A sweeping national study has found that at some American middle and high schools, as many as one in four students reported misusing prescription stimulant medications designed to treat attention deficit hyperactivity disorder. The findings, published in JAMA Network Open, represent the first large-scale look at nonmedical stimulant use among secondary school students — and researchers are calling it a major wake-up call.
"In some schools there was little to no misuse of stimulants, while in other schools more than 25% of students had used stimulants in nonmedical ways," said lead author Sean Esteban McCabe, director of the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan, as reported by CNN.
The study analyzed data from more than 230,000 teens across 3,284 schools, collected between 2005 and 2020 through Monitoring the Future, a long-running federal survey. Schools where more students had legitimate ADHD prescriptions were roughly 36% more likely to also see higher rates of misuse. But even schools with few prescribed users weren't immune — researchers found that leftover medications from family members and peer sharing from other schools kept the problem alive.
Nonmedical use ranged from taking higher-than-prescribed doses to get high, to combining stimulants with alcohol or other drugs. Students also reported using pills obtained from peers to pull all-night study sessions or finish papers under academic pressure. "We know this is happening in colleges. A major takeaway of the new study is that misuse and sharing of stimulant prescription medications is happening in middle and high schools, not just college," said Dr. Deepa Camenga, associate director of pediatric programs at the Yale Program in Addiction Medicine.
The problem was most pronounced in suburban schools across every region of the United States except the Northeast, and in communities where at least one parent typically held a college degree. Schools with higher proportions of White students and moderate levels of binge drinking also showed elevated rates. On an individual level, students who reported recent marijuana use were significantly more likely to misuse stimulants, suggesting a broader pattern of substance experimentation that schools and parents may need to address more aggressively.
