A new study, conducted in part at Texas State University, shows that nonmedical use of ADHD drugs among adolescents has declined in the last 20 years despite concerns about increased stimulant prescribing.
While medical use of prescription stimulants for ADHD among adolescents increased slightly between 2005 and 2023, nonmedical use declined.
Ty Schepis, professor in the Department of Psychology at Texas State, co-authored the study along with Sean Esteban McCabe, Vita McCabe and John Jardine, all of the University of Michigan; Emily Pasman of the University of Illinois Chicago; and Timothy Wilens of Massachusetts General Hospital.
"We found that medical use of stimulant medication in the past 30 days increased slightly from 2005 to 2023 in adolescents, with a peak in 2022 at 3.87%,” Schepis said. “In contrast, nonmedical use declined over time. Nonmedical use in the past 30 days was lowest in 2023, at 1.75%. Notably, at the beginning of the study period in 2005, nonmedical use in the past 30 days was more common than medical use, but this has reversed in the past two decades.”
Recently, prescription stimulant dispensing has increased in the United States, especially among adults. While nonmedical prescription stimulant use has decreased among teens, no national studies have examined medical and nonmedical use patterns among U.S. adolescents. One concern is that nonmedical use could have increased along with medical use.
To answer that question, the researchers analyzed data from 2005 to 2023 from 19 cohorts of 8th, 10th and 12th grade students in the Monitoring the Future Study, an annual survey at the University of Michigan that tracks student substance use and other related trends.
The current study, supported by the National Institute on Drug Abuse and the U.S. Food and Drug Administration, found that lifetime use of nonmedical stimulants in 2005 was at 10% and dropped to 6% in 2023. Lifetime medical use was roughly 8% in both 2005 and 2023.
“Overall, this is good news for treatment of ADHD,” Schepis said. “Stimulant medication is a key part of the gold standard treatment regimen for ADHD, but if nonmedical use was increasing in tandem with medical use, it would have suggested potential increased risks inherent in prescribing stimulant medication. While ongoing monitoring and prevention of nonmedical use are needed, this study indicates that increasing prescribing of stimulant medication for ADHD is not necessarily resulting in increased nonmedical use.”
The decline in nonmedical use of prescription stimulants among adolescents follows similar declines in other types of nonmedical prescription drugs use, such as opioids and benzodiazepines.
