The Correlation Between Telemedicine and Stimulant Abuse in the United States

By: Dr. Reema Hammoud, assistant vice president of clinical pharmacy at Sedgwick 

The pandemic has drastically changed the way Americans operate in many facets, including the way we live, work, eat, exercise, connect and seek help from professionals. During this time, it’s no surprise that we’ve seen a rise in telehealth startups geared towards mental health – virtually talking to a therapist or psychologist is far less scary and time consuming than attending meetings in person. However, the medical industry has also experienced growing pains with stimulant prescriptions. Prescriptions for drugs like Adderall have skyrocketed during this time and now, experts are questioning the validity of these prescriptions and patient safety during usage. 

According to a 2021 Quest Diagnostics Study, the use of amphetamines, including prescription medications such as Adderall, has more than doubled in the previous 10 years. It also found that approximately 1 out of 75 people in the United States workforce tested positive for amphetamines by urine drug test in 2018. Additionally, The American Professional Society of ADHD and Related Disorders recently released research that found that half of respondents reported using a prescription stimulant when not prescribed and 32% were snorting stimulants, 2% injecting and 4% vaping rather than taking orally. Out of these respondents, prescription stimulant snorters were more likely than overall abusers to also report using other controlled substances like marijuana, cocaine, opioids and methamphetamine. 

With access to stimulants becoming easier and telemedicine asserting its dominance for the long term, medical experts must go the extra mile to ensure they properly evaluate, prescribe and educate patients on their medicine. 

The Dangers of Unregulated Stimulants

Whether a student is trying to finish a paper late at night, a corporate employee is trying to finish a big presentation before an early morning meeting or an individual wants to stay up all night at a concert, stimulants, specifically Adderall, are constantly being abused. Adderall has become widely available and known under different names like crank, speed, black beauties and uppers. 

The street usage of stimulants is very dangerous if the user does not understand the effects of the drug that they are taking or if they mix it with other substances. For example, many believe that taking Adderall with alcohol will offset the effects since one is an upper and the other is a downer. However, this is very dangerous and can lead to an unintentional overdose as the symptoms of alcohol poisoning are masked by stimulants. 

Proper Evaluation and Prescription

As telehealth opens new medical doors for many, there is strong evidence that telemedicine and the increase in stimulant prescriptions is correlated. Despite telemedicine’s tremendous value in connecting patients and doctors over the last two years, this form of communication has also made it difficult to properly evaluate patients and prescribe them medicine. 

Proper due diligence when prescribing controlled medication is very hard to complete over the computer, and it’s even more critical for addictive drugs like stimulants, which are in the same classification as Oxycontin and Norco due to their potential for abuse. 

The checks and balances that are in place to ensure patient safety and proper prescriptions, like drug screenings and counseling, are often overlooked through telehealth. Additionally, practitioners often skip med-reconciliation which would otherwise identify what other medications patient might be taking. This leads to stimulants often being prescribed to treat the side effects of other medications such as opioids and benzodiazepines. It’s imperative to explore all potential routes for patients to ensure their treatment is aligned with the diagnosis and their medical needs. 

Patient Education 

A crucial role in avoiding stimulant abuse is educating patients on the side effects of the medications. The onus is on both the doctors and pharmacists to explain the medication, its dangers and what happens if it is not used as prescribed or shared with others who do not need the drug. For example, if a person takes Adderall and it makes them feel good, rather than help focus and regulate their behavior, that person likely does not have ADHD. A new study showed that people who feel euphoria when taking stimulants are less likely to have genes that predispose them to ADHD, and this could explain why people who take the drug unnecessarily are more prone to addiction. 

Proper diagnosis and understanding of the side effects of certain medications are also key to patient safety. Instead of prescribing a full month of a medication, doctors should consider a “trial” phase for two weeks, where patients can take the medication and see if that is helping with their symptoms or not. This will reduce the likelihood of stimulant abuse and increase the probability for proper diagnoses. 

As Americans adjust to the endemic phase and decide which trends will transfer to a post-pandemic world, medical professionals must continue to have open and honest conversations with patients and do their due diligence to keep patients safe and healthy amid the high rate of stimulant prescriptions and abuse. If we want to stop the overprescribing of these drugs and curb the potential for a full-blown stimulant crisis, Americans must come together to provide trusted resources, educate one another and understand risks associated with stimulants to protect friends, family, colleagues, and our society.