title: Adolescents' Prescription Stimulant Use and Adult Functional Outcomes: A National Prospective Study.
abstract: OBJECTIVE
  To assess the prospective 17-year relationship between the medical and nonmedical use of prescription stimulants during adolescence (age 18 years) and educational attainment and substance use disorder (SUD) symptoms in adulthood (age 35 years).
  
  
  METHODS
  A survey was self-administered by nationally representative probability samples of US high school seniors from the Monitoring the Future study; 8,362 of these individuals were followed longitudinally from adolescence (age 18, high school senior years 1976-1996) to adulthood (age 35, 1993-2013).
  
  
  RESULTS
  An estimated 8.1% reported medical use of prescription stimulants, and 16.7% reported nonmedical use of prescription stimulants by age 18 years. Approximately 43% of adolescent medical users of prescription stimulants had also engaged in nonmedical use of prescription stimulants during adolescence. Among past-year adolescent nonmedical users of prescription stimulants, 97.3% had used at least one other substance during the past year. Medical users of prescription stimulants without any history of nonmedical use during adolescence did not differ significantly from population controls (i.e., non-attention-deficit/hyperactivity disorder [ADHD] and non-stimulant-medicated ADHD during adolescence) in educational attainment and SUD symptoms in adulthood. In contrast, adolescent nonmedical users of prescription stimulants (with or without medical use) had lower educational attainment and more SUD symptoms in adulthood, compared to population controls and medical users of prescription stimulants without nonmedical use during adolescence.
  
  
  CONCLUSIONS
  Nonmedical use of prescription stimulants is common among adolescents prescribed these medications. The findings indicate youth should be carefully monitored for nonmedical use because this behavior is associated with lower educational attainment and more SUD symptoms in adulthood.
authors.affiliation: Institute for Research on Women and Gender, University of Michigan, Ann Arbor; Substance Abuse Research Center, University of Michigan. Electronic address: plius@umich.edu.
authors.forename: Sean Esteban
authors.initials: SE
authors.lastname: McCabe
authors.affiliation: Institute for Research on Women and Gender, University of Michigan, Ann Arbor.
authors.forename: Philip
authors.initials: P
authors.lastname: Veliz
authors.affiliation: Pediatric and Adult Psychopharmacology Units, Massachusetts General Hospital, Boston and School of Medicine, Harvard University, Boston.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
authors.affiliation: Institute for Social Research, University of Michigan.
authors.forename: John E
authors.initials: JE
authors.lastname: Schulenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D000697:Central Nervous System Stimulants
keywords: adolescent; adult; prescription drug misuse; stimulants; substance-related disorders