Bright George M
Adolescent Health Center, Midlothian, Virginia, USA.
Medscape J Med. 2008 May 7;10(5):111.
The objective is to assess abuse of prescription and illicit stimulants among individuals being treated for attention-deficit/hyperactivity disorder (ADHD).
A survey was distributed to patients enrolled in an ADHD treatment center. It included questions designed to gain information about demographics; ADHD treatment history; illicit drug use; and misuse of prescribed stimulant medications, including type of stimulant medication most frequently misused or abused, and how the stimulant was prepared and administered.
A total of 545 subjects (89.2% with ADHD) were included in the survey. Results indicated that 14.3% of respondents abused prescription stimulants. Of these, 79.8% abused short-acting agents; 17.2% abused long-acting stimulants; 2.0% abused both short- and long-acting agents; and 1.0% abused other agents. The specific medications abused most often were mixed amphetamine salts (Adderall; 40.0%), mixed amphetamine salts extended release (Adderall XR; 14.2%), and methylphenidate (Ritalin; 15.0%), and the most common manner of stimulant abuse was crushing pills and snorting (75.0%). Survey results also showed that 39.1% of respondents used nonprescription stimulants, most often cocaine (62.2%), methamphetamine (4.8%), and both cocaine and amphetamine (31.1%). Choice of illicit drug was based on rapidity of high onset (43.5%), ease of acquisition (40.7%), ease of use (10.2%), and cost (5.5%).
The risks for abuse of prescription and illicit stimulants are elevated among individuals being treated in an ADHD clinic. Prescription agents used most often are those with pharmacologic and pharmacokinetic characteristics that provide a rapid high. This suggests that long-acting stimulant preparations that have been developed for the treatment of ADHD may have lower abuse potential than short-acting formulations.
评估在接受注意力缺陷多动障碍（ADHD）治疗的个体中处方兴奋剂和非法兴奋剂的滥用情况。
向一家ADHD治疗中心登记的患者发放了一份调查问卷。问卷包含旨在获取有关人口统计学信息、ADHD治疗史、非法药物使用情况以及处方兴奋剂药物滥用情况的问题，包括最常被滥用的兴奋剂药物类型，以及兴奋剂的制备和服用方式。
共有545名受试者（89.2%患有ADHD）参与了调查。结果表明，14.3%的受访者滥用处方兴奋剂。其中，79.8%滥用短效制剂；17.2%滥用长效兴奋剂；2.0%同时滥用短效和长效制剂；1.0%滥用其他制剂。最常被滥用的具体药物是苯丙胺混合盐（阿得拉；40.0%）、苯丙胺混合盐缓释剂（阿得拉XR；14.2%）和哌甲酯（利他林；15.0%），最常见的兴奋剂滥用方式是碾碎药丸并吸食（75.0%）。调查结果还显示，39.1%的受访者使用非处方兴奋剂，最常使用的是可卡因（62.2%）、甲基苯丙胺（4.8%）以及可卡因和苯丙胺两者（31.1%）。非法药物的选择基于起效快（43.5%）、获取容易（40.7%）、使用方便（10.2%）和成本（5.5%）。
在ADHD诊所接受治疗的个体中，处方兴奋剂和非法兴奋剂的滥用风险有所升高。最常被使用的处方药物具有能迅速产生快感的药理和药代动力学特征。这表明，为治疗ADHD而研发的长效兴奋剂制剂的滥用可能性可能低于短效制剂。
