Significant Increase in ER Visits Involving ADHD Medications

APRIL 17, 2013
Jeannette Y. Wick, RPh, MBA, FASCP
The increase in visits to emergency departments was largely driven by abuse of ADHD drugs among adults and nonmedical use of the drugs.

Approximately two-thirds of children with ADHD between the ages of 4 and 17 took medication to treat ADHD in 2007. In children (as well as adults), the first-line treatment for ADHD are stimulants, and adverse events associated with these medications, such as nervousness, insomnia, and dizziness, are common and usually manageable. Cardiovascular or psychiatric problems can be more serious and may send patients to the nearest emergency department. Since prescription stimulants are often abused, ADHD patients are not the only ones seeking emergency treatment pursuant to stimulant use.
The number of emergency department visits involving ADHD stimulant medications more than doubled between 2005 and 2010, according to a report released by the Substance Abuse and Mental Health Services Administration (SAMHSA) on January 24, 2013. In 2005, there were 13,370 emergency room visits nationally involving ADHD stimulant medication; in 2010, there were 31,244 such visits.
This increase in emergency department visits was largely driven by an increase in visits by patients older than 18 years, leading researchers to suggest that misuse and diversion among adults should be targeted as a preventive measure. In addition, the number of emergency room visits involving nonmedical use of ADHD drugs increased from 5,212 visits in 2005 to 15,585 visits in 2010. Overall in 2010, 50% of these emergency room visits concerned nonmedical uses of prescribed stimulants; 29% concerned adverse reactions; and the remaining 21% fell into the “other” category, which included suicide attempts and accidental ingestion.

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.