Discordant reporting of nonmedical amphetamine use among Adderall-using high school seniors in the US

Amphetamine is the most prevalent prescription stimulant in the United States, both medically and nonmedically. Reliable data on nonmedical use is needed to continue to inform prevention. To determine whether adolescents accurately self-report nonmedical amphetamine use, we compared self-reports of nonmedical amphetamine use and nonmedical Adderall use in a national sample.

We examined self-reported nonmedical Adderall and amphetamine use in a nationally representative sample of 24,740 high school seniors in the Monitoring the Future study (2010-2015). We examined prevalence and correlates of discordant responses among past-year Adderall users, defined as reporting past-year nonmedical Adderall use, but not reporting past-year nonmedical amphetamine use.

While 6.9% reported nonmedical Adderall use and 7.9% reported nonmedical amphetamine use, over a quarter (28.7%) of Adderall users reported no amphetamine use. Those at highest risk for Adderall use tended to be at lower odds of providing a discordant response. Older students (aged ≥18), black students, and those with parents of lower educational attainment were more likely to report no amphetamine use, despite reporting Adderall use. Lifetime use of various drugs was associated with decreased odds of providing a discordant response; however, only nonmedical opioid use was associated with significant decreased odds in multivariable models. Disapproval towards amphetamine use increased odds of providing a discordant response, while higher exposure to users decreased odds of providing a discordant response.

Prevalence of nonmedical amphetamine use may be underreported on some surveys, particularly among specific subpopulations. Future surveys must ensure accurate and consistent responses.