By Sandy Merino and Jennifer Yen, clinical pharmacists at CHOC
With final exams right around the corner, teens will be tempted to turn to stimulants as they hope to cram in some last-minute late-night studying. Kids seem to be under more pressure now than ever before. Get to know the dangers of stimulant abuse to help your kids make smart decisions and stay healthy while performing under pressure.
These days, stimulants are only prescribed to treat a few health conditions, including attention deficit hyperactivity disorder (ADHD), narcolepsy, and rare cases of depression that have not responded to other treatments. Any time these drugs are taken in a way that is not intended, it is considered abuse.. This includes taking someone else’s prescription, taking the medication in ways other than prescribed, and taking the stimulant to get high. A basic understanding of stimulant abuse can help you as a parent protect your family and friends against it.
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 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 ten percent of children between ages 4 and 17 years are diagnosed with ADHD, and about 60 percent of them take medication. When they are taken as prescribed they are generally safe and effective. 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 their academic performance, behavior, social relationships, and self-esteem.
Unfortunately, stimulants can be abused, and often by friends and family. Did you know that almost ten percent of high school seniors admit to abusing ADHD medications in the past year, according to the National Institute on Drug Abuse? This number is as high as 35 percent among college students.
Pressure to perform tempts teens to turn to stimulants
Teens and young adults who abuse stimulants often do so for a better ability to concentrate, increased energy and more confidence. Academic pressures are the main trigger for teens and young adults to abuse 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. Students who abuse prescription stimulants actually had lower GPAs in high school and college than those who didn’t abuse 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, may hurt them in the short-term, and definitely won’t help them with their long-term goals.
While some teens turn to caffeine pills or Adderall medication believing it will help them focus and cram for school exams, others turn to energy drinks. Many teens aren’t aware of exactly how much caffeine they’re consuming in each energy drink. Although experts consider 200-300 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 80-160 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 non-cola soda all contain caffeine. Too much of it can lead to anxiety, dizziness and headaches.
Abusing stimulants to get high
While some teens abuse stimulants for academic performance, others may use 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. Prescription stimulants are normally meant to be taken by mouth in a pill form, but other ways of abusing them include crushing the tablets to snort or inject them. This can cause additional problems because inactive ingredients in the tablets can block small blood vessels, leading to severe damage to the heart, brain and other organs, not to mention the risks associated with intravenous drug abuse, such as hepatitis and HIV/AIDS. Another form of prescription stimulants 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 abuse the patch by extracting the medication and consuming it all at once or by chewing on the patch. This is an extremely unsafe method of prescription drug abuse due to the more rapid method of exposure.
Most commonly abused stimulants and their side effects
|Drug||Street Name||Medical Use||Reason for abuse||Adverse Effects|
|Amphetamines (Eg: Adderall and Dexedrine)
Methylphenidate (Eg: Ritalin and Concerta)
The Smart Drug
|Academic performance enhancement
To stay alert
| Decreased sleep
Sense of anger
Increase in blood pressure
Dangerously high body temperatures
Risk for seizures and stroke at high doses
If you or your family has ADHD medication at home, be aware that it may be of interest to friends and family. Keep a close eye on your supply, especially if you have other teens and young adults in the house. Always keep medication out of reach of children. Keep open lines of communication with your kids about the pressures they experience and healthy perspectives on drug abuse. If you notice any red flags like a rapidly dwindling medication supply or sudden increases in cash flow, talk to them about it.
If you notice some changes in your teen and suspect drug abuse, look out for red flags such as: insomnia, excessive weight loss, twitching, disinterest in their hobbies, memory problems, neglect of personal appearance, sudden disinterest in work, school, or family responsibilities, or 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.
If you or someone you know is in a crisis and need to speak with someone immediately, call the National Suicide Prevention Lifeline: 1-800-273-TALK. This is a crisis helpline that can help with a variety of issues.
If you need information on treatment and available resources, speak to your child’s primary care doctor, or visit the Substance Abuse Treatment Facility Locator, or the National Institute on Drug Abuse for Teens.