Journal Article

Trends in use of prescription stimulants in the United States and Territories, 2006 to 2016

Ogden, Christy L., Chung, Daniel Y., Nichols, Stephanie D., Simoyan, Olapeju M., Piper, Brian J., Caggiano, James F., McCall, Kenneth L.

2018

Overview

Stimulants are considered the first-line treatment for Attention Deficit Hyperactivity Disorder (ADHD) in the US and they are used in other indications. Stimulants are also diverted for non-medical purposes. Ethnic and regional differences in ADHD diagnosis and in stimulant use have been identified in earlier research. The objectives of this report were to examine the pharmacoepidemiological pattern of these controlled substances over the past decade and to conduct a regional analysis. Data (drug weights) reported to the US Drug Enforcement Administration's Automation of Reports and Consolidated Orders System for four stimulants (amphetamine, methylphenidate, lisdexamfetamine, and methamphetamine) were obtained from 2006 to 2016 for Unites States/Territories. Correlations between state level use (mg/person) and Hispanic population were completed. Amphetamine use increased 2.5 fold from 2006 to 2016 (7.9 to 20.0 tons). Methylphenidate use, at 16.5 tons in 2006, peaked in 2012 (19.4 tons) and subsequently showed a modest decline (18.6 tons in 2016). The consumption per municipality significantly increased 7.6% for amphetamine and 5.5% for lisdexamfetamine but decreased 2.7% for methylphenidate (all p < .0005) from 2015 to 2016. Pronounced regional differences were also observed. Lisdexamfetamine use in 2016 was over thirty-fold higher in the Southern US (43.8 mg/person) versus the Territories (1.4 mg/person). Amphetamine use was about one-third lower in the West (48.1 mg/person) relative to the Northeastern (75.4 mg/person, p < .05) or the Midwestern (69.9 mg/person, p ≤ .005) states. States with larger Hispanic populations had significantly lower methylphenidate (r(49) = -0.63), lisdexamfetamine (B, r(49) = -0.49), and amphetamine (r(49) = -0.43) use. Total stimulant usage doubled in the last decade. There were dynamic changes but also regional disparities in the use of stimulant medications. Future research is needed to better understand the reasons for the sizable regional and ethnic variations in use of these controlled substances.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adults / Amphetamines / Attention deficit hyperactivity disorder / Automation / Biology and Life Sciences / Cardiotonic agents / Central nervous system agents / Central Nervous System Stimulants - therapeutic use / College students / Controlled substances / Data processing / Diagnosis / Dopamine / Drug therapy / FDA approval / Geography / Health education / Humans / Hyperactivity / Low income groups / Medicine / Medicine and Health Sciences / Mental disorders / Methamphetamine / Methylphenidate / Narcotics control / No Child Left Behind Act 2001-US / Pediatrics / People and places / Pharmaceutical industry / Pharmacology / Pharmacy / Preschool children / Prescriptions / Psychiatry / Regional analysis / Regional planning / Respiratory system agents / Risk factors / School districts / Social Sciences / Stimulants / Trends / United States / United States Food and Drug Administration