The Adderall Age

Latest trends show that adolescents and young adults may be especially vulnerable to prescription drug abuse, particularly opioids and stimulants.

Data from the 2009 National Survey on Drug Use and Health (NSDUH) indicate that rates of prescription drug use were highest among young adults 18 to 25, with 6.3 percent reporting nonmedical use in the past month . That said, earlier data on past-year users of any prescription psychotherapeutic drug, prevalence of dependence or abuse is higher for the 12-17 year-old age group than for young adults (15.9 vs. 12.7 percent). In this youngest age group, females exceed males in the nonmedical use of all psychotherapeutics, including pain relievers, tranquilizers, and stimulants, and are more likely to be dependent on stimulants.

Also of concern is the diversion of stimulants, particularly ADHD medications among students, who are using them to increase alertness and stay awake to study. The growing number of prescriptions written for this diagnosis has led to dramatically greater availability of stimulant medications with potential for diversion. For those who take these medications to improve properly diagnosed mental disorders, they can markedly enhance a patient's quality of life. However, prescription stimulants are increasingly being abused for nonmedical conditions or situations (e.g., to get high; as a cognitive enhancer), which poses potential health risks, including addiction, cardiovascular events, and psychosis .

Stimulants, prescribed for ADHD and narcolepsy, include drugs such as methylphenidate (e.g. Ritalin, Concerta) and amphetamine (e.g. Adderall). These prescription medications stimulate the central nervous system, with effects similar to but more potent than caffeine. When taken orally, as prescribed, these stimulants elicit a gradual and sustained increase in the neurotransmitter (brain chemical) dopamine, which produces the expected therapeutic effects seen in many patients. In people with ADHD, stimulant medications generally have a calming and "focusing" effect, particularly in children. However, because these medications affect the dopamine system in the brain (the reward pathway), they are also similar to drugs of abuse---particularly when they are taken at doses or by routes other than what is ordinarily prescribed. For example, methylphenidate is similar to cocaine, in that it binds to similar molecular targets in the brain, thereby increasing dopamine in reward circuits. When administered intravenously, both drugs cause a rapid and large increase in dopamine, which is experienced as a rush or high. For those who abuse stimulants, the range of adverse health consequences includes risk of dangerously high body temperature, seizures, and cardiovascular complications.

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