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Old September 28th 06, 03:36 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Rich
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Posts: 112
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Jan Drew" wrote in message
m...

"Rich" wrote in message
...

"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe



Nothing is more dangerous than active ignorance. -- Goethe
Posted in 2002 by me.



Actually it's, "Es ist nichts schrecklicher als eine tätige Unwissenheit."
It loses something in translation.

YOUR active display of ignorance is legendary.



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).


Considering the number of people who are prescribed these medications,
this is a rather low rate. The ER visits for acetaminophen, narcotic
analgesics, and even iron supplements are all much higher.


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%).


Bear in mind that the "adverse reactions" are almost all transient
tachycardia which carries very little threat of injury or death in the
young population that is likely to be taking prescribed amphetamines.


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.


Well, duh. First, there are more 12-17 year-olds prescribed the
medications than those 18+. Second, a 12-17yo feeling ill is likely to be
taken to the ER by parents. An 18+ having an adverse reaction, especially
if he is using diverted drugs, or abusing his own, is more likely to wait
for the effects to subside.


If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.


No, it's not the fault of doctors when prescription drugs are abused.



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.


Yes, people who abuse drugs often abuse more than one drug.





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.


True, but for every new abuser there are likely to be many more who are
enabled to lead productive lives with the help of the medication. It's a
good trade-off.


In your opinion. The fact is they are given to very young kids. Which is
insane.
I was called a liar by your buddy, Mark Probert and others--when I posted
that
years ago. Now it is well proven
I was correct and not a liar.


You are correct that the medications are prescribed for younger patients
than in the past. That this practice is "insane" is your opinion, and in my
opinion you are wrong.





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.


Yes, those things can happen, but they very seldom do in the younger
population.


But, but,, but--Richey. Face the facts.


The fact is that healthy young hearts tolerate amphetamine induced
tachycardia very well. Those of any age with cardiac disease, particularly
tachyarrhythmias do not fare as well. Since ADHD medications are used
primarily by young people, and hardly at all by the elderly population in
which most of the cases of cardiac diseases occur, hypertension, cardiac
arrests, and stroke resulting from ADHD medications are rare events. In all
my years as an ER nurse, I've never seen one. (Actually I've only seen four
or five ER admissions related to ADHD meds, and with one exception all that
I can recall were simple panic attacks which resolved and the patients were
discharged home from the ER. The exception was a young lady (I can't recall
her age) who took her son's Ritalin because she thought it would help her
lose weight. Her tachycardia persisted, and she was admitted to the ICU. The
next day, the problem resolved and she was discharged. The cardiolgist told
us later that she had previously undiagnosed Wolf-Parkinson-White disease,
one of the above mentioned tachyarrhythmic disorders. Even with that, she
did not suffer hypertension, cardiac arrest, or 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. 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.


Amphetamines were a serious drug abuse problem in the '60's and '70's
when they were massively prescribed as "diet pills" and were available
under the counter at every truck stop. They are becoming a big problem
again now, but in the form of illegal methamphetamines ("ice" here in
Hawaii), not Ritalin or Adderal.


Is that right? Got any proof?


http://www.narconon.org/druginfo/met...mine_hist.html
http://www.nida.nih.gov/Infofacts/methamphetamine.html
http://www.addictionsearch.com/featuredtopic.php
http://www.dea.gov/pubs/cngrtest/ct080204.html

Want more? There's lots.



The prescription-drug component of the amphetamine abuse problem
is a negligible fraction. And don't give me any bull**** about the
ice-heads "starting out" on prescription drugs unless you have some solid
evidence that the rate of occurance of that is significant.


I love it *solid*. I that anything like--*Substantial* *real*
*convincing* *hard* *clear-cut* *reasonable*
*significant* *credibile* *compelling* *copious* *direct* *reliable*
*adequate* Used by your gang group.


These are all perfectly useful words. Your contempt for them implies you
prefer that evidence be insubstantial, imaginary, unconvincing, soft, vague,
unreasonable, insignificant, incredible, noncompelling, scant, indirect,
unreliable, and inadequate.







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
Ritalin© and Concerta© and amphetamine-dextroamphetamine marketed as
Adderal©. 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%


All in all, this article is interesting, but is not so scary as it is
intended to be.


Oh, dear--now you are in big trouble. Some on a.s.a.d. think DAWN is very
reliable.


I never said it wasn't. I'm just saying that this article is not something
to get your panties in a twist about.
--


--Rich

Recommended websites:

http://www.ratbags.com/rsoles
http://www.acahf.org.au
http://www.quackwatch.org/
http://www.skeptic.com/
http://www.csicop.org/