US middle and high schools with the most students taking prescription stimulants to treat ADHD also had, overall, the highest percentage of students who misused prescription stimulants within the past year, researchers report.

The findings highlight a significant association between ADHD stimulant therapy in schools and prescription stimulant misuse, says Sean Esteban McCabe, professor of nursing at the University of Michigan and principal investigator on the study published in JAMA Network Open.

At some schools, 25% or more of kids reported misusing prescription stimulants in the past year—meaning they used the medication without a doctor’s orders or nonmedically, e.g., for recreation or to stay awake.

This is the first large study to examine the prevalence of prescription stimulant misuse and correlating factors in US middle and high schools, McCabe says. Stimulant misuse among schools ranged from 0% to 25%, with some outliers that were higher. Other findings include:

  • Students in schools with the highest rates of stimulant therapy for ADHD had a 36% higher risk of misusing prescription stimulants
  • In schools with 12% or more students treated with prescription stimulants for ADHD, 8% of students reported misusing prescription stimulants
  • In schools with 6% or fewer students taking prescription stimulants for ADHD, 0-4% reported misusing prescription stimulants.
  • Other characteristics of schools with higher misuse: higher proportion of highly educated parents; located in non-Northeastern regions and suburbs; more white students; medium levels of binge drinking; and schools surveyed from 2015-2020.

“I can tell you that a student’s experience will be different at a school with no peers who misuse stimulants versus a school where 1 in 4 peers misuse stimulants,” says McCabe, director of the Center for the Study of Drugs, Alcohol, Smoking and Health.

The wide variation in misuse means individual schools should assess their own students for substance misuse behaviors rather than rely on existing data collected elsewhere, McCabe says.

Read the full article about teenagers and stimulants by Laura Bailey at Futurity.