Nonmedical
Use of
Prescription
Medications
®
• For the purposes of this presentation the
term Adderall® will refer to stimulant ADHD
(Attention Deficit/hyperactivity Disorder)
drugs such as Dextroamphetamine
(Dexedrine® and Adderall®) and
Methylphenidate (Ritalin®, Metadate®,
Methylin® & Concerta®).
• Adderall® (1996) is amphetamine based.
Ritalin® (1944) is methylphenidate
hydrochloride based. Both affect the CNS in
similar ways and both are classified as
stimulants.
http://www.iflr.msu.edu/BookStudentPapers_files/Geist_Focusing-on-Adderall.pdf
http://www.cesar.umd.edu/cesar/drugs/ritalin.asp
http://www.mayoclinic.com/health/adhd/DS00275/DSECTION=treatments-and-drugs
®
•Adderall XR (time released) is the most
commonly prescribed brand-name
prescription stimulant in the United States . It
is the most frequent abused stimulant drug on
college campuses.
•Adderall is often taken illegally as a study
agent. It has been said to increase a person's
productivity. This works for people with ADD
or ADHD. However, use of the drug without
these disorders is not recommended.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1794223
• Medical Aspects
• Legal Implications
• Surveys, Studies and Reports
http://www.healthsquare.com/newrx/add1008_2.htm Ritalin and other drugs: http://www.wcdtf.org/education/drugs/stim.htm
Stimulant Street Names:
• Addy, skippy, the smart drug, vitamin r,
bennies, black beauties, roses, hearts,
speed, or uppers.
Indented use/prescribed for:
•Short-term treatment of obesity
•Narcolepsy (sleep disorder)
•Attention-deficit hyperactivity disorder (ADHD)
According to Mayo Clinic, Adderall® is
successful in preventing hyperactivity and
increasing concentration. It also helps those
with ADHD by decreasing restlessness and
stabilizing emotions in those who have
emotional instability.
http://www.drugfree.org/Intervention/drug_guide/Prescription_Stimulants
http://www.rxlist.com/adderall-drug.htm
How is works:
•Adderall is a central nervous system stimulant
that increases the amount of dopamine and
norepinephrine in the brain.
•Dopamine affects brain processes that control
movement, emotional response, and ability to
experience pleasure and pain.
•The drug is similar chemically to speed and
cocaine. It keeps people awake, and it can
make a person more productive, but it also can
cause the jitters and make them overanxious.
Occasional Use of Adderall | eHow.com http://www.ehow.com/about_5463307_occasional-use-adderall.html#ixzz0vVXGlvz4
http://teens.drugabuse.gov/peerx/the-facts/stimulants#faq http://www.utexas.edu/research/asrec/dopamine.html
Common Side Effects -Short-term/low dosage:
•
•
•
•
•
•
•
•
•
•
•
Appetite suppression, weight loss
Wakefulness, Heightened alertness
Euphoria
Impairment of voluntary movement
Headache
Irregular or rapid heartbeat
Nausea and vomiting, stomach pain
Skin rash
Difficulty falling asleep or staying asleep
Some people may experience drowsiness
Nervousness, restlessness
http://www.cesar.umd.edu/cesar/drugs/ritalin.asp http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000166
Common Side Effects- High Dosage:
•
•
•
•
•
•
•
•
•
•
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Exhilaration and excitation
Agitation and Muscle twitching
Dilation of pupils
Confusion, Hallucinations and paranoia
Flushing
Increased blood pressure and pulse rate
Dry mouth and Vomiting
Fever and sweating
Seizures
Anxiety and restlessness
Excessive repetition of movements and
meaningless tasks
• Formication- the sensation of bugs or worms
crawling under the skin
Long-term Side Effects:
• Can be addictive in that individuals begin to
use them compulsively.
• Taking high doses of some stimulants
repeatedly over a short time can lead to
feelings of hostility or paranoia.
• For some people, taking high doses of certain
stimulants, or repeatedly abusing them, can
cause an irregular heartbeat, dangerously
high body temperatures, and the potential for
heart failure or seizures.
http://teens.drugabuse.gov/peerx/the-facts/stimulants#faq
Symptoms of Overdose:
• Neurological effects:
– Irritability, agitation, euphoria, dizziness,
restlessness, hallucinations, lethargy, seizures,
tremors (uncontrollable shaking), delusions.
• Cardiovascular manifestations:
– Chest pain, tachycardia (rapid heartbeat),
hypertension (high blood pressure),
• Upset stomach, vomiting, diarrhea, fever
“Abuse and toxicity of methyphenidate.” see references
Withdrawal Symptoms:
• People show varying degrees of withdrawal
symptoms after chronic stimulant abuse.
• Those who do have symptoms report an
inability to experience pleasure (anhedonia)
and sometimes suicidal thinking; anxiety and
irritability; fatigue, lack of energy, and
changes in sleep patterns, depression and
intense drug cravings.
http://teens.drugabuse.gov/peerx/the-facts/stimulants#faq
Abuse Potential:
• When used intranasally:
– The effects are usually similar to intranasal
use of amphetamines and crack cocaine.
– A rapid release of synaptic dopamine
occurs, producing subjective effects of an
instant “high” and intensely gratifying
euphoria… quite similar to cocaine.
http://www.psychiatrist.com/pcc/pccpdf/v02n05/v02n0502.pdf
Mixing Medications:
• It is risky and potentially fatal to take
medications simultaneously without a
doctors authorization .
• Stimulants should not be mixed with
antidepressants (because they may
enhance the effects of a stimulant) or overthe-counter cold medicines that contain
decongestants. This mixture can lead to
dangerously high blood pressure or
irregular heart rhythms.
http://teens.drugabuse.gov/peerx/the-facts/stimulants#faq
Mixing Adderall and Alcohol:
• When combining alcohol with Adderall, people find
that the depressive effects of alcohol are lessened.
• It is important to note that using stimulants like
Adderall to prolong drinking can result in a person
consuming unhealthy, and potentially dangerous,
amounts of alcohol.
• Using Adderall to fight off the depressant effects
of alcohol does not eliminate those effects, only
masks them. Your blood alcohol will still rise at
the same rate and to the same levels whether
you're "pre-medicated" or not, and very
importantly, any and all toxic effects of the
alcohol will still occur at the same rate.
http://orient.bowdoin.edu/orient/article.php?date=2005-10-14&section=3&id=2
http://www.goaskalice.columbia.edu/3440.html
“Abuse and toxicity of Methyphenidate.”
• Intravenous administration causes a
euphoric sensation similar to that of as
intravenous cocaine.
• Binding sites in the human brain are
almost identical for ADHD medication and
cocaine- both drugs bind to dopamine
transporter.
http://www.psychiatrist.com/pcc/pccpdf/v02n05/v02n0502.pdf
Adderall® and most ADHD
medications are Schedule II
controlled substance …
(high potential for abuse &
addiction).
•Using medicine without a
prescription is a felony.
•Selling medicine is a higher
degree felony.
Florida Statute 775.082
Florida Statue: 893.03
DEA drug scheduling
DEA Definitions
With today’s economy getting a job
or acceptance into college is more
competitive than previous years.
Do you really want to limit
your choices?
Being convicted of a
felony may limit your
job opportunities, career
choices, college options
and even where you live.
• Many government (state & federal)
positions limit job opportunities for felons.
• Jobs that require security clearances
may not employee felons.
• Some options may be gone forever…
doctor, lawyer, police officers, firemen,
military, teachers and coaches…
•Some apartment complexes will not
accept people convicted of a felony or with
a DUI on their record.
•Many volunteer positions such as
scouting, Little League and other
community organizations… will not accept
felons.
•The potential for addiction may lead to
increase in drug use…which may lead to
burglary, violence or other crimes in pursuit
of drugs.
Being convicted of a felony may limit your
job opportunities, career choices, college
options and even where you live. (con,’t.)
•In many States if you are driving while impaired
you could be charged with a DUI even if it is your
prescription.
•Some apartment complexes will not accept
people convicted of a felony or with a DUI on
their record.
•Many volunteer positions such as scouting,
Little League and other community
organizations… will not accept felons.
National Survey on Drug Use and
Health, April 2007
Nonmedical Use of Adderall®
among Full-Time College Students
Students who use Adderall for nonmedical
use are more likely to abuse other drugs.
http://www.oas.samhsa.gov/2k9/adderall/adderall.htm
Of concern, 89.5 % of the college students who used
Adderall® non-medically also reported past-month binge
drinking, & more than half were heavy alcohol users.
Full-time college students aged 18 to 22 were twice as
likely as their counterparts who were not full-time college
students to have used Adderall® non-medically in the
past year (6.4 vs. 3.0 %)
Full-time college students who used Adderall® nonmedically in the past year were more than twice as likely
to use Marijuana (79.9 vs. 27.2%) & almost FIVE times
more likely to use OxyContin® non-medically (44.9 vs. 8.6 %).
Rates of Emergency Department visits, by drug,
type of use and age- ADHD Medicine
2008 DATA
College - Aged
“Illicit use of Prescription ADHD
Medications on a college Campus:
A Multimethodological Approach”,
Journal of American College Health, 2008.
• First time users have little information
about stimulants before trying them
and they did not seek out or try to
discover information before using.
Illicit use of prescriptions…see references
Study Results:
• None of the 175 people interviewed sought
out information from health professionals,
medical or pharmaceutical reference
guides.)
• Students use was not to increase
productivity but to increase intelligent and
heightened cognitive aptitude.
Study Results:
• 36%- “felt smarter”- able to memorize and
retain information
• 12%- “make academic work more interesting”
• 7% Nonacademic motives- “taking them for
fun”- made them more social and talkative
during their marathon party sessions.
• Illicit use of ADHD prescription medications
was significantly more common in men, white
students, upperclassmen and Greek
members (vs. non-Greeks).
Study Results:
• Most viewed its use as not only physically
and psychologically harmless, but also
morally acceptable, because it was used for
academic purposes and not for social
entertainment.
• Many were surprised it was a crime to use
medication without a prescription.
Students Comments:
“It was just normal, you know, common.”
“Everyone is talking about it, so it was no big
deal.”
“I can grasp everything so much easier…I feel
like a genius on it.”
“I don’t use it all the time though sometimes
you don’t have a choice.
“Cheap coke.”
A Student Cautions Others:
“One college senior recalls using Adderall frequently during her
freshman and sophomore years. ‘I started to notice my own
addictive behaviors,’ she says, adding that she began using the
drug more and more. ‘The more you use it, the more you want
to use more of it.’
She knew she was becoming addicted and that she wouldn't be
able to afford her habit. So she decided to stop using Adderall.
‘It takes away your own coping skills and your own ability to
evolve your own study skills and work ethic. So it's kind of an
easy way out.’ And she says it made her feel ‘like a lesser
person,’ relying on the drug to do well. During her last two
years of college, she says, she's stayed away from Adderall —
and gotten good grades.”
http://www.npr.org/templates/story/story.php?storyId=100254163
While students feel smarter
and more intelligent, the use of
stimulants doesn't make them
"smarter" or "better", it just
makes their body's organs
worker harder and can actually
lead to the inability to
concentrate or think clearly for
any length of time.
The CHOICES
You Make
Today
Will
Affect Your
FUTURE
Forever.
Website links are on each page.
DeSantis, Webb, Noar, “Illicit use of Prescription
ADHD Medications on a college Campus: a
Multimethodological Approach”, journal of
American College Health, 2008.
Klein-Schwartz, Wendy, PharmD, MPH; “Abuse
and toxicity of methyphenidate.” Current Opinion
in Pediatrics, 2002.
Methyphenidate Abuse and Psychiatric Side
Effects. http://www.psychiatrist.com/pcc/pccpdf/v02n05/v02n0502.pdf