Study finds 7 million misuse ADHD drugs to aid performance

[Guest guest]

http://www.contracostatimes.com/mld/cctimes/news/nation/13997536.htm

Study finds 7 million misuse ADHD drugs to aid performance

By Shankar Vedantam

WASHINGTON POST

WASHINGTON - More than 7 million Americans are estimated to have misused

stimulant drugs meant to treat attention-deficit hyperactivity disorder, and

substantial numbers of teenagers and young adults appear to show signs of

addiction, according to a comprehensive national analysis tracking such

abuse.

The statistics are striking because many young people are using these drugs

recreationally or to boost academic and professional performance, doctors

say.

Although the drugs may allow people to stay awake longer and finish work

faster, scientists who published a new study concluded that about 1.6

million teenagers and young adults had misused these stimulants during a

12-month period and that 75,000 showed signs of addiction.

The study published online in February in the journal Drug and Alcohol

Dependence culled data from a 2002 national survey of about 67,000

households.

The data paint a concrete and sobering picture of what many experts have

worried about for years and present ethical and medical challenges for a

country where mental performance is highly valued and where the number of

prescriptions for these drugs has doubled every five years, said Nora

Volkow, director of the National Institute on Drug Abuse.

" We live in a highly competitive society, and you want to get the top grades

and you know your colleagues are taking stimulants and you feel pressured, "

she said. " Yes, you are going to study better in the middle of the night if

you take one of these medications. The problem is a certain percentage of

people become addicted to them, and some have toxic effects. "

Volkow said it was impossible to disentangle the skyrocketing prescriptions

of drugs for attention-deficit hyperactivity disorder from the risks of

diversion and abuse.

" As a child, you have multiple friends who are being treated with stimulant

medications, " she said. " You get the sense that these are good. "

Studies have shown that the drugs are highly effective, especially among

children, and also that they reduce the risk of substance abuse among those

correctly diagnosed with the psychiatric disorder, which is characterized by

inattention and unruly behavior. Untreated ADHD has also been associated

with conduct and academic problems.

At the same time, there have been growing concerns that the drugs are

overprescribed. A Food and Drug Administration panel last month warned that

the medications carried risks of rare, but serious, cardiovascular problems,

and it recommended the agency place serious " black box " warnings on the

drugs as a way to restrain spiraling prescriptions.

Lawrence Diller, a pediatrician in Walnut Creek, who prescribes the drugs

but is worried about their overuse, said the new study showed the real

health concerns are with diversion and abuse, not with rare side effects.

" Seventy-five thousand addicts to prescription stimulants is much more

troublesome than the 100 to 200 adults who have strokes, " he said.

The study found that men and women were equally likely to be misusing the

drugs, but women seemed to be at greater risk of dependence -- characterized

by a lack of control, physical need and growing tolerance for the drug --

while men seemed to be at greater risk of abuse, in which the medication was

used in dangerous situations, said lead author Larry Kroutil, who studies

health behavior and education at RTI International, a nonprofit research

group.

To obtain their findings, Kroutil and a team of researchers culled data from

a 2002 national survey conducted by the federal government's Substance Abuse

and Mental Health Services Administration. H. Westley , director of

SAMHSA's Center for Substance Abuse Treatment, said the 2002 data were

obtained through face-to-face interviews. RTI has not yet culled data from

subsequent years regarding the misuse of ADHD drugs.

Since then, prescription rates and the popularity of various drugs have

changed, and Kroutil said continuing research is needed to track the

phenomenon. noted that data from 2003 suggested the problem of

stimulant misuse was greater among adults 18 to 25 years old than among

teenagers.

The RTI study was paid for by Eli Lilly and Co., which makes the

nonstimulant ADHD drug Strattera. Although nonstimulant treatments such as

Strattera were an option for ADHD patients, they were often not as potent as

stimulant drugs, Volkow said.

Both Volkow and Kollins, who heads Duke University's ADHD program,

said the full range of ADHD drugs is a valuable tool. But Kollins said the

study brought home what he has seen anecdotally: A colleague who visited his

college-age son's fraternity was mobbed by requests for Adderall

prescriptions by young men seeking to boost academic performance.

" If I took Ritalin, I would probably stay up longer and write my grants

faster, " Kollins said. But besides the fact that he did not think this is

right, Kollins said the rare side effects highlighted by the FDA panel meant

people using the drugs for nonmedical purposes were placing themselves at

risk for those adverse events.

Volkow was more blunt: " You are playing roulette, " she said. " If you get

addicted, you will not only not get into Harvard, you will not finish high

school. "

[Guest guest]

" A Food and Drug Administration panel last month warned that

the medications carried risks of rare, but serious, cardiovascular problems,

and it recommended the agency place serious " black box " warnings on the

drugs as a way to restrain spiraling prescriptions. "

Gee, is that what the black box warning is for? I thought it was a way of

highlighting a potentially life-threatening side effect. I guess the black box

warning about suicidality for SSRI's was to slow down the rush to prescribe

antidepressants, too, huh? Wrong. And aren't there " Black Box " suicidality

warnings on the horizon for AHDH meds, too?

That's one of the problems with the media. Even when facts are coming out,

they allow the same " experts " who are being proven wrong to defend their

inaccuracies and/or incompentencies rather than talking to someone who has been

screaming the truth from the fringes. This " reporter " should have looked up the

name of a " kook " who wrote a scathing email about a previous pro-Big Pharma

fluff piece. Like me...I would have said " We told you so " and quoted other

supporting evidence and " So now what should we do about it? " and offered

solutions to the problem which would have included a huge public education

program. And I would have pointed out the suicidality, homicidality, psychosis

issues, etc, etc. Instead we get someone who is watering down the impact of a

" Black Box Warning. "

Terry

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