Study Quantifies Risk of Adverse Medical Outcomes from Stimulant Misuse

Newly published research highlights serious medical outcomes associated with misuse of prescription stimulants, with administration of the drugs by injection associated with the most adverse effects.

Published this month in the Journal of Attention Disorders, the study found that people who intentionally misused prescription amphetamines were at higher risk for adverse outcomes than people who called into a poison control center to report their unintentional exposure to prescription amphetamines. While only 22% of the control group that reported unintentional exposure required hospitalization, rates of hospitalization were 68% for the intentional injection group, 64.7% for an intentional oral administration group, and 49% for a group that intentionally misused stimulants by snorting.

The results were based on an analysis of reports of prescription stimulant use processed by regional poison control centers and uploaded to the National Poison Data System (NPDS) between 2012 and 2016. Records for both adolescents and adults were analyzed, with nearly 16,000 records examined in all.

Study author Stephen Faraone, PhD, a professor of psychiatry and neuroscience and physiology at SUNY Upstate Medical University, tells Addiction Professional it is important to emphasize that these results do nothing to alter the status of prescribed amphetamines as first-line treatment for attention-deficit/hyperactivity disorder (ADHD). These results are about non-medical use of stimulants, not prescribed use under a physician's guidance.

With respect to intentional misuse of prescription stimulants, “All routes of use had an increased risk of potentially deadly adverse effects,” Faraone says.

Death risk was around 22 times greater for people who intentionally used stimulants non-medically by injection than it was for those who had been unintentionally exposed to prescription stimulants.

In addition, those who injected the drugs were more likely to be admitted to a critical care unit than were the other intentional users and the unintentionally exposed.

However, suicide attempts were more common in the group that intentionally misused prescription amphetamines orally, the researchers reported. “Rates of oral [non-medical use] and suicide attempts increased simultaneously over the five years of the NPDS data analysis, suggesting that [non-medical use] of amphetamines is increasing as a method for suicide attempts,” states a SUNY Upstate news release about the findings.

Faraone concludes about the overall message of the findings, “We need to educate a wide range of people about the dangers of prescription amphetamines.” Research has shown that individuals who misuse stimulants most commonly receive the drugs from family members or friends.

Faraone serves as a paid consultant for Arbor Pharmaceuticals, which funded the study. Arbor Pharmaceuticals' portfolio includes formulations of amphetamine sulfate and dextroamphetamine sulfate.