A Tragedy Puts ADHD Medications in the Spotlight

On Monday morning, the number one most emailed article on the The New York Times website was the sad story of how a young man’s addiction to prescription drugs drove him to suicide at the age of twenty-four. With this excellent piece of journalism by Alan Schwarz, we hope that Richard Fee’s death will not be in vain, but will instead serve as a cautionary tale for college students, parents, and physicians alike as the nation looks more closely at the way ADHD medications are viewed by the medical community (and subsequently the public) as innocuous, and consequently get doled out all too freely. The article draws attention to the popularity of stimulant medications like Adderall. “…the tunnel-like focus the medicines provide has led growing numbers of teenagers and young adults to fake symptoms to obtain steady prescriptions for highly addictive medications that carry serious psychological dangers.”

“Young adults are by far the fastest-growing segment of people taking A.D.H.D medications. Nearly 14 million monthly prescriptions for the condition were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to the data company I.M.S. Health. While this rise is generally attributed to the maturing of adolescents who have A.D.H.D. into young adults — combined with a greater recognition of adult A.D.H.D. in general — many experts caution that savvy college graduates, freed of parental oversight, can legally and easily obtain stimulant prescriptions from obliging doctors.”

In Richard Fee’s case, consistent and unnecessary (Mr. Fee did not suffer from ADHD) overuse of Adderall, and a similar drug called Vyvanse, led to psychotic behavior. Although rare, this reaction is well documented.

“…stimulants are exceptionally successful at mollifying the impulsivity and distractibility that characterize classic A.D.H.D., but that they can cause insomnia, increased blood pressure and elevated body temperature. Food and Drug Administration warnings on packaging also note “high potential for abuse,” as well as psychiatric side effects such as aggression, hallucinations and paranoia…A 2006 study in the journal Drug and Alcohol Dependence claimed that about 10 percent of adolescents and young adults who misused A.D.H.D. stimulants became addicted to them. Even proper, doctor-supervised use of the medications can trigger psychotic behavior or suicidal thoughts in about 1 in 400 patients, according to a 2006 study in The American Journal of Psychiatry. So while a vast majority of stimulant users will not experience psychosis — and a doctor may never encounter it in decades of careful practice — the sheer volume of prescriptions leads to thousands of cases every year, experts acknowledged.”

Take some time this week to read the entire article. Chances are, if you ask around (as I did), you’ll find that someone you know has used Adderall — either without a prescription, or with a prescription they obtained knowing they didn’t have ADHD — never thinking of the medication as potentially harmful.  Then tell them the story of Richard Fee.

https://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html?hp

Adderall is not the only medication that is being misused with catastrophic results; the widespread use of opiate painkillers by pregnant women has recently garnered the attention of addiction experts.