"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe 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.
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.
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.
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. 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.
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%
All in all, this article is interesting, but is not so scary as it is
intended to be.
--
--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/