After a lull in the rates of prescription stimulant abuse in youth, it looks as though the phenomenon is on the rise again, results of a new survey show. Investigators conducting the Study of Non-Oral Administration of Prescription Stimulants (SNAPS) found that almost 14% of young respondents who used a prescription stimulant had snort, smoke, or inject the drug.

“If youth start misusing stimulants, there’s a chance they’re going to misuse other things as well. They may get into marijuana and other drugs, and may start vaping and smoking cigarettes,” she said. The findings were present here at the American Psychiatric Association (APA) 2019 annual meeting.

Produce mood altering

Chemically relate to cocaine and methamphetamine, prescription stimulants; which are commonly use to treat attention deficit hyperactivity disorder (ADHD); so can produce mood altering, euphoric effects over the short term. It is estimate that about 11% of youth report having use prescription stimulants, and of these, one third have engage in non medical use of these agents; which is define as not having a prescription or taking more than prescribed.

As with other drugs, taking stimulants by snorting or injecting them means they reach the brain more quickly than oral administration. For the study, investigators interview youth in urban areas of three populous states: California (Los Angeles), Texas (Houston and Dallas), and Florida (Tampa, Orlando, and Miami). They went to places where we think youth are going to hang out at places such as malls, parks, and theatres, and we interview them there, said Cottler.

Researchers analyze surveys from 1777 respondents ages 10 to 17 years. The results show that among users, 68.9% indicated oral use, 9.7% indicate snorted/sniff misuse, and 4.1% indicate smoking misuse. About 0.5% said they were injecting stimulants, which Cottler called a very dangerous route. About 12.7% of those survey were involve in some kind of diversion for example, selling, giving away, or stealing the drugs.

Children misuse stimulants

“These youths may not be using these drugs themselves; but they know kids want these stimulants. They know that a friend or their brother or sister has them; so they can take them out of the medicine cabinet and start to divert them,” said Cottler. Children misuse stimulants for different reasons. Some might take the drug to “get a buzz,” others to stay up at night to study; also still others might just be curious about what their friends are talking about, she added.

So there would be an increase in the number of stimulant prescriptions and more people would be getting hold of them,” they said. There’s no consensus as to why ADHD rates are going up. Experts have point to environmental factors such as smoking and lead exposure, and to increase screen time among youth, as possible factors, “but nothing seems to clearly match up,” said Leikauf.

Of Leikauf’s patients with ADHD, the majority are 13 years and younger; so although he does treat some older teens and young adults. As with opioid manufacturers, producers of stimulants are making these medications more difficult to divert. “Some of the newer long-acting versions; which we tend to use a lot more these days, are a lot harder to crush,” they said. One of the newer drugs, lisdexamfetamine (Vyvanse, Shire), “doesn’t become active until it’s actually metabolized in your blood” which can reduce the risk of misuse, said Leikauf.