Though the ongoing opioid crisis has understandably been one of the top behavioral health priorities in the United States in recent years, the misuse of another category of prescription drugs has become a cause for concern in the healthcare community as well.
A recent study published in the American Journal of Psychiatry found that roughly 5 million people in the United States are taking prescription pills illegally to improve concentration/mental stamina. Another study found that 16 million American adults use, misuse, and/or abuse prescription amphetamines like Adderall and methylphenidate (Concerta, Ritalin). Of those 16 million adults, it is believed that 400,000 are abusing the medications.
Amphetamines are often prescribed to children and teenagers for the treatment of ADHD, but adults have increasingly been receiving prescriptions. In 2015, 55% of stimulant prescriptions were handed out to people over the age of 20.
Prescriptions for stimulants written for children and teenagers are on the rise as well, and they are being written at an earlier age. More children between the ages of 6 and 11 had prescriptions for ADHD medications in 2014 compared to the years around the turn of the millennium. During this 12-15 year time period, prescriptions for amphetamines almost doubled, with over 2% of children between 6 and 11 being prescribed in recent years.
Due to the recent growth in overall use and misuse, avenues to avert misuse of amphetamines have become an area of interest for researchers. One potential option is prescribing a combination of methylphenidate (Ritalin, Concerta) and naltrexone (Vivitrol), a drug commonly used to treat alcohol and opioid abuse.
A clinical trial at Massachusetts General Hospital that was funded by the Department of Defense found that the combination therapy could help those at risk of stimulant addiction by reducing feelings of euphoria associated with amphetamine use without affecting the clinical efficacy of the ADHD therapy. Using a Drug Rating Questionnaire that gives scores ranging from 1 to 29, participants in the study reported an initial “drug liking” score of 10 for methylphenidate. When the combination was administered, the “drug liking” score experienced a steep decline to 2.
Mark Stein, who heads the ADHD and Related Disorder Clinic at Seattle Children’s Hospital, said that the combination therapy could be a “promising approach to make the effects of methylphenidate more specific and personalized to adults with ADHD,” which he described as a population in which there are concerns of stimulant-related euphoria developing into abuse. The combination, however, would not be useful for children, since this age group more commonly reports dysphoria when taking ADHD-related amphetamines.
The next step, according to Stein, would be identifying how effective the combination therapy is in groups who are at risk of SUD.
Story by Correspondent John Boyle