Whether it’s virtual learning, onsite learning or a hybrid of the two, kids are going back to new normal at school during the COVID-19 pandemic — and they are under more pressure now than ever before.
Because of this pressure, some children and teens are misusing stimulants, or a class of prescription medications used to treat attention deficit hyperactivity disorder (ADHD), narcolepsy, and rare cases of depression that have not responded to other treatments.
Katie Bui, CHOC clinical pharmacist, wants parents to know the dangers of stimulants so they can help their kids make smart decisions while performing under pressure to avoid misusing stimulants.
Any time these stimulants are taken in a way that is not intended, it is considered misuse. This includes taking someone else’s prescription, taking the medication in ways other than prescribed or for purposes other than intended. A basic understanding of stimulant misuse can help parents protect their families and friends against it.
How parents can prevent their kids from misusing stimulants
If you or your family has a prescription stimulant at home, be aware that it may be of interest to friends and other members of the family. Keep a close eye on your supply, especially if you have other teens and young adults in the house, and always keep medications out of reach of children.
Keep open lines of communication with your kids about the pressures they experience and healthy perspectives on drug misuse. If you notice any red flags like a rapidly dwindling medication supply or that they suddenly have more money than usual, talk to them about it.
If you notice some changes in your teen and suspect drug abuse, look out for these red flags:
- Excessive weight loss
- Disinterest in their hobbies
- Memory problems
- Neglect of personal appearance
- Sudden disinterest in work, school, or family responsibilities
- Change in spending habits (for example, money missing or sudden requests for money without a reasonable explanation).
If you notice or suspect signs of a drug problem in your teen, take action right away. Consult their primary care physician or school guidance counselor.
The science behind stimulants
As the name suggests, prescription stimulants increase biochemical activity in the brain that can help boost alertness, attention and energy. The most common prescription stimulants are prescriptions are amphetamine and dextroamphetamine salts or methylphenidate, commonly known as Adderall, Ritalin and Concerta.
ADHD is one of the most commonly diagnosed conditions in children and adolescents. According to the Centers for Disease Control (CDC) and National Institutes of Health (NIH), approximately 10% of children between ages 2 to 17 years are diagnosed with ADHD, and about 60% of them take medications for it.
When taken as prescribed, the stimulant medications are generally safe and effective, says Katie. Doctors prescribe these medications starting at low doses and then gradually increase them, monitoring for effectiveness and side effects. The lowest effective dose is then continued, and the child is monitored on a regular basis. When taken as prescribed, many of these children will experience a reduction in ADHD symptoms and an improvement in their academic performance, behavior, social relationships and self-esteem.
Unfortunately, stimulants can be misused, often by friends and family of the prescribed. More than 5 million young adults reported having a substance use disorder; 87% of those with substance use disorders went untreated. Almost 10% of high school seniors reported abusing ADHD medications in the past year, according to the National Institute on Drug Abuse. This number increases to as high as 35% among college students.
Pressure to perform tempts teens to turn to stimulants
Teens and young adults who misuse stimulants often do so to increase concentration, energy and confidence, says Katie. Academic pressures are the main trigger for teens and young adults to misuse stimulants, such as pulling all-nighters to study.
What they might not realize, though, is that these drugs can be habit-forming when abused and can be dangerous when taken in high doses. Stimulants can speed up heart rate and blood pressure and cause insomnia and anxiety. Although students expect stimulants to help their academic performance, studies have found that stimulants do not increase learning or thinking ability when taken by people who are not diagnosed with ADHD. In fact, students who misuse prescription stimulants actually had lower grade point averages in high school and college than those who didn’t misuse prescription stimulants, according to the NIH.
Although a late-night study session and some Adderall might seem like a good way to cram for exams, it actually doesn’t work, Katie says. In turn, it may hurt teens in the short term, and definitely won’t help them with their long-term goals, she cautions.
While some teens turn to Adderall believing it will help them focus and cram for school exams, others might turn to energy drinks. Many teens aren’t aware of exactly how much caffeine they’re consuming in each energy drink. Although experts consider 200 to 300 mg of caffeine a day to be a moderate amount for adults, teens should limit their consumption to much less, about 100 mg per day.
Meanwhile, many caffeinated drinks easily contain 80 to 160 mg of caffeine in one serving. Some popular energy drinks contain up to 240 mg per can. Teens consume caffeine in more places than they realize: hot chocolate, iced tea and many sodas all contain caffeine. Too much of it can lead to anxiety, dizziness and headaches.
Misusing stimulants to get high
While some teens misuse stimulants for academic performance, others may misuse them to get high. When stimulant medications are taken suddenly and in ways not prescribed, they can rapidly increase dopamine activity in the brain, causing a sense of euphoria, which can increase the risk of addiction. This effect on the body and brain is similar to the effect of illicit drugs, says Katie.
Prescription stimulants are normally meant to be taken by mouth in pill form, but other ways of misusing them include crushing the tablets to snort or inject them. This can cause additional problems because the inactive ingredients in the tablets can block small blood vessels, leading to severe damage to the heart, brain and other organs. There are also additional risks associated with intravenous drug abuse, such as hepatitis and HIV/AIDS.
Another form of a prescription stimulant is a prescription patch, which contains an entire day’s worth of medication that is meant to release slowly over time through the skin. Some people misuse the patch by extracting the medication and consuming it all at once or by chewing on the patch. This is an extremely unsafe non-medical use of prescription medication due to the more rapid method of exposure.
Mental Health Resources
for Orange County, CA
Download and print this card with a list of phone numbers to keep on hand in case of a mental health emergency.
If you or someone you know is in a crisis and needs to speak with someone immediately, call the National Suicide Prevention Lifeline: 988. This is a crisis helpline that can help with a variety of issues.
They can also find support through the Substance Abuse and Mental Health Services (SAMHSA) or call 1-800-662-HELP (4357) for treatment referral. SAMHSA’s National Helpline is free and confidential, with a year-round treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
For more health and wellness resources from the pediatric experts at CHOC, sign up for the Kids Health newsletter.
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The mental health team at CHOC curated the following resources on mental health topics common to kids and teens, such as depression, anxiety, suicide prevention and more.