The practices of diversion and misuse of pharmaceutical stimulants give serious cause for concern due to their potential to increase the risk of drug toxicity, dependence, and serious adverse health consequences. These practices may be particularly harmful among illicit psychostimulant users. This will be the first to study the nature of diversion and misuse of pharmaceutical stimulants among illicit psychostimulant users and the first to examine the associated correlates and consequences.
The main pharmacotherapy for ADHD is stimulant medication. The primary concerns about the prescription of these medications are the risks of diversion and inappropriate use. Previous research has demonstrated diversion and/or misuse of prescribed stimulant medication among adolescents and university students. No major studies of the diversion or misuse of ADHD medication have been conducted among illicit psychostimulant users, among whom high rates of misuse and diversion would be expected. This projecet aimed to examine the nature of diversion and/or misuse of ADHD medications, as well as the patterns and correlates of such use.
- Examine the nature of the diversion of prescribed pharmaceutical stimulants among illicit psychostimulant users;
- Investigate the misuse of prescribed and illicitly obtained pharmaceutical stimulants among illicit psychostimulant users; and
- Determine the correlates of the diversion and misuse of pharmaceutical stimulants.
This study employed a cross-sectional survey design. 300 illicit methamphetamine or cocaine users were administered a structured interview examining prescribed and illicit use of medications used to treat the symptoms of ADHD (i.e. Ritalin, Dexamphetamine).
The most commonly reported use of stimulant medications among the sample was the use of diverted stimulant medication (31%), typically dexamphetamine and methylphenidate.Of those who had used diverted medications, 20% had injected them and 60% had used on more than 5 occasions. The majority of those who used diverted medication did so for recreational purposes, although 18% reported using to self-medicate symptoms of ADHD.
A minority of the sample reported misusing (4%) or diverting (3%) their medication, reflecting the small proportion that had ever been prescribed stimulant medication (7%).
Misuse was in the form of taking more tablets than prescribed (67%), taking tablets more frequently than prescribed (42%), and deliberately missing doses (50%). There were no reports of intranasal or injecting use of tablets. Of those who misused their medication, 40% had misused more than 20 times. Almost one third (32%) of those prescribed stimulant medication had given their medication away to others, and 26% had sold their medication, typically friends, relatives and acquaintances.
A substantial proportion of illicit psychostimulant users, particularly younger users, have access to, and use, diverted stimulant medication. Most use for recreational purposes, but some may be using to self-medicate undiagnosed and untreated ADHD. Among those prescribed stimulant medications, there are significant levels of medication misuse and diversion.
Conclusions: A substantial proportion of illicit psychostimulant users, particularly younger users, have access to, and use, diverted stimulant medication. Most use for recreational purposes, but some may be using to self-medicate undiagnosed and untreated ADHD. Among those prescribed stimulant medications, there are significant levels of medication misuse and diversion.
Peer reviewed papers are in preparation.
Conference Presentations:
Kaye, S., Darke, S., & Torok, M. The Diversion and Misuse of Stimulant Medication for ADHD among Illicit Psychostimulant Users. The Australasian Professional Society on Alcohol and Other Drugs National Conference, Hobart, November 2011.
Kaye, S. Diversion and misuse of pharmaceutical stimulants within illicit drug markets, NDARC Annual Research Symposium, Sydney, August 2012.
This study will provide the first data on the nature of diversion and misuse of pharmaceutical stimulants among illicit psychostimulant users and will be the first to provide information as to the potential consequences and risks of such behaviour.