Taken correctly, prescription drugs used to treat attention-deficit/hyperactivity disorder (ADHD) can help teens and young adults navigate their condition, but a new study finds many are dying from overdosing on these medications.
In 2019, benzodiazepines like Xanax and stimulants like Adderall accounted for more than 700 and 900 overdose deaths, respectively, in the United States, according to the U.S. Centers for Disease Control and Prevention.
"In recent years, there has been considerable attention devoted to risks of addiction associated with diverted or illicitly obtained benzodiazepines and stimulants," said senior researcher Dr. Mark Olfson. He is a professor of psychiatry, medicine and law at Columbia University Irving Medical Center in New York City.
"The new study serves as a reminder that prescription benzodiazepines and stimulants also pose overdose risks to the patients who are prescribed them," Olfson said.
Sadly, many of the overdose deaths among teens and young adults who had prescriptions for these drugs are intentional suicides, he added.
The upshot of the finding? Doctors and parents need to be careful about prescribing and having their kids take these drugs.
"Prior to prescribing benzodiazepines or stimulants to young people, physicians should assess the patient's self-injury risk and consider other treatment options for youth who have substantial risk," Olfson advised.
"Parents also have an important role in preventing suicidal behavior in their adolescent and young adult children, especially if the young person is going through a stressful period," he added. "This can involve parents being attentive to changes in the youth's behavior, listening to them, being supportive rather than intrusive, taking suicidal threats seriously, and helping them to locate professional help if necessary."
For the study, Olfson and his colleagues collected data on privately insured youths aged 15 to 24 who were seen in emergency rooms for overdosing on benzodiazepines or stimulants from 2016 through 2018. The investigators then identified who among these patients had a doctor's prescription for these drugs.
The researchers found that 29% of the overdose deaths from benzodiazepines were among youths who had a doctor's prescription for the drug in the month before overdosing, as did 25% of those who died from an overdose of a stimulant.
Among those who overdosed on benzodiazepines, 42% had been given a prescription in the last six months, as did 39% of those who died from an overdose of a stimulant, the findings showed.
The researchers also found that those who intentionally overdosed on benzodiazepines and stimulants were more likely to have recent prescriptions for these drugs than those whose overdose was accidental.
The findings were published online March 2 in the journal Pediatrics.
Pat Aussem is vice president for consumer clinical content development at the Partnership to End Addiction in New York City. She said, "This has been the deadliest year on record, as we've experienced over 100,000 overdose deaths in our country - the highest it's ever been. Teens and young adults haven't been spared. Overdose deaths for 15- to 24-year-olds increased between 2019 and 2020 by almost 50%, and the rate of drug overdose deaths has been steadily increasing."
Having mental health problems is one of the key risk factors for an overdose in young people, Aussem said.
"Feelings of loneliness, isolation and anxiety fueled by the pandemic have likely contributed to a sense of hopelessness for many," she added. "Consuming alcohol and other drugs, as well as misusing prescription and over-the-counter medications, can be a way to cope or self-medicate."
Doctors need to educate parents and patients on not only what the medication is used for and instructions for taking it, but also the misuse and overdose potential, as well as the risks of combining it with other substances like alcohol or opioids, Aussem advised.
"Counseling in addition to medication may help to encourage healthier ways of thinking and behaviors. Taking the time to truly understand how the patient is doing in follow-up visits is critical, as well," she said.
Also, the United States continues to be flooded with counterfeit pills that look like Xanax and Adderall, in addition to pain pills like Vicodin and Percocet, Aussem said.
"The U.S. Drug Enforcement Administration reports that two out of every five pills they have seized contain a potentially lethal dose of fentanyl," she said.
"Health care providers can educate young people on the risks of getting pills from a friend or off the street instead of or in addition to a legitimate pharmacy," Aussem added.
"It's important for parents and other caregivers to monitor symptoms and report any significant changes to the prescriber," she stressed.
For more on mental health and drugs, head to the Partnership to End Addiction.
SOURCES: Mark Olfson, MD, MPH, professor, psychiatry, medicine and law, Columbia University Irving Medical Center, New York City; Pat Aussem, LPC, vice president, consumer clinical content development, Partnership to End Addiction, New York City; Pediatrics, March 2, 2022, online