Attention-Deficit Hyperactivity Disorder Stimulant Therapy and Prescription Drug Misuse During Transition to Young Adulthood
Abstract
Objective:
Limited prospective data exist about the impact of stimulant therapy for attention-deficit hyperactivity disorder (ADHD) during adolescence on the risk for later prescription drug misuse (PDM; i.e., of benzodiazepines, opioids, and stimulants).
Methods:
National longitudinal multicohort panels (baseline cohort years 2005–2017) of U.S. 12th grade students (N=11,066; ages 17 and 18 years) from the Monitoring the Future study were surveyed via self-administered questionnaires and followed up biennially during young adulthood (ages 19–24). A multivariable analysis was used to assess whether adolescents’ lifetime history of stimulant therapy for ADHD was associated with subsequent PDM.
Results:
Overall, 9.9% of adolescents reported lifetime stimulant therapy for ADHD at ages 17 and 18. No significant differences were found in the adjusted odds of later incidence or prevalence of past-year PDM during young adulthood between adolescents with lifetime stimulant therapy and adolescents with no stimulant therapy. Over the 5-year follow-up, past-year PDM during young adulthood was most prevalent among adolescents who reported both stimulant therapy and prescription stimulant misuse (53.1%) and those who reported prescription stimulant misuse only (51.5%). Compared with adolescents in a control group without lifetime stimulant therapy or misuse, adolescents reporting prescription stimulant misuse had significantly higher adjusted odds of later incidence and prevalence of PDM during young adulthood.
Conclusions:
Adolescents’ stimulant therapy for ADHD was not significantly associated with increased risk for later PDM during young adulthood. In contrast, adolescents’ misuse of prescription stimulants strongly predicted later PDM. Monitoring adolescents for prescription stimulant misuse may help identify and mitigate the risk for future PDM.
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History
Received: 19 August 2023
Revision received: 10 November 2023
Accepted: 7 December 2023
Published online: 7 February 2024
Published in print: July 01, 2024
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Competing Interests
Dr. Wilens reports consultant work for 3D Therapeutics; receiving book royalties from Cambridge University Press, Elsevier, and Guilford Press; having a licensing agreement with 3D Therapeutics and Ironshore; and serving as a clinical consultant to Bay Cove Human Services, Gavin House, Massachusetts General Hospital, Major and Minor League Baseball, and the National Football League. The other authors report no financial relationships with commercial interests.
Funding Information
This study was supported by a research award from the U.S. Food and Drug Administration (FDA; 75F40121C00148) and research awards from the National Institute on Drug Abuse (NIDA) of the NIH (R01DA001411, R01DA016575, R01DA031160, R01DA036541, UH3DA050252, and R01DA043691).The FDA, NIDA, and NIH had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation or approval of the manuscript; or decision to submit the manuscript for publication. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the FDA, NIDA, NIH, or the U.S. government. This study contains the results of secondary analysis of the U.S. Monitoring the Future (MTF) surveys. The authors followed university and MTF protocols regarding access to and analysis of the data for this study. Data are not available without written consent from MTF, and interested researchers can apply for MTF panel data access through the U.S. National Addiction & HIV Data Archive Program at the University of Michigan. More information may be found at https://www.icpsr.umich.edu/web/NAHDAP/studies/37072.
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