Physician practices to prevent ADHD stimulant diversion and misuse

Area of Science:

• Medical Research
• Adolescent Health
• Pharmacology

Background:

• Adolescent misuse and diversion of prescription stimulants are significant concerns.
• Physicians play a crucial role in preventing improper use and distribution of these medications.
• This study examines physician practices and perceptions regarding the prevention of stimulant misuse in adolescent ADHD patients.

Purpose of the Study:

• To evaluate the extent to which physicians implement prevention practices for adolescent ADHD patients.
• To assess physicians' perceptions of the effectiveness of various prevention strategies.
• To identify differences in practice based on physician subspecialty and prescribing volume.

Main Methods:

• A questionnaire was distributed to US-based child and adolescent psychiatrists, child neurologists, and developmental-behavioral pediatricians.
• Descriptive statistics and regression analyses were performed on the data from 828 respondents.
• Response rate was 18.4%.

Main Results:

• A majority of physicians rarely or never use medication contracts (85.2%) or print materials (81.0%) for suspected misuse.
• Prescribing long-acting stimulants (79.2%) and non-stimulants (71.9%) were the most frequent practices.
• Physicians perceived prescribing non-stimulants (71.4%) as very effective, but medication contracts (53.4%) and print materials (31.5%) as not effective.
• Child and adolescent psychiatrists were more likely to use certain prevention practices.

Conclusions:

• Physicians should increase the implementation of prevention practices for adolescent ADHD patients at risk of stimulant misuse.
• The study's findings may be limited by selection and response bias, affecting generalizability.
• Further research is needed to understand physician views on stimulant risks/benefits and to establish best practices for misuse prevention.