Regulatory agencies and others have highlighted prescription ADHD stimulant medications as emerging drugs of misuse/abuse. College students, an especially high-risk group for stimulant misuse/abuse, were recruited via an online panel to complete a survey regarding nonmedical use (NMU; use for any reason or in any way other than prescribed, including misuse/abuse) of prescription stimulants.
Among 583 college students age 18-26 years reporting prescription stimulant NMU, 249 (43%) reported an ADHD diagnosis; of which 38% exaggerated/lied about symptoms to get an ADHD prescription and 59% had taken a prescription medication to treat ADHD. Of those with an ADHD diagnosis and history of prescription stimulant therapy (n=146), 64% reported modifying their ADHD medication (45% snorted, 42% chewed then swallowed, 40% dissolved in liquid then swallowed, 28% smoked, and 27% injected). 73% reported taking more medication than prescribed namely “to enhance performance at work/school” (61%), “for energy” (51%), “to treat ADHD/ regular dose wasn’t working” (44%), “to improve mood/elevate spirit” (35%), and “to get high” (22%). Motivations for NMU via oral routes were primarily to achieve a better effect on ADHD symptoms while motivations for non-oral routes were “to achieve a faster effect on ADHD symptoms” and “faster/more intense high”.
A majority of college students with a history of ADHD and stimulant medication therapy reported modifying their prescription and engaging in NMU via non-oral routes. Targeted interventions, including development of medications that are difficult to manipulate into a form that permits non-oral use, may be useful to consider in college students with ADHD.