Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA.
Department of Pharmacy Practice, School of Pharmacy, University of Mississippi, University, MS, USA.
J Addict Dis. 2020 Apr-Jun;38(2):176-185. doi: 10.1080/10550887.2020.1732762. Epub 2020 Apr 3.
Malingering of ADHD symptoms is a potential means of nonmedical use of prescription stimulants (NMUPS). The Subtle ADHD Malingering Screener (SAMS) provides a potential avenue for identification of symptom malingering. However, no real world evidence of this scale has been published to date. The goal of this study was to examine patterns of use of stimulant prescriptions and to evaluate the ability of the SAMS to identify NMUPS. This study employed a cross-sectional observational design to administer an online, self-administered survey instrument in a convenience sample of college-enrolled young adults with a prescription for stimulant medications at a campus pharmacy. Respondents were asked about their prescription characteristics, nonmedical use and drug diversion behavior, along with ratings on the SAMS. Over 33% of respondents self-reported past-year NMUPS and 18% reported past-year drug diversion. Over 35% of respondents rated NMUPS as being slight or no risk and 55% were classified by the SAMS as likely to be malingering or exaggerating their symptoms. Individuals reporting past-year NMUPS or diversion consistently scored higher on the SAMS. The SAMS showed potential for future application in the pharmacy setting. Further research is needed to evaluate the relationship of SAMS to NMUPS or drug diversion. The results of this study also highlight several growing issues with the diagnosis and treatment of ADHD among young adults enrolled in college. Addressing perception of risk, social norms, and providing healthcare professionals with tools to prevent misdiagnosis is critical to the management of this issue.
注意缺陷多动障碍（ADHD）症状的装病是处方药兴奋剂（NMUPS）非医学用途的一种潜在手段。微妙注意缺陷多动障碍装病筛查器（SAMS）为识别症状装病提供了一种潜在途径。然而，迄今为止，还没有关于该量表的实际证据发表。本研究的目的是检查兴奋剂处方的使用模式，并评估 SAMS 识别 NMUPS 的能力。本研究采用横断面观察性设计，在校园药房开具兴奋剂药物处方的大学生便利样本中，在线管理自我管理调查工具。受访者被要求报告他们的处方特征、非医学用途和药物转用行为，以及 SAMS 的评分。超过 33%的受访者报告过去一年存在 NMUPS，18%的受访者报告过去一年存在药物转用。超过 35%的受访者认为 NMUPS 的风险轻微或没有风险，55%的受访者被 SAMS 归类为可能在装病或夸大他们的症状。报告过去一年存在 NMUPS 或转用的个体在 SAMS 上的得分始终较高。SAMS 显示出在药房环境中的未来应用潜力。需要进一步研究来评估 SAMS 与 NMUPS 或药物转用的关系。本研究的结果还强调了在大学就读的年轻成年人中 ADHD 的诊断和治疗方面出现的几个日益严重的问题。解决对风险的认知、社会规范问题，并为医疗保健专业人员提供预防误诊的工具，对于管理这一问题至关重要。
