Bogle Kristin E, Smith Bradley H
Department of Psychology, University of South Carolina, Columbia, South Carolina, Columbia, SC 29208, USA.
Curr Drug Abuse Rev. 2009 May;2(2):157-76. doi: 10.2174/1874473710902020157.
Methylphenidate hydrochloride (MPH) is one of the most widely available prescription stimulants. In response to an increase in stimulant treatment for Attention-Deficit/Hyperactivity Disorder, the prescription and production rates of MPH have increased dramatically in the past two decades. Given that college students and adolescents might be attracted to MPH for its attention-focusing, weight loss, or euphoric effects, there is concern that the rise in therapeutic use of MPH might also coincide with a rise in illicit (non-medical) use. After a dramatic increase in the 1990s, recent large-scale surveys of high-school students suggest that rates of illicit MPH use are either holding steady, or even decreasing in this population. Across studies, annual usage rates for secondary school students are below 5%, and lifetime usage rates remain below 7%. Among college students, self-reported rates range from 1.5% to 31% among the various surveys, with the most nationally representative study estimating annual illicit MPH usage at about 4%. Although more research is needed to corroborate findings, this review was able to begin developing a profile of individuals who might be more likely to illicitly use MPH. Among college students, available evidence suggests illicit MPH users were more likely to be white, male, affiliated with a formally organized fraternity, and more likely to use other illicit and illegal substances. The majority of college students reported that the primary reason for use was to improve academic performance. Future studies should provide more information on the motivations and subtypes of illicit MPH, especially repeated users and those diagnosed with ADHD. Research on prevention of illicit MPH or other stimulants used to treat ADHD would make major contributions to the literature.
盐酸哌甲酯（MPH）是市面上最常见的处方兴奋剂之一。随着针对注意力缺陷多动障碍（ADHD）的兴奋剂治疗需求增加，在过去二十年中，MPH的处方量和产量急剧上升。鉴于大学生和青少年可能因其注意力集中、减肥或欣快作用而被MPH吸引，人们担心MPH治疗用途的增加可能与非法（非医疗）用途的增加同时出现。在20世纪90年代急剧增加之后，最近对高中生的大规模调查表明，非法使用MPH的比率要么保持稳定，要么在这一人群中甚至有所下降。在各项研究中，中学生的年使用率低于5%，终生使用率仍低于7%。在大学生中，不同调查的自我报告使用率从1.5%到31%不等，最具全国代表性的研究估计MPH的年非法使用率约为4%。尽管需要更多研究来证实这些发现，但本综述能够开始勾勒出可能更有可能非法使用MPH的个体特征。在大学生中，现有证据表明，非法使用MPH的人更有可能是白人、男性，隶属于正式组织的兄弟会，并且更有可能使用其他非法和违禁物质。大多数大学生报告使用的主要原因是提高学业成绩。未来的研究应提供更多关于非法使用MPH的动机和亚型的信息，特别是重复使用者和被诊断患有ADHD的人。对预防非法使用MPH或其他用于治疗ADHD的兴奋剂的研究将对该领域文献做出重大贡献。
