ADHD More Common in Stimulant-Abusing Students

Students who misuse prescription stimulants to improve their academic performance are more likely to have attention-deficit/hyperactivity disorder (ADHD).

A new study published in the Journal of Clinical Psychiatry conducted structured interviews with 300 participants 18 to 28 years who were enrolled as undergraduates in Boston-area colleges and universities. After screening the students for “college lifestyle” factors, such as ADHD diagnoses and drug or alcohol use, the research team identified 100 patients who met the study’s criteria for prescription stimulant misuse.

Notably, immediate-release stimulants were found to be more commonly misused than extended-release formulations.

Based on their analysis of the students’ responses, the researchers determined that the participants who were classified as stimulant misusers were more likely to have been diagnosed with ADHD or to have exhibited related symptoms than nonabusers. Stimulant misusers were also found to be more likely to have substance-use disorder, with 67% of the study’s identified stimulant misusers meeting or approaching the criteria for substance-use disorder.

“Our data suggest that college students who misuse prescription stimulant medications are more likely to exhibit clinically relevant psychiatric dysfunction,” said corresponding author Timothy Wilens, MD, in a press release.

Pointing to additional research that indicated a link between untreated ADHD and an elevated risk of substance-use disorders, Dr. Wilens acknowledged that he wasn’t surprised by his team’s findings. Nevertheless, he warned students of the risks of stimulant misuse, especially when combined with other risky behaviors.

“Someone may report on a survey that they misused stimulants on ‘a handful of occasions’ and have never been diagnosed with a substance-use disorder. But, during the intensive interview process, it may be found that they mixed prescription stimulants with alcohol and that they had problematic interactions with others that led to legal action,” Dr. Wilens said. “While that misuser may deny having a stimulant-use disorder, when systematically queried, it may be found that he or she met or approached the criteria for a full disorder.”

In a previous study, nearly two-thirds of college students had been offered stimulants for nonmedical use, with 31% of respondents using them for these purposes over a 4-year period. A separate study estimated that ADHD medications are misused by about 17% of college students.