The Potential for Misuse and Abuse of Medications in ADHD: A Review

@article{Clemow2014ThePF,
  title={The Potential for Misuse and Abuse of Medications in ADHD: A Review},
  author={David B Clemow and Daniel J. Walker},
  journal={Postgraduate Medicine},
  year={2014},
  volume={126},
  pages={64 - 81},
  url={https://api.semanticscholar.org/CorpusID:207580823}
}
The data suggest that ADHD medication misuse and diversion are common health care problems for stimulant medications, with the prevalence believed to be approximately 5% of high school students and 5% to 35% of college students, depending on the study.
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158 Citations
Highly Influential Citations
7
Background Citations
51
Methods Citations
3
Results Citations
3

158 Citations

Misuse of Methylphenidate.

Methylphenidate-induced regional elevations in brain dopamine appear to be integral to both efficacy in attention-deficit/hyperactivity disorder and potential for abuse, raising potential concerns for drug safety and prescription drug diversion costs associated with nonmedical use.

Malingering and Stimulant Medications Abuse, Misuse and Diversion

It is concluded that no questionnaire has proved sufficiently robust against false positives against malingering and that self-report rating measures are easily simulated by patients without ADHD.

Reviewing the role of emerging therapies in the ADHD armamentarium

A robust pipeline of stimulants and nonstimulants in development are found, formulated to optimize onset and duration of effect, alter the time of administration, obviate the need to swallow whole capsules or tablets and to deter abuse.

Methylphenidate for Attention-Deficit and Hyperactivity Disorder in Adult Patients With Substance Use Disorders: Good Clinical Practice

Carefully applied guideline-based diagnostics to clarify the potential presence of ADHD as well as a responsible prescription practice in a well-defined therapeutic setting with reliable monitoring of medication intake and regular consultations are essential conditions for a safe and proficient MPH treatment of ADHD in patients with SUD.

Recent advances in pharmacological management of attention-deficit/hyperactivity disorder: moving beyond stimulants

Although many effective formulations for the treatment of ADHD are available, more than 33% of children and 50% of adults discontinue treatment during the first year, and the development of new nonstimulants may offer hope for patients who need medication alternatives.

Attention-deficit hyperactivity disorder medication use: factors involved in prescribing, safety aspects and outcomes

Factors involved in prescribing and medication use in individuals diagnosed with ADHD are reviewed, focusing on the difficulties facing patients with ADHD seeking treatment, as well as the safety and tolerability aspects of ADHD pharmacotherapies, with particular attention on the cardiovascular adverse events and the potential risk of misuse or diversion of ADHD medications.

Adverse effects of stimulant medications in children and adolescents: focus on drug abuse

Safety and efficacy considerations due to misuse of extended-release formulations of stimulant medications

Modifications to routes of administration that may alter PK properties of stimulant-based medication for treating ADHD are reviewed, which are of clinical interest because they may pose safety hazards and affect efficacy.

Illicit use of Methylphenidate: the other side of the medical prescription

Treatment with MPH requires adequate medical indication and supervision, not only for its potential cardiovascular side effects and exacerbation of psychiatric disorders, but also due to the risk of illicit use and intoxication.

A review of the efficacy of atomoxetine in the treatment of attention-deficit hyperactivity disorder in children and adult patients with common comorbidities

In the studies identified and assessed in this review, atomoxetine did not appear to exacerbate any of the comorbid conditions and could, therefore, be an important therapy choice for the treatment of ADHD in the presence ofComorbid disorders.
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184 References

Abuse liability of medications used to treat attention-deficit/hyperactivity disorder (ADHD).

The existing published evidence has been reviewed and is summarized here, with an emphasis on delineating a number of related but independent issues that are often confused.

Managing attention-deficit/hyperactivity disorder in the presence of substance use disorder.

Clinical recommendations for treating this dual diagnosis include using nonstimulant agents or extended-release stimulant formulations in conjunction with psychosocial therapies to treat both the ADHD and the SUD.

Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature.

The literature suggests that individuals both with and without ADHD misuse stimulant medications and the need to carefully monitor high-risk individuals for the use of nonprescribed stimulants and educate individuals with ADHD as to the pitfalls of the misuse and diversion of the stimulants.

Abuse of medications employed for the treatment of ADHD: results from a large-scale community survey.

The risks for abuse of prescription and illicit stimulants are elevated among individuals being treated in an ADHD clinic, and long-acting stimulant preparations that have been developed for the treatment of ADHD may have lower abuse potential than short-acting formulations.

ADHD in Adults: Current Treatment Trends with Consideration of Abuse Potential of Medications

Impairments from ADHD can be chronic and persistent and they can affect daily educational, occupational, and personal functioning so that clinicians need to consider medication duration of action when selecting a pharmacotherapy intervention for adults with ADHD.

Comparing the abuse potential of methylphenidate versus other stimulants: a review of available evidence and relevance to the ADHD patient.

Existing neuropharmacologic data suggest that methylphenidate has pharmacokinetic properties that reduce its abuse potential as compared with other stimulant drugs of abuse, such as cocaine.

From attention-deficit/hyperactivity disorder to medical stimulant use to the diversion of prescribed stimulants to non-medical stimulant use: connecting the dots.

Connections were demonstrated at the population level between ADHD, medical methylphenidate use, the diversion of prescribedmethylphenidate and the non-medical use of methylphenidates.

Safety of stimulant treatment in attention deficit hyperactivity disorder: part II

This paper is a continuation of an earlier paper that reviewed the safety profile of newer stimulant agents, especially in relation to special populations, and is a thorough review of safety concerns in stimulants.

Misuse of Prescribed Stimulant Medication for ADHD and Associated Patterns of Substance Use: Preliminary Analysis Among College Students

There is a strong relationship between misuse of prescribed stimulants for ADHD and substance use behaviors, as well as other deleterious behaviors such as diversion.

Substance-use disorders in adolescents and adults with ADHD: focus on treatment.

Improvements in adults with ADHD and brief abstinence of their SUD showed improvements in both ADHD and SUD with treatment, and findings from pharmacotherapy suggest mild improvement in ADHD without demonstrable changes in SUD unless the addiction was stabilized prior to treating the ADHD.
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