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Methylphenidate use and misuse among medical residents in Israel: a cross-sectional study
Eden Zahavi1,2, Liat Lev-Shalem1, Ilan Yehoshua1,2
1Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel.
Background:
Methylphenidate (MPH) and other stimulants may be misused, mainly as cognitive enhancers and recreational drugs. Data regarding misuse among medical residents are scarce. This study aimed to evaluate the prevalence of and main reasons for methylphenidate (MPH) use and misuse among Israeli medical residents.
Methods:
In this cross-sectional study, we sent an online questionnaire to medical residents who had completed their first residency exam and specialists with up to 2 years of experience. We asked about the use of MPH before and during residency and attitudes toward the use of MPH as a cognitive enhancer. We also added the Adult ADHD Self-Report Scale (ASRS) questionnaire, a validated tool used to screen for the presence of attention deficit hyperactivity disorder (ADHD). Users and misusers were classified based on self-report of use and formal ADHD diagnosis. Logistic regression analysis was used to evaluate factors associated with MPH misuse.
Results:
From March 2021 to August 2021, 370 physicians responded to our questionnaire (response rate 26.4%). Twenty-eight met the exclusion criteria and were not included. The respondents' average age was 36.5 years. Women comprised 63.5% of the respondents. Of the participants, 16.4% were classified as users and 35.1% as misusers. The prevalence of misusers was 45.6% among surgery and OB/GYN physicians, 39.4% among pediatricians and internists, and 24% among family physicians (P < 0.001). Misusers had a more liberal approach than others to MPH use as a cognitive enhancer. Factors associated with misuse of MPH included not being a native-born Israeli (OR-1.99, 95% CI 1.08, 3.67) and type of residency (OR-2.33, 95% CI 1.22, 4.44 and OR-4.08, 95% CI 2.06, 8.07 for pediatrics and internal medicine and surgery, respectively).
Conclusion:
Very high levels of MPH misuse during residency may be related to stress, long working hours, night shifts, and the academic burden of the residency period. We believe that our findings should be considered by healthcare policymakers as they make decisions regarding the conditions of medical residencies. The use of MPH as a cognitive enhancer should be further studied and discussed.
Insights
Medical residents misuse methylphenidate (MPH) at high rates, often as a cognitive enhancer. Factors like residency type and origin are linked to this misuse, highlighting the need for policy review.
Area of Science:
- Medical Education
- Pharmacology
- Public Health
Background:
- Stimulant misuse, including methylphenidate (MPH), is a concern for cognitive enhancement and recreational use.
- Data on MPH misuse among medical residents is limited.
- This study investigated MPH use and misuse prevalence and reasons among Israeli medical residents.
Purpose of the Study:
- To determine the prevalence of methylphenidate (MPH) use and misuse among Israeli medical residents.
- To identify the primary reasons for MPH use and misuse in this population.
- To explore attitudes towards MPH as a cognitive enhancer and associated risk factors.
Main Methods:
- A cross-sectional online survey was distributed to medical residents and early-career specialists.
- The survey assessed MPH use history, attitudes towards cognitive enhancement, and included the Adult ADHD Self-Report Scale (ASRS).
- Logistic regression analysis identified factors associated with MPH misuse.
Main Results:
- 16.4% of respondents were MPH users and 35.1% were misusers.
- MPH misuse was highest in surgery/OB-GYN (45.6%) and internal medicine/pediatrics (39.4%) residents.
- Not being a native-born Israeli and specific residency types were significantly associated with MPH misuse.
Conclusions:
- High rates of MPH misuse during residency may stem from stress and demanding work conditions.
- Findings suggest a need for healthcare policymakers to address residency conditions.
- Further research and discussion on MPH use as a cognitive enhancer are warranted.
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