Each 12 months, the National Drug and Alcohol Research Centre on the University of New South Wales in Sydney surveys a whole bunch of regular drug users in Australia to seek out out understand trends within the use of psychoactive substances throughout the country.
Today we published Report 2024during which 740 people from Australian capital cities who usually use ecstasy or other illegal stimulants were surveyed.
While the first focus of our research is illicit drugs and markets, we also monitor trends within the over-the-counter use of pharmaceutical stimulants, resembling ADHD medications.
This 12 months, 54% of people we spoke to had used pharmaceutical stimulants previously six months after they weren’t prescribed them, the best percentage now we have seen since we began asking people about this kind of drug use in 2007.
What are pharmaceutical stimulants?
Pharmaceutical stimulants include the drug methylphenidate (trade names Concerta and Ritalin), in addition to dexamfetamine and lisdexamfetamine (Vyvanse).
These medications are commonly prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsya chronic neurological disorder that causes excessive sleepiness and sudden sleep attacks through the day.
These drugs work in other ways depending on the kind. However, they treat ADHD by increasing levels of necessary chemicals (neurotransmitters) within the brain, including dopamine and norepinephrine.
However, as with many pharmaceutical substances, people also use these stimulants after they should not prescribed. There is range of reasons someone may select to make use of these medications without a prescription.
Tests University students have shown that these substances are sometimes used to extend alertness, concentration and memory. Studies conducted amongst wider populations have shown that they may also be used experimentor to get high.
All over the world, including in Australiawere significant increases within the prescription of ADHD medications lately, likely on account of increased identification and diagnosis of ADHD. As prescriptions increase, the danger of these substances being diverted to illegal drug markets increases.
What we found
The percentage of people using stimulants without a prescription has tripled since monitoring began – from 17% of respondents in 2007 to 54% in 2024. It has remained at a similar level lately (52% in 2022 and 47% in 2023).
Frequency of use remained relatively low. Respondents typically reported using non-prescribed pharmaceutical stimulants monthly or less continuously.
In this study, participants most continuously reported using dexamfetamine, followed by methylphenidate and lisdexamfetamine. Most (79%) said it was “easy” or “very easy” to acquire these substances, just like 2022 and 2023.
Of course, provided that our study focused on regular drug users, the over-the-counter use of pharmaceutical stimulants doesn’t reflect their use in the final population.
In 2022–2023 National Household Drug Strategy Surveygeneral population survey of Australians aged 14 years and over, 2.1% of the population (comparable to about 400,000 people) reported using pharmaceutical stimulants for non-medical purposes within the previous 12 months. This was just like the proportion of people reporting using ecstasy.
What are the risks?
Pharmaceutical stimulants are considered to have a relatively secure toxicity profile. However, like all stimulants, these substances increase activity sympathetic nervous systemwhich controls various functions within the body during times of stress. This in turn increases heart rate, blood pressure and respiration rate.
These changes may cause acute cardiac events (resembling arrhythmias or irregular heartbeats) and, with repeated use of high doses, chronic changes in heart work.
Recent Australian research has documented increase in poisoning involving these substances, although a significant proportion of these seem like intentional poisonings. In the poisonings that involved only pharmaceutical stimulants, the drugs were mostly taken orally, with the median dose being more than ten times the everyday prescribed dose. The commonest symptoms were hypertension (hypertension), tachycardia (fast heart rate), and agitation.
In our study, individuals who took pharmaceutical stimulants most frequently took them in pill form, taking a dose barely higher than that typically prescribed.
However, about one in 4 people reported snorting as a route of administration. This can lead to physical harm, resembling damage to the sinuses, and will increase the potential risks of the drug because it will possibly come into effect faster within the body.
Some pharmaceutical stimulants are “long-acting,” released into the body throughout the day. So there may additionally be a risk of premature re-dosing if people unknowingly use these preparations more than once a day. That is, if people don’t experience desired effects They may take one other dose on the expected time, which can increase the danger of uncomfortable side effects.
Finally, non-prescribed stimulants can have negative effects when taken with other medications. This can include a “masking effect” (for instance, a stimulant may mask the symptoms alcohol poisoning).
So what should we do?
Pharmaceutical stimulants are necessary medications within the treatment of ADHD and narcolepsy, and when used as directed, they’re relatively secure. However, there are additional risks when people use these substances without a prescription.
Harm reduction campaigns that highlight these risks, including differences between formulations, will be useful. Ongoing monitoring, alongside more in-depth investigation of associated harms, can also be key.