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All three states had incidents within the previous year that fit the profile of the types of diversion and misuse/abuse previously outlined. While there were not an overwhelming number of incidents in each state, there was a sufficient number of events "unmasked" by this cursory examination to suggest that these activities are far from rare. Some examples of these incidents include: Indiana - a 14 year old sold his girlfriend's MPH medication to an undercover agent - a 16 year old crushed his MPH tablets and brought the powder to school - an 18 year old female student was encountered with crashed MPH powder at school and admitted to abusing it for longer than a year a school nurse reported missing/stolen MPH f~om supplies held at school - 12 high school students were trafficking MPH at school - a student was stealing MPH medication from another student's medication bottle. Although prescribed MPH, he said he needed more. South Carolina - a father brought a MPH tablet to the police for identification: son later admitted he was snorting Ritalin - a 16 year old was arrested for marijuana possession and was found to be carrying 65 MPH tablets. He admitted to crushing the tablets and snorting the powder. He did not have a prescription for MPH. - school officials reported MPH theft from the nurse's office - several students were suspended from school for distributing MPH on the school bus - four male Citadel students were expelled for non-medical use of MPH Wisconsin - 12 students were suspended/expelled for selling MPH on the school bus - a 13 year old boy was selling his brother's medication at school - a 16 year old male was found to be trading his MPH medication for marijuana - a female student distributed her MPH medication on the school bus. She had left home with 60 tablets and arrived at school with 4 - three schools were broken into and MPH medication was taken Information gathered from interviews combined with poison control data suggest that a number of factors may be contributing to the diversion and misuse/abuse of medication intended for ADHD treatment. For example, medications are kept in relatively unsecured areas at home and at school. Keeping medication on the kitchen counter or table makes it accessible to other siblings and children that visit. Many schools reported keeping medication in unlocked drawers or teacher's desks making theft at school relatively easy. Physicians rarely address drug abuse issues with parents or children: if parents are unaware of the abuse potential associated with a medication they are unlikely to take any special precautions. While many schools have rules against children carrying medication at school, those rules are variably applied especially for older students. In addition, very few schools have a nurse on duty to dispense medication and frequently untrained personnel are given this task. Some schools that reported missing/stolen medication could not identify file amounts missing or even which children were affected by the loss as no records or log books were maintained. Adolescent drug treatment centers reaffirmed what had previously been reported to the DEA: there is a high incidence of illicit use of MPH among adolescents who are already abusing other drugs. In South Carolina one treatment center started requiring routine urine checks for MPH because the incidence of MPH abuse was so high. However, illicit use of MPH is not the exclusive domain of "bad kids." School officials seemed genuinely surprised by the actions of some of their better students who were identified as using MPH illicitly. In general, adolescents who want to use MPH for any reason (to get high, to lose weight, to stay up late and study) have little difficulty obtaining it. They don't need to rob a drug store, forge a prescription or make a visit to the local drug dealer. Conclusion: The DEA recognizes that psychostimulants like MPH and amphetamine are effective in treating the symptoms associated with ADHD. The present data indicate that chronic, oral, low-dose stimulant medication in the treatment of properly diagnosed ADHD is generally not associated with children abusing their own medication. However, given the high abuse potential of these drugs and significant data that show they are being used illicitly by a growing number of children, the DEA remains concerned about the ease in which these drugs are available to individuals, choose to use them illicitly. The DEA concurs with other medical professionals who have urged the proactive efforts of many groups including physicians, parents, school personnel and law enforcement to curb the continued diversion, misuse and abuse of these medications. Failure to ensure medication compliance and continued lax handling of medication coupled with persisting efforts to have more children recognized and treated with stimulants is a formula for increased stimulant drug abuse among U.S. children. |
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