By Melissa Healy
7:18 PM EDT, May 21, 2013
By the end of high school, 12% of teens say they have taken a stimulant medication for reasons other than to treat attention-deficit hyperactivity disorder (ADHD). But parents, including many of those whose kids are taking ADHD drugs in a bid to boost their academic performance, appear to be clueless.
Among parents whose kids have not been prescribed ADHD medication, a University of Michigan study found, only 1% said they believed their child had used prescription stimulant medication -- including Ritalin, Adderall and Vyvanse -- as a study drug.
University of Michigan pediatrician Dr. Matthew Davis calls the gap between student behavior and parental suspicion a "big mismatch." Parental concern about such drug abuse appears to run pretty high: 54% of white parents, 38% of African American parents and 37% of Latino parents said they were "very concerned" about illicit study drug use among adolescents in their communities. But only 27% said they had talked to their kids about study drugs.
It could be a dangerous mismatch as well, said Davis, director of the C.S. Mott Children's Hospital's National Poll on Children's Health: Use of stimulant medication by children without ADHD can lead to acute exhaustion, abnormal heart rhythms, and -- if an adolescent becomes addicted and goes into withdrawal -- to confusion and psychosis.
And, for the record, adds Davis, there is no evidence that for children without an ADHD diagnosis, taking a prescription stimulant medication improves academic performance. (Davis cites many studies, as well as his own clinical experience, that stimulant medication does improve academic performance in kids with an ADHD diagnosis. And many physicians acknowledge that stimulants may enhance stamina and focus in other kids. But "as you can imagine," says Davis, "no one's going to do a randomized control trial" to prove that.)
There's been a lively ethical debate on the use of performance-enhancing drugs for the academically ambitious too (you can read about that here). The bottom line: neurologists and bioethicists believe there's good reason for kids to understand that they're on shaking ethical ground, too, when they take such drugs.
Parents polled by C.S. Mott were keen on the idea that schools should talk to students about the dangers of using study drugs -- 76% said school officials should address those dangers. And 79% said that kids with an ADHD diagnosis who take such medications should be required to keep their pills in a secure location such as a nurse's office -- a measure that might reduce their ready availability.
Davis says that surveys find that the use of stimulant medication as a study drug is concentrated heavily among white children, and is far less prevalent among Latino or African American kids. This, he acknowledges, may be a problem of affluent and academically ambitious communities, and parents may have many reasons for not recognizing the possibility that their kids might be using.
These parents, he says, "may see prescription drugs differently than illicit drugs that people buy on the street." And that failure to see stimulant abuse for the illicit drug use that it is, he says, is dangerous.
"We know teens may be sharing drugs or spreading the word that these medications can give their grades a boost," said Davis. But the bottom line, he says, is that "these prescription medications are drugs, and teens who use them without a prescription are taking a serious risk with their health."
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