Filling Prescriptions Before It’s Time

Methylphenidate prescriptions for ADHD may overlap and contribute to stimulant drug abuse

August 20, 2012 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) One of the more difficult forms of drug abuse to control among teens is prescription drug abuse. Prescription drugs, like stimulants prescribed for attention deficit hyperactivity disorder, can be abused for recreational purposes. 

Attention deficit hyperactivity disorder (ADHD) is commonly treated with methylphenidate (brand names Concerta and Ritalin). Methylphenidate is also popular among substance abusers who use the drug for recreation only.

A recent study has found that an overlap in prescriptions for children who legitimately need ADHD drugs might be one avenue to reduce the needless availability.

"Only renew Rx when needed."

The study, led by Chuan-Yu, PhD, of the Institute of Public Health at National Yang-Ming University in Taiwan, wanted to find out the extent to which prescriptions for a stimulant used to treat ADHD might overlap.

This means a family filled a prescription for the medication before they needed it, which is a concern because the medication can also be misused by other adolescents.

"A series of observational studies has indicated a sharp rise in recent decades in the use of psychotropic drugs in the pediatric population," the authors wrote. "Gradually health professionals and the public have raised concerns regarding prescription safety in the younger population."

The study involved 3,081 children, aged 17 or younger, diagnosed with ADHD in Taiwan during 2002.

The researchers pulled pharmacy claims from 1999 to 2002 from the country's National Insurance Program and looked at the overlapping days across new, renewed or refilled prescriptions for methylphenidate.

The researchers found that about 3 to 4 percent of the children newly diagnosed with ADHD had an overlap in prescriptions. This means they filled a prescription before their previous one was ready for a renewal or refill.

Children who lived in rural areas were more than twice as likely to have overlap. Kids who had changed from one prescribing doctor to another at any point were three times more likely to have overlap in their prescriptions.

The likelihood for overlap was also more than three times greater if the doctor ordering the prescription was over age 46. Children who had more than one health or mental health condition were also more likely to have overlapping days of the prescription.

The prevalence of ADHD, which researchers estimate affects about 5.3 percent of the world's population, means that a high number of prescriptions for stimulants such as methylphenidate are also issued for treatment of ADHD.

"At the same time, stimulants gradually have become one of the medication categories that warrants most attention because of its high potential for abuse and wide availability through the illegal drug trade," the authors wrote.

"In an effort to improve the quality and safety of prescription of controlled substances in younger populations, interventions or policies should be devised to target both the service providers and the patients," they wrote.

The study was published August 15 in the journal Psychiatric Services. The research was funded by the National Health Research Institutes and a grant from the Taiwan Ministry of Education's Aim for the Top University Plan. The authors reported no conflicts of interest.

Reviewed by: 
Review Date: 
August 17, 2012
Last Updated:
August 20, 2012