A review by the Federal Agency for Prescription Drug Monitoring Programs reveals that Massachusetts has the highest rate of stimulant prescriptions among 26 representative states, including drugs to treat ADHD such as Adderall, Ritalin, and Concerta.
John Eadie, who tracks drug prescriptions under the National High Intensity Drug Trafficking Zone (HIDTA) program, presented the data at a state legislative hearing on Tuesday to address concerns about the increasing use of illegal stimulants such as cocaine and methamphetamines. Eadie said it was not clear why Massachusetts stands out when it comes to the use of legal stimulants, or why there was a significant increase in prescriptions between 2010 and 2019.
“You will want to carefully consider whether this is due to sudden and sweeping changes in the health and medical diagnoses of your condition,” Eadie said, “or if, more likely, it is more about hijacking and using.”
Eadie stressed that stimulants are an important treatment for ADHD, but said he was concerned that these drugs could be diverted to teens who “take Adderall for non-medical purposes.” Students can use the pills for more energy and to stay awake while studying or partying. Walpole Police Chief John Carmichael told lawmakers stimulant pills are often traded in schools.
âChildren who are prescribed this drug for ADHD, for example, divert it to other children,â said Carmichael, who chairs the Massachusetts Association of Chiefs of Police Substance Abuse committee. “Our kids seem to have the notion that, because it’s prescribed by a doctor, it’s not a problem they need to worry about.”
Carmichael said counterfeit Adderall, which is actually methamphetamine, is also a growing problem. He said prescribed stimulants can be a âstarter drugâ that leads to addiction.
State Senator Julian Cyr, co-chair of the Joint Committee on Mental Health, Substance Use and Recovery, called Massachusetts’ position “alarming.”
âWe already have a problem and we have a bigger problem ahead,â said Cyr, a Democrat whose district includes Cape Cod, Martha’s Vineyard and Nantucket.
Dr Tim Wilens, co-director of the Center for Addiction Medicine at Massachusetts General Hospital, told the committee that ADHD treatment does not lead to cocaine or methamphetamine, but treatment for the disease cannot.
âIf you don’t treat ADHD, 50% of adults with ADHD will have a substance use disorder,â said Wilens, who is also chief of child and adolescent psychiatry at the MGH.
Wilens also expressed concern about the non-medical use of stimulants, which he sees most often in colleges and boarding schools, of which there are many in Massachusetts. He said the maximum age for us is 22, and about half of those abusive stimulants already suffer from a substance use disorder.
Wilens told lawmakers that extended-release stimulants are less likely to be misused than immediate-release stimulants such as Adderall.
âSo the first lesson is to think about using more sustained-release stimulants and less immediate-release stimulants in a high-risk setting,â he said.
Sen. Cyr asked Wilens and Dr. Scott Hadland of Boston Medical Center why prescription of stimulants had increased rapidly in Massachusetts over the past decade.
Wilens responded that people with ADHD often do not receive treatment, but this may be less likely in the greater Boston area, which he says has the highest density of child psychiatrists in the country. This, combined with a concentration of students who come with or get a prescription for stimulants, may help explain the increase.
âWe’re just one place, part of the country, with a lot of medical services and we make sure people get the treatment they need, and a lot of people need treatment for ADHD,â he said. said Hadland, pediatrician and drug addict. specialist at Boston Medical Center.
Wilens and Hadland said they were watching for signs of inappropriate stimulant prescribing. A similar increase in prescriptions has helped fuel the opioid epidemic.
The State Department of Public Health is working on a report that will take a closer look at prescribing stimulants in Massachusetts.