Abstract
Introduction There have been substantial increases in the use of Schedule
II stimulants in the United States. Schedule II stimulants are the gold standard
treatment for attention-deficit hyperactivity disorder (ADHD), but also carry
the risk of addiction. Since the neurocognitive deficits seen in ADHD resemble
those of chronic cannabis use, and the rise in stimulant use is incompletely
understood, this study sought to determine if recreational cannabis (RC)
legalization increased distribution rates of Schedule II stimulants.
Methods The distribution of amphetamine, lisdexamfetamine, and
methylphenidate were extracted from the ARCOS database of the Drug Enforcement
Administration. The three-year population-corrected slopes of distribution
before and after RC sales were evaluated.
Results Total stimulant distribution rates were significantly higher in
states with RC sales after (p=0.049), but not before (p=0.221),
program implementation compared to states without RC. Significant effects of
time (p<0.001) and RC sales status (p=0.045) were observed,
while time x RC sales status interaction effects were not significant
(p=0.406).
Discussion RC legalization did not contribute to a more pronounced rise in
Schedule II stimulant distribution in states. Future studies could explore the
impact of illicit cannabis use on stimulant rates and the impact of cannabis
sales on distribution rates of non-stimulant ADHD pharmacotherapies and ADHD
diagnoses.
Keywords
marijuana - attention-deficit hyperactivity disorder - amphetamine - lisdexamfetamine - methylphenidate
