REVIEW article
Front. Psychiatry
Sec. ADHD
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1612785
Misuse and Diversion of Stimulant Medications Prescribed for the Treatment of ADHD: A Systematic Review
Provisionally accepted
- 1Mercy Mental Health, Melbourne, Australia
- 2Faculty of Medicine and Health, Leeder Centre for Health Policy Economics and Data, University of Sydney, Sydney, Australia
- 3Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- 4Northern Adult Area Mental Health Service, Melbourne, Victoria, Australia
- 5Centre for Human Psychopharmacology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Aim: Stimulant medications are an evidence-based treatment for ADHD. However, stimulant medications are associated with a risk of misuse and diversion. Given the paucity of research, this systematic review evaluates the prevalence of misuse and diversion of stimulant medication by those who are prescribed the medication for a diagnosis of ADHD, and explores risk factors for misuse and diversion.Methods: This systematic review was registered with PROSPERO (CRD42023469041). A systematic search of original articles from PubMed and PsycInfo on the topic of interest over a period of 10 years (2012-2023) was conducted. Risk of bias was assessed through JBI Critical Appraisal Checklist for Prevalence Studies. A meta-analysis was conducted using JBI SUMARI software.Results: Twelve cross sectional surveys met the inclusion criteria, with study populations ranging from 88 respondents to 10,000 respondents. Meta-analysis found an average prevalence of past year prescription stimulant medication misuse of 22.6%, past year diversion of 18.2%, and lifetime diversion of 17.9%. Risk factors for misuse included being prescribed an amphetamine-based stimulant, reporting comorbid depressive and anxiety symptoms, and believing that misuse was not associated with risks. Risk factors for diversion included exposure to peers who were misusing stimulant medication, and having surplus medication available.Conclusion: With more than one in five people reporting misuse of their prescribed stimulant medication, and one in six diverting their prescribed stimulant medication, comprehensive risk assessment and risk mitigation strategies are needed. Further research in a variety of geographic and demographic settings is needed to develop effective risk assessment tools and targeted interventions.
Keywords: ADHD, diversion, Psychotropic medications, Stimulant misuse, Systematic review
Received: 16 Apr 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Forrest, Chen and Jagadheesan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Winnie Chen, Faculty of Medicine and Health, Leeder Centre for Health Policy Economics and Data, University of Sydney, Sydney, Australia
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.