About one in 10 college students used an attention-deficit hyperactivity disorder (ADHD) prescription stimulant for nonmedical use in 2013, according to a study(www.sciencedirect.com) published in the July issue of Addictive Behaviors.
To help spur education about and additional research to examine the growing issue of ADHD medication misuse, abuse and diversion on college campuses across America, the AAFP has joined the Coalition to Prevent ADHD Medication Misuse(www.cpamm.org) (CPAMM), which launched Aug. 28.
This collection of medical, mental health, higher education, student and pharmaceutical organizations plans to initially focus its efforts on college students, but might expand its focus later, according to a recent news release(www.cpamm.org).
The other members of CPAMM are Children and Adults with ADHD, the Jed Foundation, NASPA (formerly the National Association of Student Personnel Administrators) -- Student Affairs Administrators in Higher Education, the BACCHUS Initiatives of NASPA and Shire. CPAMM also has enlisted student advisers to collaborate on developing the coalition's strategies and messaging.
This year, CPAMM will conduct market research to examine the perceptions and attitudes of college students about ADHD prescription misuse, abuse and diversion to help create educational campaigns to prevent nonmedical use.
- In response to the growing problem of misuse of attention-deficit hyperactivity disorder (ADHD) medications, the AAFP has joined the Coalition to Prevent ADHD Medication Misuse.
- This year, the coalition will conduct market research to examine the perceptions and attitudes of college students regarding ADHD prescription misuse, abuse and diversion to help create educational campaigns designed to prevent nonmedical use.
- Throughout 2015, the coalition plans to survey medical professionals to identify primary care strategies to help reduce ADHD medication misuse, abuse and diversion.
The AAFP National Research Network (NRN) is currently working with CPAMM on a project to explore the role of primary care health professionals and current practices in patient education, patient-provider communications, and prevention of misuse among teens and young adults.
"The project will survey AAFP members, general pediatricians and college health professionals regarding their perceptions, current practices, gaps, needs, etc., in preventing medication misuse in young adults with and without ADHD," said NRN Director of Evaluation Natalia Loskutova, M.D., Ph.D. Detailed results of the project will be available for dissemination in fall 2015.
Then, throughout 2015, CPAMM plans to survey medical professionals to identify primary care strategies to help reduce ADHD medication misuse, abuse and diversion. In addition, the coalition will conduct focus groups among college students and administrators to try to gain a better understanding of how the college environment affects the issue.
With the results of this research, CPAMM intends to develop peer-to-peer interventions for use by college students to help prevent the nonmedical use of ADHD stimulant medications. Also, the coalition will evaluate potential partnerships with other organizations, associations and programs that reach college students.
Reaching College Students About ADHD Misuse
Julie Wood, M.D., AAFP vice president of health of the public and interprofessional activities, said CPAMM is focusing on key subgroups in the college population that are involved in ADHD medication misuse. These groups are students who are:
- substance abusers looking for some type of altered sensorium,
- overachievers trying to do better in school, and
- procrastinators who postponed studying but, belatedly, try to stay awake for long periods to do so.
There currently is a bias on campus against students with ADHD who are legitimately taking medication for the condition, with their peers misperceiving that these students have an advantage in studying, she said. But research contradicts that view.
"Research has shown that ADHD medication doesn't actually improve cognitive function," Wood said. "It may indeed keep (students) awake longer, but they don't actually perform better."
Family Physicians' Role in ADHD Education
CPAMM plans to reach out to family physicians to encourage them to have conversations with college students whether or not those students have been prescribed ADHD medication.
For students who have never used ADHD medication, Wood suggested talking with them before they leave for school the first time. She recommended telling students, "Don't take these medications if you don't need them. This is a safety issue, and they really aren't going to help you."
For students who are prescribed ADHD medication, make sure to tell them not to be embarrassed to take it or feel obliged to share their medication, Wood said. Tell these patients, "You don't have a competitive edge. You are just taking this to treat a condition that you have been diagnosed with and you should continue to take your medications as prescribed. But you should not share your medication."
College students don't always realize that taking medication that is not prescribed for them is the same as using any other illegal substance, she added.
Wood said the ADHD misuse issue isn't something that is on every family physician's radar when meeting with an adolescent who is leaving for college. But it should be.
Family physicians care for multiple groups of patients to whom this message could be delivered, Wood noted. Whether it's a teenager who has received care from the same family physician throughout his or her lifetime and is now leaving for college or a teen who for years had seen a pediatrician but now is transitioning to a family physician practice -- both could benefit from this advice. Also, as campus physicians, many family doctors care for college students, she added.
"That is one of the reasons CPAMM sought out the AAFP," she said. "We are in many different situations where we see this demographic."
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