Attention Deficit Hyperactivity Disorder (ADHD) and Stimulant Medications

At the same time that teens are bombarded with anti-drug messages, many are also given prescriptions for psychoactive medications, including those that treat Attention Deficit Hyperactivity Disorder (ADHD). Experts continue to debate whether these medications are more harmful or helpful, and whether habituating young people to taking psychoactive medication increases the risk that those young people will develop addictive behaviors and become drug users later in life. Recent studies have shown that some youth have begun using ADHD medication recreationally, a dangerous and alarming trend.

Approximately 5 percent of children, ages 6 to 17, in the U.S. are afflicted by ADHD, and approximately twice as many boys suffer from ADHD as girls. This data comes from a recent survey conducted by the federal Centers for Disease Control and Prevention (CDC).

Symptoms of ADHD may include trouble focusing, short attention span, hyperactivity and impulsivity. Studies have shown that severe symptoms of ADHD, such as extreme inattention and impulsivity, put kids at higher risk for many negative outcomes, including substance abuse, unemployment, crime and automobile accidents.

Stimulants Being Prescribed

Most medications prescribed for ADHD are stimulants. Although it may sound counter-intuitive to chemically stimulate hyperactive kids, these medications are thought to enhance activity in the parts of the brain that regulate attention and self-control. Stimulant treatments for ADHD have been shown to improve attention, concentration and productivity, and suppress impulsive behavior, which purportedly improves the lives of young people who are struggling with this disorder.

The CDC estimated in 2005 that approximately 9 percent of boys and 4 percent of girls in the U.S. are taking stimulant medications to help treat their ADHD. The majority of patients take methylphenidate (sold under the brand names of Ritalin and Concerta), whereas most of the rest are prescribed an amphetamine such as Adderall.

Proponents of ADHD medications argue that appropriate medications help keep kids suffering from ADHD out of trouble, including helping them to avoid interaction with law enforcement, addiction to illicit substances, and poor academic and work-related performance.

However, some experts are still worried that ADHD medications may be doing kids more harm than good. Some ADHD stimulants are actually amphetamines, the same type of drug that teens are warned against in the form of “speed,” “crank” and even “meth.” This close association has provoked concerns about the long-term psychological and physical effects that these drugs may have on still-developing bodies and brains.

In addition, young people who take ADHD medications are now often being encouraged to continue taking the medications into adulthood. In 2008, two new stimulants received approval from the U.S. Food and Drug Administration for treating adult forms of ADHD.

Brain Function Affected

A number of studies over the past couple years indicate that prolonged use of stimulants may, in fact, alter brain functioning in a negative way. A 2005 study by the University of California, San Diego found that methamphetamine users required larger sections of their brains to regulate attention, motivation and the control of movement, and that they scored lower than non-methamphetamine users in tests of brain function.

According to a 2005 report authored by Susan McLean regarding studies conducted by MacLean Hospital and Harvard Medical School, exposure to stimulants significantly impacted brain development in children and youth:

The maturation and refinement of the brain during childhood and adolescence, including the overproduction and selective elimination of synapses, is based on genetic programming and experience. The effects of stimulant drugs during different stages of this process have unique short-term, acute effects that also influence their long-term effects. Chronic, pre-pubertal exposure alters the expected developmental trajectory of brain structure and function and results in a different topography in adulthood. The timing of exposure (childhood versus adolescence), the age of examination after drug exposure (immediately or delayed into adulthood) and sex influence the observable effects.

Increase in Drug Misuse

An unpleasant social side effect of the widespread availability of ADHD drugs is that the drugs are often misused and that many youth are experimenting with using the drugs recreationally. A 2006 study by RTI International, a nonprofit research group, estimated that more than 7 million Americans have misused stimulant drugs meant to treat ADHD, and substantial numbers of teenagers and young adults appeared to show signs of addiction.

A study recently published in the journal Pediatrics found that urgent calls to poison control centers involving teen abuse of prescription ADHD medications increased by 76 percent between 1998 and 2005. To collect this compelling data, researchers at Cincinnati Children’s Hospital Medical Center analyzed data from the American Association of Poison Control Center’s National Poison Data System for those years.

Consequences of ADHD Stimulant Abuse

The effects of ADHD stimulant abuse are serious. Physical consequences may include the following:

• Extreme fatigue
• Nutritional disorders
• Poor hygiene and self-care
• Skin disorders and secondary skin infections
• Hair loss
• Muscle pain and tenderness
• Difficulty breathing
• Headaches
• Strokes
• Seizures
• Vision loss
• Choreoathetoid (involuntary movement) disorders
• Impaired sexual performance and reproductive functioning
• Cerebrovascular changes, including evidence of cerebral hemorrhages and atrophy with associated cognitive deficits
• Gastrointestinal issues

Psychological effects may include paranoia with misinterpretation of environmental cues, psychosis with delusions and hallucinations, apprehension or acute anxiety, severe depression and eating disorders.