"Jan Drew" wrote in message
m...
https://dawninfo.samhsa.gov/files/TNDR09ADHDmeds.htm
Excerpts:
Emergency Department Visits Involving ADHD Stimulant Medications
a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder (ADHD).
b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).
Nonmedical use? The problem is that the patient is not taking the medication
as prescribed, not the drug itself.
c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher than
the rates for patients aged 18 or older.
Gee, more kids than adults take the drug. What a surprise.
d.. Over two thirds (68%) of the visits involving nonmedical use of
these two drugs also involved another substance, such as alcohol, an
illicit drug, or pharmaceutical.
I doubt many many doctors prescribing these two drugs recommend the use of
alcohol, illicit drugs or other pharmaceuticals with the drugs.
Recent studies have indicated that as many as 7 percent of children and 4
percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD.
More prescriptions will likely lead to increases in medical side effects
associated with the use of these medications and, potentially, greater use
of these drugs for nonmedical purposes as well.4 A recent Food and Drug
Administration (FDA) advisory panel recognized the danger of side effects
for ADHD stimulants and recommended that they carry a warning of an
increased potential for cardiac problems, such as hypertension, cardiac
arrests, and stroke.5 The possibility of medical problems may be
exacerbated by using ADHD stimulant medications improperly or in
combination with other drugs.
The potential for greater access of these medications to persons without a
prescription is supported by research, which has shown that peers are a
common source of ADHD medications.6 Although the potential for diversion
has increased, estimates from the 2003 National Survey on Drug Abuse and
Health (NSDUH) indicate that nonmedical use of ADHD stimulant medications
is still relatively low: 0.3 percent of the population aged 12 or older
reported using such stimulants nonmedically during the past year.
0.3%? That means that in an average middle school, two students out of the
whole school used such stimulants nonmedically. WHile that is two too many,
that is probably much smaller than the numbre of students using other
illegal drugs, like cigarettes, put, marihuana or alcohol.
However, those aged 18 to 25 had a higher rate of nonmedical use than
those who were younger or older.7 College students, who may use these
drugs as study aids because of their stimulant properties, fall primarily
in this 18-to-25 age group.
The Drug Abuse Warning Network (DAWN), which collects data from a national
sample of short-term, general, non-Federal hospitals,8 provides estimates
of drug-related emergency department (ED) visits. The findings presented
in this issue of The DAWN Report are based on ED visits related to two of
the pharmaceuticals commonly used to treat ADHD-methylphenidate and
amphetamine-dextroamphetamine. DAWN includes both generic and branded
drugs, including methylphenidate marketed as Ritalinİ and Concertaİ and
amphetamine-dextroamphetamine marketed as Adderalİ. Based on DAWN data,
this report examines the reasons for the ED visits and the relative
frequency of these ED visits for different age groups. Finally, for the ED
visits involving nonmedical use, DAWN provides the ability to examine the
drugs used along with the ADHD drugs. DAWN, which observes drug-related
morbidity in ED visits, offers a different view of drug use than the
NSDUH, which measures prevalence of nonmedical use in the population at
large.
Overview
In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about 2
million ED visits in 2004 were drug related, and the ADHD drugs examined
in this report were implicated in about 1 percent of those drug-related
visits. Methylphenidate was involved in an estimated 3,601 ED visits, and
amphetamine-dextroamphetamine was involved in an estimated 4,272 ED
visits.
Table 1. Estimated ED visits, by reason for ED visit and drug Reason for
visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%
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