More than half of party drug users take ADHD medication without a prescription, novel study finds

Each year, the National Drug and Alcohol Research Centre at the University of Up-to-date South Wales in Sydney surveys hundreds of regular drug users in Australia to find out understand trends in the apply of psychoactive substances throughout the country.

Today we published Report 2024in which 740 people from Australian capital cities who regularly apply ecstasy or other illegal stimulants were surveyed.

While the primary focus of our research is illicit drugs and markets, we also monitor trends in the over-the-counter apply of pharmaceutical stimulants, such as ADHD medications.

This year, 54% of people we spoke to had used pharmaceutical stimulants in the past six months when they were not prescribed them, the highest percentage we have seen since we started asking people about this type of drug apply in 2007.

What are pharmaceutical stimulants?

Pharmaceutical stimulants include the drug methylphenidate (trade names Concerta and Ritalin), as well as 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 during the day.

These drugs work in different ways depending on the type. However, they treat ADHD by increasing levels of critical chemicals (neurotransmitters) in the brain, including dopamine and norepinephrine.

However, as with many pharmaceutical substances, people also apply these stimulants when they are not prescribed. There is range of reasons someone may choose to apply these medications without a prescription.

Tests University students have shown that these substances are often used to enhance alertness, concentration and memory. Studies conducted among wider populations have shown that they can also be used experimentor to get high.

All over the world, including in Australiawere significant increases in the prescription of ADHD medications in recent years, likely due to increased identification and diagnosis of ADHD. As prescriptions enhance, the risk 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 in recent years (52% in 2022 and 47% in 2023).

Frequency of apply remained relatively low. Respondents typically reported using non-prescribed pharmaceutical stimulants monthly or less frequently.

In this study, participants most frequently reported using dexamfetamine, followed by methylphenidate and lisdexamfetamine. Most (79%) said it was “uncomplicated” or “very uncomplicated” to obtain these substances, similar to 2022 and 2023.

Of course, given that our study focused on regular drug users, the over-the-counter apply of pharmaceutical stimulants does not reflect their apply in the general population.

In 2022–2023 National Household Drug Strategy Surveygeneral population survey of Australians aged 14 years and over, 2.1% of the population (equivalent to about 400,000 people) reported using pharmaceutical stimulants for non-medical purposes in the previous year. This was similar to 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 enhance activity sympathetic nervous systemwhich controls various functions in the body during times of stress. This in turn increases heart rate, blood pressure and breathing rate.

These changes may cause acute cardiac events (such as arrhythmias or irregular heartbeats) and, with repeated apply 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 appear to be 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 typical prescribed dose. The most common symptoms were hypertension (high blood pressure), tachycardia (brisk heart rate), and agitation.

In our study, people who took pharmaceutical stimulants most often took them in pill form, taking a dose slightly higher than that typically prescribed.

However, about one in four people reported snorting as a route of administration. This can result in physical harm, such as damage to the sinuses, and may enhance the potential risks of the drug because it can come into effect faster in the body.

Some pharmaceutical stimulants are “long-acting,” released into the body throughout the day. So there may also be a risk of premature re-dosing if people unknowingly apply these preparations more than once a day. That is, if people do not experience desired effects They may take another dose at the expected time, which may enhance the risk of side effects.

Finally, non-prescribed stimulants can have negative effects when taken with other medications. This can include a “masking effect” (for example, a stimulant may mask the symptoms alcohol poisoning).

So what should we do?

Pharmaceutical stimulants are critical medications in the treatment of ADHD and narcolepsy, and when used as directed, they are relatively secure. However, there are additional risks when people apply these substances without a prescription.

Harm reduction campaigns that highlight these risks, including differences between formulations, can be useful. Ongoing monitoring, alongside more in-depth investigation of associated harms, is also key.

For free and confidential advice on alcohol and other drugs, call the national alcohol and drug helpline on 1800 250 015.