Stimulant use is stimulated…

Well, at least among the Insured in Texas and associated states. This is a research letter that looks at Blue Cross/Blue Sheild dispensing data 2010 -2014 from Texas, Olakama, Illinois, and New Mexico. The rate of prescriptions is high and steady among children and increasing among adults.

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2014 population distribution by sex: stimulant prescriptions TX, IL, NM, OK. from Blue Cross / Blue Shield.

The authors summarize thusly.

In a commercially insured population, in just 5 years, between 2010 and 2014, the proportion of adults treated with stimulants grew rapidly in contrast to youths, who had a modest increase in stimulant use. The increase in adult stimulant use may be largely driven by increases in outpatient diagnoses of adult ADHD. However, consistent with previous reports, we show that a large proportion of stimulant-treated adults lacked an ADHD diagnosis, potentially reflecting off-label use. This raises concerns regarding potential nonmedical use of prescription stimulants.

The study limitations include dispensings that may not represent actual consumption and limited data on clinical appropriateness of treatment. Finally, the findings may not be nationally representative. Nevertheless, our study reports a prominent expansion in stimulant use among adults in a large, commercially insured population and supports further research to better understand outcomes of stimulant use, particularly among adult women.

We have had problems with stimilant abuse: when I was working in Auckland with “P” — what would be called crystal meth in the rest of the world — and there are subgroups in certain southern towns who are abusing this. I’m reluctant to prescribe methamphetamine, even when someone has ADHD: there are alternatives.

The suggestion that over ten percent of boys need medication worries me even more. It may be better to let them play roughly, add some more PE (even for the librarians and geeks) and have some male teachers. But that would require changing the culture, which is deemed far too expensive than continuing with failure.

One understands how the meme that state schools is equivelent to child damage has come about. Lobby for change, and avoid the stimilants unless your child is crippled with ADHD. There are non medication options with evidence of effectiveness, such as social skills training.

2 thoughts on “Stimulant use is stimulated…

  1. There was a “Valley of the Dolls” themed article in Elle this month (I mostly get it for the pictures, but I was bored) that would have had you screaming. I don’t think any of the ladies who were sharing Ativan would be able to get a prescription from you…

    Apparently Meth tastes like nasturtiums. There is your extremely random bit of information for the day.

  2. One obvious explanation for the increase in scrips to adults is simple: when a boy is drugged from age 8 to age 18, his body adapts to the presence of the drug. He expects it. He goes to work or he goes to college, and he still expects it.

    Perhaps some, or even many, of those adults on ADHD meds were boys on ADHD meds 5 or 8 or 10 years ago, and they feel they still need that drug, regardless of any actual physiological requirement. So one way or another, they get it.

    The cynic in me observes that people get “hooked” on opiates like heroin, but they are “helped” by Ritalin lifelong. Perhaps because big pharma doesn’t make a profit off of heroin?

    Which reminds me.
    Have you read the book BIology of Desire?

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