More than half of party drug users take ADHD medication without a prescription, new research shows

Each year, UNSW Sydney's National Drug and Alcohol Research Centre surveys hundreds of people in Australia who regularly use drugs to understand trends in substance use across the country.

Today we released the 2024 report, which surveyed 740 people across Australian capital cities who regularly use ecstasy or other illegal stimulants.

While the focus of this research is largely on illicit drugs and markets, we also observe trends in the use of pharmaceutical stimulants without a prescription, such as ADHD medications.

This year, 54% of the people we surveyed had taken non-prescribed pharmaceutical stimulants in the past six months, the highest percentage we have seen since we began surveying this type of drug use in 2007.

What are pharmaceutical stimulants?

Pharmaceutical stimulants include the drug methylphenidate (brand names Concerta and Ritalin) and dexamphetamine and lisdexamfetamine (Vyvanse).

These medicines are often prescribed to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy, a chronic neurological disorder that causes excessive sleepiness and sudden episodes of sleep during the day.

These medications work in different ways depending on the type, but they treat ADHD by increasing the levels of important chemicals (neurotransmitters) in the brain, including dopamine and norepinephrine.

However, as with many pharmaceutical substances, these stimulants are also taken without a prescription. There are a number of reasons why someone might choose to take these medications without a prescription.

Studies on university students have shown that these substances are often used to increase attention, concentration and memory. Studies in the wider population have shown that they can also be used for experimentation or to get high.

Worldwide, including in Australia, the number of prescriptions for ADHD medications has increased significantly in recent years, likely due to the increased recognition and diagnosis of ADHD. As prescriptions increase, so does the risk of these substances entering the illegal drug market.

Our findings

Non-prescription use of pharmaceutical stimulants has tripled since monitoring began, from 17% of respondents in 2007 to 54% in 2024. It has been similarly high in recent years (52% in 2022 and 47% in 2023).

The frequency of use has remained relatively low, with respondents typically reporting using non-prescription pharmaceutical stimulants monthly or less frequently.

In this survey, participants most commonly reported using dexamphetamine, followed by methylphenidate and lisdexamfetamine. Most (79%) reported that it was “easy” or “very easy” to obtain these substances, similar to 2022 and 2023.

Of course, since our research refers to individuals who regularly use drugs, the use of pharmaceutical stimulants without a prescription does not reflect consumption in the general population.

In the 2022–23 National Drug Strategy Household Survey, a general population survey of Australians aged 14 and over, 2.1% of the population (equivalent to about 400,000 people) reported using pharmaceutical stimulants for non-medical purposes in the past year. This was similar to the percentage of people who used ecstasy.

What are the risks?

Pharmaceutical stimulants are considered relatively safe in terms of toxicity. However, like all stimulants, these substances increase the activity of the sympathetic nervous system, which controls various body functions in stressful situations. This, in turn, increases heart rate, blood pressure and respiratory rate.

These changes can cause acute cardiac events (such as cardiac arrhythmias or irregular heartbeat) and, with repeated use of high doses, chronic changes in cardiac function.

Recent Australian studies have documented an increase in poisonings with these substances, although a significant proportion of these appear to be deliberate poisonings. In the poisonings involving only pharmaceutical stimulants, the drugs were mostly taken orally, with the mean dose being more than ten times the normally prescribed dose. The most common symptoms were hypertension (high blood pressure), tachycardia (increased heart rate) and agitation.

In our survey, those who had used pharmaceutical stimulants most often took them in tablet form and generally took a slightly higher dose than that normally prescribed.

However, about a quarter of respondents said they took the drug by snorting it. This can cause physical harm, such as sinus damage, and increases the drug's potential risks because it can work faster in the body.

Some pharmaceutical stimulants have a “long-acting effect,” meaning they are released into the body over the course of a day. There is therefore also a risk of premature re-dosing when people unknowingly take these preparations more than once a day. That is, if the desired effects do not occur within the expected time period, they may take another dose, which can increase the risk of side effects.

Finally, non-prescription pharmaceutical stimulants can have side effects when taken with other medications. These may include a “masking effect” (the stimulant may mask the signs of alcohol intoxication, for example).

So what should we do?

Pharmaceutical stimulants are an important medication for treating ADHD and narcolepsy and are relatively safe when used as directed. However, there are additional risks when people take these substances without a prescription.

Harm reduction campaigns that highlight these risks, including the differences between formulations, can be helpful. Continued monitoring and more in-depth investigation of the associated harms are also crucial.

This article is republished from The Conversation under a Creative Commons license. Read the original article.