Health Secretary Robert F. Kennedy Jr. often criticizes prescription stimulants such as Adderall, which are primarily used to treat attention deficit hyperactivity disorder.
“We've hurt this whole generation,” he said last year on a podcast. “We poisoned them.”
In February, the Kennedy-led Make America Healthy Again committee announced plans to assess the “threats” posed by drugs like prescription stimulants.
But are they a threat? If so, who?
Like many medications, prescription stimulants have potential side effects, and some people misuse them. However, these drugs are also considered some of the most effective and well-researched treatments psychiatry has to offer, says Dr. Jeffrey H. Newcone, director of ADHD and learning disabilities at ICAHN School of Medicine in Mount Sinai, New York.
Below are some answers to general questions and concerns about stimulants.
What are prescription stimulants?
Prescription stimulants are drugs that help change the brain's mechanisms by increasing communication between neurons.
They are divided into two classes: methylphenidate (such as ritalin, focalin, concerto, etc.) and amphetamines (such as Vyvanse and Adderall).
Drugs are mostly prescribed to treat ADHD, but are also used in conditions such as narcolepsy and bulimia. It is also used in cases other than relabels due to treatment-resistant depression or tension, a syndrome that can cause patients to move, become motionless or stop talking in an abnormal way.
Drugs function by amplifying the activity of the neurotransmitters dopamine and norepinephrine in neurons of the brain. Dopamine plays a role in creating a desire for something and the motivation to get it, but norpinephrine increases arousal and makes it easier to concentrate.
Using meth essentially helps to be “uniform” because people with ADHD may have a deficit on both of these chemicals.
For some users, the effect is profound. “It's like glasses for poor vision,” Dr. Rostein said.
Are stimulants always used to treat ADHD?
no.
Not all people diagnosed with ADHD take meth. There are also non-stimulants like Strattera (Atomoxetine). And some people don't need medicine at all.
Other interventions that regulate sleep and exercise, such as behavioral therapy, parent training, school support, and lifestyle changes, are important whether someone needs medication or not.
How many people are taking them?
Prescription stimulants use has been increasing since 2012, especially among adults, and has increased significantly in recent years among women and patients aged 20-39.
In 2023, an estimated 6% of adults had a current diagnosis of ADHD, and about a third of those patients reported taking prescription stimulants, according to an analysis by the Centers for Disease Control and Prevention.
However, in children and adolescents, the number of meth prescriptions has become more stable in recent decades.
Overall, it is estimated that around 5% of children in the US are currently prescribed medications for ADHD (not 15%, but the numbers Kennedy said at a January confirmation hearing).
A study published in February found that prescriptions actually decreased among children after the pandemic began.
How often do prescription stimulants get abused?
According to the government's drug use survey, in 2022, 1.5% of people over the age of 12 reported misusing prescription stimulants over the past year. Sometimes people aim to be more productive or awaken, but drugs are also used in recreational ways and are expensive when swallowed, smoked, or smoked.
Young adults aged 18-25 had the highest misuse rate: 3.7%.
Of the 12-17 adolescents, the rate of misuse was much smaller, at 0.9%.
This number may vary depending on where you live. Some schools in the US report that one in four high school students misuse prescription stimulants. Some schools report that stimulants are not ok with misuse.
What are the potential side effects?
Taking stimulants can cause increased blood pressure and heart rate, lowered appetite, difficulty sleeping, calming and agitating.
Other common side effects include headaches, increased temperature, and abdominal pain.
Though not often, stimulants are known to temporarily slow children's growth, Dr. Rostein said. He said that health care providers should monitor their height and weight while taking the drug.
There is also a small risk of developing psychosis that can be linked to dosage. And when stimulants are misused, they are addictive.
Patients and their physicians should weigh the benefits of taking meth against these risks. ADHD is associated with reckless behaviors such as careless driving, unsafe gender, substance abuse, and attack, especially when left untreated. Recent studies have shown that people with a diagnosis die on average faster than their peers. Men were about 7 years ago, and women were about 9 years ago.
How many stimulants should I use?
it depends.
Studies have shown that symptoms of ADHD change over time, improve, and then worsen again, or vice versa. “It's not consistent,” Dr. Rostein said. “They wax and decline for a lot of people.”
As a result, people may end up using ADHD medications intermittently, he added.
Still, some people take these medications for a long time, says Dr. Lenard A. Adler, director of the Adult ADHD program at NYU Langone Health.
“That being said, it's always appropriate if someone is stable to try and lower the dose,” Dr. Adler added.
If the patient is not going well, he said, then it's worth exploring whether the medication is still needed.
Are there still no medication shortages?
yes.
The stimulant shortage that began in 2022 continues. As of March, methylphenidate hydrochloride extended release tablets and patches, as well as other types of amphetamine tablets, are either unavailable or shortage, according to the Food and Drug Administration.
The availability of certain drugs and formulations may vary from region to region, Dr. Rostein said.
“It leads to a lot of uncertainty, unpredictability and a lot of anxiety on the part of patients,” he added.
