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Prescription Stimulant Medical and Nonmedical Use Among US Secondary School Students, 2005 to 2020

Developed by Indonesia ITTC

Published on 4/18/2023

IMPORTANCE



KEPENTINGAN



Recent information on the prevalence of prescription stimulant therapy for attention-deficit/hyperactivity disorder (ADHD) and nonmedical use of prescription stimulants (NUPS) at the school-level among US secondary school students is limited.



Informasi terkini mengenai prevalensi terapi stimulan resep pada gangguan deficit perhatian/hiperaktivitas (attention deficit/hyperactivity disorder; ADHD) dan penggunaan nonmedis stimulan resep (nonmedical use of prescription stimulants; NUPS) di tingkat sekolah pada siswa-siswa sekolah menengah di Amerika Serikat masih terbatas.



 



OBJECTIVE



TUJUAN



To investigate the school-level prevalence of and association between stimulant therapy for ADHD and NUPS among US secondary school students.



Meneliti prevalensi tingkat sekolah dan hubungan antara terapi stimulan bagi ADHD dan NUPS pada siswa-siswa sekolah menengah di Amerika Serikat.



 



DESIGN, SETTING, AND PARTICIPANTS



DISAIN, SETTING, DAN PARTISIPAN



This cross-sectional study used survey data collected between 2005 and 2020 as part of the Monitoring the Future study (data collected annually via self-administered survey in schools from independent cohorts). Participants were from a nationally representative sample of 3284 US secondary schools. The mean (SD) response rates were 89.5% (1.3%) for 8th-grade students, 87.4% (1.1%) for 10th-grade students, and 81.5% (1.8%) for 12th-grade students. Statistical analysis was performed from July to September 2022.



Penelitian potong-lintang ini menggunakan data survei yang dikumpulkan antara tahun 2005 dan 2020 sebagai bagian dari studi “Monitoring The Future” (data dikumpulkan setiap tahun melalui survei mandiri di sekolah-sekolah dari kohort independen). Partisipan berasal dari sampel perwakilan nasional dari 3.284 sekolah menengah AS. Tingkat respons rata-rata (SD) adalah 89,5% (1,3%) untuk siswa kelas 8, 87,4% (1,1%) untuk siswa kelas 10, dan 81,5% (1,8%) untuk siswa kelas 12. Analisa statistik dilakukan dari bulan Juli sampai dengan September 2022.



 



MAIN OUTCOME AND MEASURE



HASIL DAN KELUARAN UTAMA



Past-year NUPS.



NUPS tahun lalu.



 



RESULTS



HASIL PENELITIAN



The 3284 schools contained 231 141 US 8th-, 10th-, and 12th-grade students (111 864 [50.8%, weighted] female; 27 234 [11.8%, weighted] Black, 37 400 [16.2%, weighted] Hispanic, 122 661 [53.1%, weighted] White, 43 846 [19.0%, weighted] other race and ethnicity). Across US secondary schools, the past-year prevalence of NUPS ranged from 0% to more than 25%. The adjusted odds of an individual engaging in past-year NUPS were higher at secondary schools with higher proportions of students who reported stimulant therapy for ADHD, after controlling for other individual-level and school-level covariates. Students attending schools with the highest rates of prescription stimulant therapy for ADHD had approximately 36% increased odds of past-year NUPS compared with students attending schools with no medical use of prescription stimulants (adjusted odds ratio, 1.36; 95% CI, 1.20-1.55). Other significant school-level risk factors included schools in more recent cohorts (2015-2020), schools with higher proportions of parents with higher levels of education, schools located in non-Northeastern regions, schools located in suburban areas, schools with higher proportion of White students, and schools with medium levels of binge drinking.



3,284 sekolah terdiri dari 231,141 siswa kelas 8, 10, dan 12 AS (111 864 [50,8%, weighted] perempuan; 27 234 [11,8%, weighted] kulit hitam, 37 400 [16,2%, weighted] hispanik, 122 661 [53,1%, weighted] kulit putih, 43 846 [19,0%, weighted] ras dan etnis lain). Di seluruh sekolah menengah AS, prevalensi NUPS tahun lalu berkisar Antara 0% sampan lebih dari 25%. Adjusted odds dari individu yang terlibat NUPS tahun lalu lebih tinggi di sekolah menengah dengan proporsi lebih tinggi pada siswa yang melaporkan penggunaan terapi stimulant untuk ADHD, setelah mengendalikan kovariat tingkat individu dan tingkat sekolah lainnya. Siswa yang menghadiri sekolah dengan angka terapi stimulan resep untuk ADHD tertinggi memiliki sekitar 36% peningkatan peluang NUPS dibandingkan dengan siswa yang menghadiri sekilah tanpa penggunaan medis stimulan resep (adjusted odds ratio, 1.36; 95% CI, 1.20-1.55). Faktor risiko tingkat sekolah yang signifikan lainnya termasuk sekolah-sekolah dalam kohort terbaru (2015 – 2020), sekolah-sekolah dengan proporsi tinggi orangtua yang memiliki tingkat pendidikan tinggi, sekolah-sekolah yang terletak di wilayah non-Timur Laut, sekolah-sekolah yang terletak di daerah pinggiran kota, sekolah-sekolah dengan proporsi tinggi siswa kulit putih, dan sekolah-sekolah dengan pesta minuman keras tingkat sedang.



 



CONCLUSIONS AND RELEVANCE



KESIMPULAN DAN RELEVANSI



In this cross-sectional study of US secondary schools, the prevalence of past-year NUPS varied widely, highlighting the need for schools to assess their own students rather than relying solely on regional, state, or national results. The study offered new evidence of an association between a greater proportion of the student body that uses stimulant therapy and a greater risk for NUPS in schools. The association between greater school-level stimulant therapy for ADHD and other school-level risk factors suggests valuable targets for monitoring, risk-reduction strategies, and preventive efforts to reduce NUPS.



Pada studi potong-lintang sekolah menengah AS ini, prevalensi NUPS tahun lalu sangat bervariasi, menyoroti kebutuhan bagi sekolah untuk menilai siswa-siswa mereka daripada hanya mengandalkan hasil regional, negara bagian, atau nasional. Studi ini memberikan bukti baru akan adanya asosiasi antara proporsi tinggi pada siswa yang menggunakan terapi stimulant dan risiko tinggi bagi NUPS di sekolah. Asosiasi antara tingginya terapi stimulan bagi ADHD di tingkat sekolah dan factor risiko tingkat sekolah lainnya menunjukkan target-target penting bagi monitoring, strategi pengurangan risiko, dan upaya pencegahan untuk mengurangi NUPS.


https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2803941

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The International Consortium of Universities for Drug Demand Reduction (ICUDDR) supports the rapid improvement in competencies and skills among current and future generations of addiction professionals to meet the increasing demand for prevention, treatment and public health services. Toward this end, the ICUDDR facilitates networking among universities to promote high quality education and training in the field of addiction prevention, treatment and public health interventions. It also pursues related applied addictions research, outreach and advocacy.

ICUDDR is funded by the Bureau of International Narcotics and Law Enforcement Affairs (INL). INL works to keep Americans safe at home by countering international crime, illegal drugs, and instability abroad. INL helps countries deliver justice and fairness by strengthening their police, courts, and corrections systems. These efforts reduce the amount of crime and illegal drugs reaching U.S. shores.