To assess the prevalence, patterns, acquisition, administration routes, and health consequences of ADHD stimulant medication misuse among US adults.
Approach:
Study Selection: Researchers searched PubMed and PsycINFO for US-based studies published from 2004 through September 2024, including 64 studies across 71 publications.
Risk of Bias Assessment: Risk of bias in cross-sectional studies was assessed using the Joanna Briggs Institute Checklist, and in longitudinal studies using the Quality in Prognosis Studies tool.
Key Findings:
Past-year misuse of Adderall among adults aged 19 to 30 years declined from 7.8% in 2022 to 3.7% in 2023.
Past-year misuse of Ritalin was 1.2% in 2023, with no significant change over the past decade.
1.4% of Americans aged 12 years and older misused ADHD stimulant medications in 2023.
High-frequency misuse was associated with obtaining stimulants from physicians or dealers rather than friends or relatives.
Intentional exposures to stimulants were linked to higher critical care and psychiatric admission rates.
Interpretation:
ADHD stimulant medication misuse among adults is declining.
Limitations:
Many university studies used convenience samples and had low response rates, which may limit the generalizability of the findings.
The literature relied on self-reported data without toxicologic confirmation, which may affect the accuracy of misuse estimates.
Longitudinal studies did not assess potential long-term neurologic or cardiovascular health effects of stimulant misuse.
Conclusion:
Research gaps remain regarding long-term health outcomes of stimulant misuse.
