- Prescription Stimulants and College
- Prescription Stimulants and the Brain
- Prescription Drugs for ADHD
- Psychiatric Comorbidities
- Treatment
Illicit use of these medications often stems from the desire for cognitive enhancement and has been prevalent in academic and business professionals, students, athletes, and performers.What are Prescription Stimulants?
Prescription stimulants are administered to treat disorders in which attention, activity levels, and/or moods are affected, most commonly attention deficit hyperactivity disorder (ADHD).
How Do They Work?
The main function of prescription stimulants is to increase activity in the central nervous system (CNS), primarily through acting on the neurotransmitters dopamine and norepinephrine.
- The result is an increase in alertness, wakefulness, and/or motivation, in addition to an elevation in heart rate and blood pressure; suppressed appetite; and interruptions in sleep patterns.
- Thus, while prescription stimulants can enhance mental concentration or performance, heightened CNS activity can lead to adverse physiological reactions.
- The long-term effects of stimulants on the body and brain are not well researched and, given their short-term risks and adverse effects, may lead to poor health over time.
Prescription Stimulants and College
College students are a particularly vulnerable group for misuse of prescription stimulants because of the accessibility and desired cognitive effects.
Studies have found 4.1% to 10.8% of college students reported non-medical use of prescription stimulants over the past year. Students report the most common way to obtain these drugs is from a friend that has a prescription. This is known as diversion which is the act of sharing, selling or trading prescription medications; 61.7% of students with ADHD report diverting prescriptions.
- To improve concentration.
- Studying.
- Alertness.
- Experimentation.
- Excessive drinking.
- Other drug use.
- Psychiatric distress.
- Depressed mood.
- Increased suicidal thoughts.
Interestingly, despite the reported academic reasons for use, illicit prescription stimulant use is associated with lower GPA, skipping class and attention difficulties.
Prescription Stimulants and the Brain
Prescription stimulants are intended to correct disorders in which ‘deficiencies’ of dopamine in the central nervous system are thought to play a role.
- Stimulants increase the amount of dopamine in the synaptic cleft by excessive presynaptic release or by blocking dopamine reuptake or breakdown.
- Higher levels of dopamine are associated with elated mood and increased motor function.
- The actions of dopamine are associated with attentional processes, some emotion-related behaviors, as well as motivation and reward.
- An excess of dopamine may lead to increasingly atypical and uninhibited behavior over time. It may also lead to changes in the brain that affect the subjective need (or ‘craving’) for stimulant drugs.
- This may lead to the risk of over-using prescription stimulants, or augmenting these with other legal or illegal amphetamine-type drugs.
Researchers have not determined the exact neurochemical process of stimulant addiction, but some evidence has been found that chronic stimulant use changes the function and structure of neuronal networks in the brain.
- In addition, chronic exposure to increased dopamine may be associated with oxidative stress in the brain.
- This involves the release of irritant or inflammatory chemicals that can damage or kill cells in their vicinity.
- There is some evidence that oxidative stress may also contribute to some psychiatric and neurological disorders.
Prescription Drugs for ADHD
Psychiatric Comorbidities
People with prescription stimulant use disorder and other additional conditions such as ADHD may also be at risk of other, additional mental health problems. These may include:
- Bipolar disorder.
- Anxiety disorders.
- Depression.
- Antisocial tendencies and/or behavior.
- Eating disorders.
- Academic problems (such as poor school attendance or dropping out).
- Illegal drug use.
Having a mental health condition like ADHD puts one at greater risk for a co-occurring substance use disorder, known as dual-diagnosis. Anxiety disorders, for example, co-occur with substance use disorders at a 12-month prevalence rate of 33-45%, with lifetime prevalence of drug abuse and dependence at 25% to 30%.
Treatment
Treatment for prescription stimulant abuse (with or without a co-occurring mental health disorder) can take several different forms:
- Psychotherapy and behavioral modification is often considered the first line of treatment, given individuals' existing predisposition for prescription medication abuse. Psychotherapeutic or behavioral approaches may include:
- Cognitive-Behavioral Therapy (CBT).
- Motivational Interviewing.
- 12-Step or other support groups.
- Contingency management.
- Alternative approaches such as:
- Sometimes, alternative medications to stimulants may be used, such as SSRI's or other antidepressants.
- Inpatient or outpatient substance abuse programs can be helpful if you have an addiction and need structured support.
In the case of ADHD, instead of using stimulants to enhance attention and concentration, methods like meditation and neurofeedback are holistic alternatives to prescription or illicit drugs. They teach individuals to self-regulate their attention on their own - instead of relying on external agents (i.e., medication) with side effects - which can create long-term changes in neural networks in the brain.
Finding Treatment
If you are considering treatment, here are a few options:
- Use the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment finder to locate inpatient and outpatient treatment centers in your area.
- Call 1-888-993-3112Who Answers? to learn about inpatient rehab centers in your area.
- Contact your insurance company.
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