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Læknablaðið - 01.12.2017, Side 21

Læknablaðið - 01.12.2017, Side 21
LÆKNAblaðið 2017/103 541 R A N N S Ó K N ENGLISH SUMMARY Introduction: ADHD is a neurodevelopmental disorder that usually surfaces before seven years of age. Stimulants are commonly used medications for the treatment of this disorder in Iceland, but they carry with them a significant risk of both abuse and diversion – i.e. when it is used by an individual other than it was prescribed for by a physician. The purpose of this study was to estimate the prevalence of diversion amongst Icelandic adolescents. Material and methods: This study is based on data collected in the Icelandic portion of the European School Survey Project on Alcohol and Other Drugs (ESPAD) focused on the drug and alcohol use of 10th graders in Europe. Results: Of the 2,306 students that participated in the study 91% (2,098) claimed they had never been prescribed stimulant medications while 9% (208) claimed they had. Boys were twice as likely to get a stimulant prescription compared to girls. Almost 18% of the participants that had been prescribed simulants said they had at some point in time diverted their stimulant medication. Conclusion: The diversion of stimulants by 10th graders in Iceland is quite common compared to studies from other countries where the prevalence is closer to 5-10%. These findings demonstrate the importance of carefully overseeing stimulant use of adolescents, for the benefit of both those who divert as well as those diverted to. The diversion of prescribed stimulant medications of 10th graders in Iceland Gísli Kristófersson1, Ársæll Arnarsson2, Guðmundur Heimisson3, Dagbjörg Sigurðardóttir4 1School of Health Sciences, Akureyri, 2University of Iceland, Reykjavík, 3University of Akureyri, 4National University Hospital. Key words: diversion, stimulants, ADHD, adolescents. Correspondence: Gísli Konráðsson, gislik@unak.is Heimildir 1. Feldman HM, Reiff MI. Attention deficit–hyperactivity disorder in children and adolescents. N Engl J Med 2014; 370: 838-46. 2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®) American Psychiatric Pub, Arlington 2013. 3. Jóhannsson M, Einarsson ÓB, Guðmundsson LS, Bárðarson L. ADHD og misnotkun lyfja I. Læknablaðið 2013; 99: 537. 4. Chang Z, Lichtenstein P, Halldner L, D'Onofrio B, Serlachius E, Fazel S, et al. Stimulant ADHD medication and risk for substance abuse. J Child Psychol Psychiatr 2014; 55: 878-85. 5. Abikoff H, Hechtman L, Klein RG, Weiss G, Fleiss K, Etcovitch J, et al. Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. J Am Acad Child Adolesc Psychiatr 2004; 43: 802-11. 6. hagstofan.is - nóvember 2017. 7. Bachmann CJ, Wijlaars LP, Kalverdijk LJ, Burcu M, Glaeske G, Schuiling-Veninga CC, et al. Trends in ADHD medication use in children and adolescents in five western countries, 2005-2012. Eur Neuropsychopharmacol 2017; 27: 484-93. 8. Zoëga H, Valdimarsdóttir UA, Hernández-Díaz S. Age, academic performance, and stimulant prescribing for ADHD: a nationwide cohort study. Pediatrics 2012; 130: 1012-8. 9. Guðmundsdóttir BG. Misnotkun örvandi lyfseðilsskyldra lyfja og ADHD-einkenni meðal háskólanema á Íslandi. Læknablaðið 2016; 102: Fylgirit 89 vegna VI Vísindaþings Geðlæknafélag Íslands. 10. Bjarnadottir GD, Magnusson A, Rafnar BO, Sigurdsson E, Steingrimsson S, Johannsson M, et al. Intravenous Use of Prescription Psychostimulants; A Comparison of the Pattern and Subjective Experience between Different Methylphenidate Preparations, Amphetamine and Cocaine. Eur Addict Res 2016; 22: 259-67. 11. Bjarnadottir GD, Haraldsson HM, Rafnar BO, Sigurdsson E, Steingrimsson S, Johannsson M, et al. Prevalent intra- venous abuse of methylphenidate among treatment-seek- ing patients with substance abuse disorders: a descriptive population-based study. J Addict Med 2015; 9: 188. 12. Epstein-Ngo QM, McCabe SE, Veliz PT, Stoddard SA, Austic EA, Boyd CJ. Diversion of ADHD stimulants and victimization among adolescents. J Pediatr Psychol 2016; 41: 786-98. 13. Cassidy TA, Varughese S, Russo L, Budman SH, Eaton TA, Butler SF. Nonmedical Use and Diversion of ADHD Stimulants Among U.S. Adults Ages 18-49: A National Internet Survey. J Atten Disord 2015; 19: 630-40. 14. Wilens T, Gignac M, Swezey A, Monuteaux MC, Biederman J. Characteristics of adolescents and young adults with ADHD who divert or misuse their prescribed medications. J Am Acad Child Adolesc Psychiatry 2006; 45: 408-14. 15. Cottler LB, Striley CW, Lasopa SO. Assessing prescription stimulant use, misuse, and diversion among youth 10-18 years of age. Curr Opin Psychiatry 2013; 26: 511-9. 16. Morton WA, Stockton GG. Methylphenidate Abuse and Psychiatric Side Effects. Prim Care Companion J Clin Psychiatry 2000; 2: 159. 17. lyfjastofnun.is - maí 2017. 18. Garnier LM, Arria AM, Caldeira KM, Vincent KB, O’Grady KE, Wish ED. Sharing and selling of prescription med- ications in a college student sample. J Clin Psychiatr 2010; 71: 262-9. 19. McCabe SE, West BT, Teter CJ, Ross-Durow P, Young A, Boyd CJ. Characteristics associated with the diversion of controlled medications among adolescents. Drug Alcohol Depend 2011; 118: 452-8. 20. Stadler C, Feifel J, Rohrmann S, Vermeiren R, Poustka F. Peer-victimization and mental health problems in ado- lescents: are parental and school support protective? Child Psychiatry Hum Dev 2010; 41: 371-86. 21. Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, Kokkevi A, et al. The 2011 ESPAD report – substance use among students in 36 european countries. The Swedish Council for Information on Alcohol and Other Drugs, Stokkhólmi 2012. 22. McCabe SE, Teter CJ, Boyd CJ. The use, misuse and diversion of prescription stimulants among middle and high school students. Subst Use Misuse 2004; 39: 1095-16. 23. Wilens TE, Adler LA, Adams J, Sgambati S, Rotrosen J, Sawtelle R, et al. Misuse and diversion of stimulants prescribed for ADHD: A systematic review of the literat- ure. J Am Acad Child Adolesc Psychiatry 2008; 47: 21-31. 24. Lasopa SO, Striley CW, Cottler LB. Diversion of prescription stimulant drugs among 10-18-year-olds. Curr Opin Psychiatry 2015; 28: 292-8. 25. Ramtekkar UP, Reiersen AM, Todorov AA, Todd RD. Sex and age differences in attention-deficit/hyperactivity dis- order symptoms and diagnoses: implications for DSM-V and ICD-11. J Am Acad Child Adolesc Psychiatry 2010; 49: 217-28. e3.

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