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Teenagers sell and give away their prescription drugs

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7319.956/e (Published 27 October 2001) Cite this as: BMJ 2001;323:956
  1. David Spurgeon
  1. Quebec

    More teenage state school students surveyed in Canada's Atlantic provinces took prescription stimulants such as methylphenidate hydrochloride (Ritalin), dexamfetamine sulphate (Dexedrine), and pemoline (marketed in Canada as Cylert) for recreational purposes than for medical conditions, a study from Dalhousie University in Halifax, Nova Scotia, has found (Canadian Medical Association Journal 2001;165:1039-44).

    A total of 13 549 students in Nova Scotia, New Brunswick, Prince Edward Island, Newfoundland, and Labrador in 1998 completed an anonymous questionnaire about their use of stimulants. Non-medical use in the year before the survey was reported by 8.5% of the students, compared with 5.3% reporting medical use.

    The students were randomly chosen from grades 7, 9, 10, and 12. The mean age was 15.2 years overall; the median age was 13 years in grade 7, 15 years in grade 9, 16 years in grade 10, and 18 years in grade 12.

    “The vast majority of students taking stimulant medications appeared to be using them as sanctioned,” wrote author Christiane Poulin, an associate professor with the university's department of community health and epidemiology.

    But among those who reported using medical stimulants in the year before the survey, 14.7% said they had given some of their medication to others, 7.3% said they had sold some of it, 4.3% had some stolen, and 3% were forced to give some of it up. Those who gave some of their medication away were more likely to be those who used the drugs recreationally. Compared with students who did not report non-medical use, those who did report it were about 3.3 times more likely to report having given some of their medication away and 4.6 times as likely to have sold it.

    Students who used alcohol or cannabis or who smoked cigarettes were also more likely to use stimulants, either medically or non-medically, although the association with non-medical use of stimulants was stronger.

    The annual prevalence of non-medical stimulant use among adolescents in Nova Scotia increased from 5% in 1991 to 11% in 1998. In Canada as a whole the amount of methylphenidate prescribed increased about fivefold from the early 1990s to the mid-1990s. In the United States the increase was about threefold from 1990 to 1995; the largest increase there (311%) occurred among high school students aged 15-19, Professor Poulin said.

    She urged doctors prescribing stimulants to be vigilant about potential misuse, particularly among adolescent patients known or thought to be using other substances. Physicians and parents should keep track of stimulant medication, especially when several months' supply is prescribed.

    But she says her study should not detract from the value of methylphenidate and dextroamfetamine, which are well established, safe, and effective in treating attention-deficit /hyperactivity disorder.

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