Abstract
Introduction There has been a pronounced increase in the use of Schedule
II stimulants to treat attention-deficit hyperactivity disorder (ADHD) in the
United States over the last two decades. Interestingly, chronic medical cannabis
(MC) use can present with cognitive impairments that resemble ADHD symptoms.
This study aimed to determine if MC legalization increased prescription
stimulant distribution.
Methods Information on the distribution of methylphenidate, amphetamine,
and lisdexamfetamine for 2006 to 2021 was extracted from the Drug Enforcement
Administration’s comprehensive database and the three-year
population-corrected slopes of stimulant distribution before and after MC
program implementation were compared.
Results We found a significant main effect of time
(p<0.001); however, contrary to the hypothesis, the sales status
of states’ MC, did not influence slopes of distribution
(p=0.391). There was a significantly large interaction effect of
time and MC sales status on slopes of distribution (p<0.001).
Slopes of distribution rates of stimulants were significantly lower in states
that proceeded to legalize MC prior to MC program implementation than those
states that did not (p=0.022). After MC program implementation,
however, the distribution rates of the Schedule II stimulants were not
significantly different when comparing states with MC sales to those without
(p=0.355).
Discussion These findings suggest that MC program legalization did not
contribute to certain states having rapid increases in Schedule II stimulant
distribution rates over time. Other factors, including the liberalization of the
adult ADHD diagnostic criteria in the DSM-5 and the introduction of Binge Eating
Disorder, also likely contributed to elevations in stimulant distribution.
Key words
cannabis - marijuana - stimulants - attention-deficit/hyperactivity disorder (ADHD)
