Medication+Misuse


 * __ Medication Misuse

__** http://www.richardschiropractic.com/blog1/uploaded_images/ritalin-705586.jpg)


 * The issue of medication misuse is a very popular topic of discussion and a current issue within the research world. Many studies have been published with the purpose of determining the frequency and nature of prescription drug misuse. The misuse among the student population is becoming a common phenomenon, especially during exam periods. Other studies have been conducted to assess the prevalence of misuse among the adult population. ** 

Darredeau and colleagues (2007) conducted a study to assess methylphenidate (MPH) misuse. MPH is a stimulant drug commonly prescribed to individuals to alleviate ADHD symptoms such as inattention (Darredeau //et al. //, 2007). Previous research in this area has concluded that the **best predictor of non-prescription MPH use within college/university students was the use of illicit drugs. **
 * __Methylphenidate Misuse Among Adult Population: __**

Thus, the objective for this study was to see if these findings could be generalized to the adult population. The purpose was to identify any patterns and predictors of MPH compliance, diversion and misuse within adults prescribed this medication to alleviate ADHD symptoms (Darredeau //et al //., 2007).

The study included 66 adults from the Montreal area who were currently held a MPH prescription. All participants provided the following information: age of first prescription, current daily dose and the number of days they used MPH as prescribed in past 30 days. As well, additional information was collected regarding compliance, misuse and diversion (Darredeau //et al., // 2007).

 <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">28/29 (97%) gave away medication <span style="font-family: 'Georgia','serif'; font-size: 12pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">5/29 (17%) sold medication <span style="font-family: 'Georgia','serif'; font-size: 12pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">14/29 (14%) did both <span style="font-family: 'Georgia','serif'; font-size: 12pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Methylphenidate diverters were on average younger, received their prescription earlier and were more likely to use illicit substances since receiving prescription, as well as misuse methylphenidate. <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">
 * __<span style="color: black; font-family: 'Georgia','serif'; font-size: 16pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">The general results from the study revealed: __**
 * <span style="color: red; font-family: 'Georgia','serif'; font-size: 13pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Methylphenidate Diversion **<span style="color: red; font-family: 'Georgia','serif'; font-size: 13pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">

<span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">16/19 (84%) oral misuse <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">14/19 (74%) intranasal misuse <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">2/19 (11%) smoking misuse <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">12/13 (92%) of polysubstance users reported misusing MPH orally <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">
 * <span style="color: red; font-family: 'Georgia','serif'; font-size: 13pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Methylphenidate Misuse **<span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">

<span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">ADHD support group members showed significantly better compliance <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Poor compliance associated with illicit substance abuse since MPH onset <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: 'Courier New'; mso-bidi-font-size: 14.0pt; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;">o <span style="font-family: 'Georgia','serif'; font-size: 7pt; mso-bidi-font-family: 'Times New Roman'; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Use of illicit drugs since onset of MPH was best predictor <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">
 * <span style="color: red; font-family: 'Georgia','serif'; font-size: 13pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Methylphenidate Compliance **<span style="color: red; font-family: 'Georgia','serif'; font-size: 13pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">

<span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Results reveal that particular caution should be granted to those individuals who have previously demonstrated comorbid illicit substance use. Historical reports of comorbid substances use distinguish methylphenidate misusers from non-misusers. Furthermore, giving cocaine users access to methylphenidate outside of a supervised setting may not be advisable as they may be at risk of misuse. compliance and the reduced likelihood of misuse and diversion is associated with concurrent involvement in alternative treatments (e.g. ADHD support groups).

To add, diversion was more common among methylphenidate misusers than non-misusers and associated with both a younger age and a younger age of prescription onset. Those who reported never diverting their medication were on average older than typical college students at the time of their first prescription. Among non-diverters with a history of illicit substance use the age of first methylphenidate prescription was older on average that the age of onset for illicit substance use. <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">

<span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">A large study was conducted by Dr. Arria and colleagues (2008) to investigate the nature and frequency of non-medical use of stimulants to treat attention-deficit hyperactivity disorder within a student population. The main focus of the study was to identify overuse & using another individuals medication. Approximately 1200 students (age 17-20) were interviewed about their stimulant use, as well as any polysubstance use (Arria //et al.//, 2008). <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> __<span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">The results from this study revealed: __<span style="font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="font-family: 'Georgia','serif'; font-size: 10pt; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">
 * __<span style="color: blue; font-family: 'Georgia','serif'; font-size: 24pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Non-medical Use of Prescription Stimulants Among University Students: __**<span style="color: blue; font-family: 'Georgia','serif'; font-size: 24pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">

<span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;"> <span style="color: black; font-family: Symbol; font-size: 14pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: EN-CA; msobidifontfamily: Symbol; msobidifontsize: 11.0pt; msobidifontweight: bold; msofareastfontfamily: Symbol; msofareastlanguage: EN-CA; msolist: Ignore;">· <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">45/1208 (4%) held a formal diagnosis of ADHD <span style="color: black; font-family: 'Courier New'; font-size: 14pt; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA; msobidifontsize: 11.0pt; msobidifontweight: bold; msofareastfontfamily: 'Courier New'; msofareastlanguage: EN-CA; msolist: Ignore;">o <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">12/45 (27%) overused medication at least once in lifetime <span style="color: black; font-family: 'Courier New'; font-size: 14pt; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Courier New'; mso-fareast-language: EN-CA; msobidifontsize: 11.0pt; msobidifontweight: bold; msofareastfontfamily: 'Courier New'; msofareastlanguage: EN-CA; msolist: Ignore;">o <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">7/45 (16%) have used someone else’s medication <span style="color: black; font-family: Symbol; font-size: 14pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: EN-CA; msobidifontfamily: Symbol; msobidifontsize: 11.0pt; msobidifontweight: bold; msofareastfontfamily: Symbol; msofareastlanguage: EN-CA; msolist: Ignore;">· <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">218/1208 (18%) engaged in non-prescription drug use <span style="color: black; font-family: Symbol; font-size: 14pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: EN-CA; msobidifontfamily: Symbol; msobidifontsize: 11.0pt; msobidifontweight: bold; msofareastfontfamily: Symbol; msofareastlanguage: EN-CA; msolist: Ignore;">· <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Non-prescription drug use was most associated with studying <span style="color: black; font-family: Symbol; font-size: 14pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: EN-CA; msobidifontfamily: Symbol; msobidifontsize: 11.0pt; msobidifontweight: bold; msofareastfontfamily: Symbol; msofareastlanguage: EN-CA; msolist: Ignore;">· <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Some non-prescription drug use was associated with partying and getting high (not very common) <span style="color: black; font-family: Symbol; font-size: 14pt; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: Symbol; mso-fareast-language: EN-CA; msobidifontfamily: Symbol; msobidifontsize: 11.0pt; msobidifontweight: bold; msofareastfontfamily: Symbol; msofareastlanguage: EN-CA; msolist: Ignore;">· <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">Non-prescription drug use was also associated with alcohol and marijuana dependence <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">

<span style="font-family: Georgia,serif; font-size: 120%;">​ <span style="color: black; font-family: 'Georgia','serif'; font-size: 14pt; mso-bidi-font-family: Arial; mso-bidi-font-size: 11.0pt; mso-bidi-font-weight: bold; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">As previous studies have revealed the best predictor of medication misuse is the use of illicit substances. Specifically amongst the student population the use/dependence of alcohol and marijuana can be the best predictors of MPH misuse. Students often misuse MPH as a study aid; however, a few have admitted to using MPH as a party drug, since it is a stimulant (like cocaine).

<span style="font-family: 'Georgia','serif'; font-size: 10pt; line-height: 115%; mso-bidi-font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-CA;">

<span style="font-family: 'Georgia','serif';">