Cocaine or Methamphetamine Use During Young Adulthood Following Stimulant Use for Attention-Deficit/Hyperactivity
Sean Esteban McCabe1,2,3,4, John E Schulenberg1,3,5, Timothy E Wilens1,6,7
1Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor.
JAMA Network Open
|July 11, 2023
Summary
Adolescent ADHD stimulant therapy did not increase later illicit stimulant use. However, prescription stimulant misuse in teens significantly elevated risks for cocaine and methamphetamine use in young adulthood.
Area of Science:
- Neuroscience and Behavioral Health
- Public Health and Epidemiology
Background:
- Prescription stimulant use for attention-deficit/hyperactivity disorder (ADHD) has risen in the US.
- Prescription stimulants are frequently misused by adolescents, with a notable increase in overdose deaths.
- The transition from prescription stimulants to illicit substances like cocaine and methamphetamine is not well understood.
Purpose of the Study:
- To investigate the longitudinal links between adolescent prescription stimulant exposure and young adult cocaine/methamphetamine use.
- To differentiate risks associated with prescribed ADHD stimulant therapy versus prescription stimulant misuse (PSM).
Main Methods:
- A national longitudinal study followed US 12th-grade students from 2005-2017.
- Participants were assessed annually for 6 years, up to ages 23-24.
- Outcomes included past-year use of cocaine and methamphetamine during young adulthood.
Main Results:
- Adolescent ADHD stimulant therapy was not significantly linked to increased young adult cocaine or methamphetamine use.
- Adolescents misusing prescription stimulants (without ADHD treatment) showed significantly higher odds of later cocaine/methamphetamine use (aOR=2.64).
- Population controls (no stimulant exposure) served as the comparison group for risk assessment.
Conclusions:
- Adolescent ADHD stimulant therapy does not appear to elevate the risk of subsequent illicit stimulant use.
- Prescription stimulant misuse during adolescence is a significant risk factor for transitioning to cocaine or methamphetamine use.
- Screening and monitoring for PSM in adolescents are crucial for preventing future substance use disorders.
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