Diversion and Abuse of Prescribed Methylphenidate – A Survey of an Outpatient Clinic for Adult Persons with ADHD

Methylphenidate (MPH) is currently the first-choice medication of adult ADHD, followed by lisdexamfetamine [1]. In Germany, only extended-release MPH (ER- MPH) is licensed for adults. As a norepinephrine-dopamine reuptake inhibitor (NDRI) MPH has the potential to induce euphoria, drive enhancement, and other psychotropic effects of amphetamine-like stimulants, especially after intranasal and intravenous administration [2]. Therefore, there are concerns that MPH-treated patients might abuse their medication, might feign ADHD symptoms in order to receive a prescription, and/or might aggravate ADHD symptoms in order to receive a higher dosage [3]. Moreover, especially according to studies from the USA, ADHD patients treated with MPH at considerable rates reported of diverting (e. g. 11 and 44%; [3]) and abusing their medication (e. g. 14% to 29% [3] [4] [5]).