Characterizing Prescription Stimulant Use in Adults with Overdose Involving Psychostimulants

Main Article Content

Elizabeth Bolt, MD Wen-Jan Tuan, DHA, MS, MPH

Abstract

The objective of this brief report is to characterize the use of prescription stimulants in adults with psychostimulant-related overdose in the United States amid the rising prevalence of stimulant prescriptions and stimulant-related overdose deaths. Using the International Classification of Diseases, Tenth Revision coding system, we identified adults with diagnoses related to overdose involving psychostimulants between 2010 and 2022 and used descriptive statistics to characterize these individuals. The analysis included 15,744 adults with stimulant-related overdoses (16.5% intentional, 83.5% unintentional). We found that 17.7% of adults with stimulant-related overdose events had a previous stimulant prescription. Nearly half of those with a stimulant-related overdose had a previously identified mental health disorder (49.9%) or substance use disorder (43.2%). The prevalence of overdose in high-risk adult populations highlights the need for additional safety interventions. Risk-benefit analysis and tailored guidelines for prescribing stimulants, especially in populations with mental health or substance use disorders, are warranted to mitigate overdose risk and enhance patient safety.

Article Details

How to Cite
BOLT, Elizabeth; TUAN, Wen-Jan. Characterizing Prescription Stimulant Use in Adults with Overdose Involving Psychostimulants. Medical Research Archives, [S.l.], v. 13, n. 7, aug. 2025. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/6741>. Date accessed: 05 dec. 2025. doi: https://doi.org/10.18103/mra.v13i7.6741.
Section
Research Articles

References

1. Spencer M, Garnett M, Miniño A. Drug Overdose Deaths in the United States, 2002-2022. National Center for Health Statistics (U.S.); 2024. doi:10.15620/cdc:135849
2. Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional Drug Overdose Death Counts. National Center for Health Statistics; 2024. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
3. Ciccarone D. The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis. Current Opinion in Psychiatry. 2021;34(4):344-350. doi:10.1097/YCO.0000000000000717
4. U.S. Food and Drug Administration. FDA Updating Warnings to Improve Safe Use of Prescription Stimulants Used to Treat ADHD and Other Conditions.; 2023:13. https://www.fda.gov/media/168066/download?attachment
5. Volkow, Nora. Rising Stimulant Deaths Show that We Face More than Just an Opioid Crisis. National Institute on Drug Abuse. November 12, 2020. https://archives.nida.nih.gov/news-events/noras-blog/2020/11/rising-stimulant-deaths-show-we-face-more-than-just-opioid-crisis
6. Burcu M, Zito JM, Metcalfe L, Underwood H, Safer DJ. Trends in Stimulant Medication Use in Commercially Insured Youths and Adults, 2010-2014. JAMA Psychiatry. 2016;73(9):992. doi:10.1001/jamapsychiatry.2016.1182
7. Compton WM, Han B, Blanco C, Johnson K, Jones CM. Prevalence and Correlates of Prescription Stimulant Use, Misuse, Use Disorders, and Motivations for Misuse Among Adults in the United States. Am J Psychiatry. 2018;175(8):741-755. doi:10.1176/appi.ajp.2018.17091048
8. Chen LY, Crum RM, Strain EC, Alexander GC, Kaufmann C, Mojtabai R. Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants. J Clin Psychiatry. 2016;77(03):e297-e304. doi:10.4088/JCP.14m09291
9. Kariisa M, Scholl L, Wilson N, Seth P, Hoots B. Drug Overdose Deaths Involving Cocaine and Psychostimulants with Abuse Potential — United States, 2003–2017. MMWR Morb Mortal Wkly Rep. 2019;68(17):388-395. doi:10.15585/mmwr.mm6817a3
10. Topaloglu U, Palchuk MB. Using a Federated Network of Real-World Data to Optimize Clinical Trials Operations. JCO Clinical Cancer Informatics. 2018;(2):1-10. doi:10.1200/CCI.17.00067
11. Perugi G, Pallucchini A, Rizzato S, et al. Pharmacotherapeutic strategies for the treatment of attention-deficit hyperactivity (ADHD) disorder with comorbid substance-use disorder (SUD). Expert Opinion on Pharmacotherapy. 2019;20(3):343-355. doi:10.1080/14656566.2018.1551878
12. Crunelle CL, van den Brink W, Moggi F, et al. International Consensus Statement on Screening, Diagnosis and Treatment of Substance Use Disorder Patients with Comorbid Attention Deficit/Hyperactivity Disorder. Eur Addict Res. 2018;24(1):43-51. doi:10.1159/000487767
13. Fields SA, Johnson WM, Hassig MB. Adult ADHD: Addressing a unique set of challenges. J Fam Pract. 2017;66(2):68-74.
14. Goldstick JE, Guy GP, Losby JL, Baldwin G, Myers M, Bohnert ASB. Changes in Initial Opioid Prescribing Practices After the 2016 Release of the CDC Guideline for Prescribing Opioids for Chronic Pain. JAMA Netw Open. 2021;4(7):e2116860. doi:10.1001/jamanetworkopen.2021.16860
15. Jain R, Jain S, Montano CB. Addressing Diagnosis and Treatment Gaps in Adults With Attention-Deficit/Hyperactivity Disorder. Prim Care Companion CNS Disord. 2017;19(5):17nr02153. doi:10.4088/PCC.17nr02153
16. Sauer CM, Chen LC, Hyland SL, Girbes A, Elbers P, Celi LA. Leveraging electronic health records for data science: common pitfalls and how to avoid them. The Lancet Digital Health. 2022;4(12):e893-e898. doi:10.1016/S2589-7500(22)00154-6
17. Rowe CL, Santos GM, Kornbluh W, Bhardwaj S, Faul M, Coffin PO. Using ICD-10-CM codes to detect illicit substance use: A comparison with retrospective self-report. Drug and Alcohol Dependence. 2021;221:108537. doi:10.1016/j.drugalcdep.2021.108537