@cchmc.org Abstract OBJECTIVE: We sought to better understand the trend for prescription attention-deficit/hyperactivity disorder (ADHD) medication abuse by teenagers. METHODS: We queried the American Association of Poison Control Center's National Poison Data System for the years of 1998-2005 for all cases involving people aged 13 to 19 years, for which the reason was intentional abuse or intentional misuse and the substance was a prescription medication used for ADHD treatment. For trend comparison, we sought data on the total number of exposures. In addition, we used teen and preteen ADHD medication sales data from IMS Health's National Disease and Therapeutic Index database to compare poison center call trends with likely availability. RESULTS: Calls related to teenaged victims of prescription ADHD medication abuse rose 76%, which is faster than calls for victims of substance abuse generally and teen substance abuse. The annual rate of total and teen exposures was unchanged. Over the 8 years, estimated prescriptions for teenagers and preteenagers increased 133% for amphetamine products, 52% for methylphenidate products, and 80% for both together. Reports of exposure to methylphenidate fell from 78% to 30%, whereas methylphenidate as a percentage of ADHD prescriptions decreased from 66% to 56%. Substance-related abuse calls per million adolescent prescriptions rose 140%. CONCLUSIONS: The sharp increase, out of proportion to other poison center calls, suggests a rising problem with teen ADHD stimulant medication abuse. Case severity increased over time. Sales data of ADHD medications suggest that the use and call-volume increase reflects availability, but the increase disproportionately involves amphetamines. |
Anonymous
Your cluelessness is no surprise. |
Anonymous
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Second opinions improve ADHD prescribing in a medicaid-insured community population.
Thompson JN, Varley CK, McClellan J, Hilt R, Lee T, Kwan AC, Lee T, Trupin E. Washington State Department of Social and Health Services, WA, USA. ThompJ@dshs.wa.gov Abstract OBJECTIVE: The appropriate use of psychotropic medications in youths is an important public health concern. In this article, we describe a review process developed to monitor the use of stimulants and atomoxetine for attention-deficit/hyperactivity syndrome (ADHD) in youths receiving fee-for-service Medicaid services. METHOD: Washington State Medicaid developed threshold safety parameters for ADHD medications through a process involving the community. A second opinion was mandated when safety thresholds based on dose, combination therapies, or age was exceeded. Use and cost were compared 2 years before and after the program began. RESULTS: From May 2006 to April 2008, 5.35% of ADHD prescriptions exceeded safety thresholds, resulting in 1,046 second-opinion reviews. Of those, 538 (51.4%) resulted in a prescription adjustment. Adjustments were made to primary care physician (52%), psychiatrist (50%), nurse practitioner (54%), and physician assistant-written (51%) prescriptions. When the preperiod and postperiod were compared, second opinions reduced ADHD medication at high doses (53%), in combinations (44%), and for patients 5 years of age and younger (23%). The review process resulted in a savings of $1.2 million, with 538 fewer patients exceeding safety thresholds. This was a 10:1 return over administrative costs; however, the overall Medicaid expenditures for ADHD medication still increased because of higher unit costs and the preferential use by clinicians of newer brands entering the market. CONCLUSIONS: A statewide second-opinion process reduced outlier ADHD medication prescription practices and was cost-effective. Suggestions for process and quality improvements in prescribing to children diagnosed with ADHD are discussed. |
Anonymous
| To the person who's posting the entire summary - it's better just to provide a link and provide a brief summary with your point. Your posts are needlessly taking up space and it's not clear what your point it. I don't think anyone has argued that some people who don't have ADHD get prescriptions and the numbers cited in the studies you posted don't support the hysteria some exhibit. |
Anonymous
To 13:32 I trust the previous posts have satisfied your thirst for peer-reviewed research to related to potential abuse of ADHD drugs. If you need further literature I'd be happy to provide additional studies for you. |
Anonymous
Is that the best response you have? Your lack of documentation to support your opinion and your personal attacks show that this really isn't about ADHD as a social issue. As a PP noted, it's more likely you feel ADHD kids taking medication have an advantage over your kid. I'm sorry you feel that way. You should know that having ADHD isn't something I'd wish on anyone, especially a kid. |
Anonymous
Of course there's potential for abuse. Who said there wasn't? You haven't provided anything indicating that ADHD is overdiagnosed and overmedicated which is what the unsupported assertion was. Oh - and if you find some peer reviewed research that indicates that, post a link. Otherwise, your point is easily lost. |
Anonymous
Please do not read the posts if you are so inclined. I prefer them to your 'seat of the pants documentation'. I think the posts have clarified the issue the poster has tried to make but you prefer to take as a personal attack. I hope you don't think the authors of these papers are also attacking you because of their research. |
Anonymous
Have you read any of the abstracts? I think I have provide sufficient documentation if you are indeed reading and processing. I have a few more clearly identifying the role of parental behavioural therapy in the treatment of their children with ADHD. Would you like references to this new and exciting research area? Some of the initial studies are quite intriguing particularly in the younger child and adolescent with ADHD. Some investigators hypothesize this approach will minimise polypharmacy for this coondition. |
Anonymous
You think the National Institutes of Health is "seat of the pants documentation"? Did you even read read the articles you posted? Do you understand statistics? What you posted doesn't support the assertions that ADHD is overdiagnosed and overmedicated, they only show increased awareness is required to prevent non-medical use of ADHD. The incidence of non-medical use also isn't very high. If you want to get worked up about non-medical use of drugs, focus on the painkillers. Why isn't anyone getting worked up about that? Ritalin hardly got a mention in today's WaPo article. It was all about the painkillers. And, I don't see how I could take anyone questioning whether I've ever had a pregnancy or calling me 'clueless' as anything other than a personal attack. |
Anonymous
| 13:32 signing off. My kids' medication is wearing off and they require increased support at this time. Medications have made a huge difference in the quality of our lives and my kids' ability to learn. I'm sorry there are those who don't understand what it's like to live with untreated ADHD and the tragic outcomes it can have. Substance abuse/addiction are much more common in people with ADHD as is risky behavior (poor driving, teenage sex, etc.). It's taken a tragic toll on my family and as difficult as it is, there is comfort that my kids will be much less likely to follow the path my untreated siblings have. |
Anonymous
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1. You provide seat of the panty documentation--no data
2. Yes, I have read all the papers I posted for your review. There are several more if you would like to read them yourself. 3. Yes, the abstracts I posted for your review do suggest polypharmacy, overprescription and abuse for ADHD drugs in America 4. The documentation of these facts is not hysteria simply point of fact 5. I do not think that anyone would agree with your assertion " the incidence of non-medical use of ADHD drugs isn't very high" 6. No one here is getting worked up about narcotic drug abuse because that is not the topic under discussion tonight. In case you have forgotten the subject and issue concerns drugs for ADHD 7. Ritalin does get mentioned in today's front page article in the Washinton Post on oft-abuse of prescription drugs 8. Any pregnant woman in her third trimester will describe to you in detail what happens to her fetus/baby shortly after a sugar or caloric bolus. Enough said. This is not a personal attack just fact. 9. None of the above statements (1-8) are personal attacks. 10. In addition, the researchers of papers on ADHD are not attacking you personally |