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Pharmacopsychiatry 2024; 57(05): 249-254
DOI: 10.1055/a-2334-6253
Original Paper

Recreational Cannabis Legalization: No Contribution to Rising Prescription Stimulants in the USA

Garrett D. Alexander    ‡ 
1   Geisinger Commonwealth School of Medicine, Scranton, PA
,
Luke R. Cavanah    ‡ 
1   Geisinger Commonwealth School of Medicine, Scranton, PA
,
Jessica L. Goldhirsh
1   Geisinger Commonwealth School of Medicine, Scranton, PA
,
Leighton Y. Huey
1   Geisinger Commonwealth School of Medicine, Scranton, PA
2   Behavioral Health Initiative, Scranton, PA
,
Brian J. Piper
1   Geisinger Commonwealth School of Medicine, Scranton, PA
3   Center for Pharmacy Innovation and Outcomes, Danville, PA
› Author Affiliations Funding Information National Institute on Drug Abuse — http://dx.doi.org/10.13039/100000026; L30 DA027582-01 National Institute of Environmental Health Sciences — http://dx.doi.org/10.13039/100000066; T32-ES007060-31A1 Health Resources and Services Administration — http://dx.doi.org/10.13039/100000102; D34HP31025
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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

 ‡  Authors contributed equally to the work: Garrett D. Alexander, Luke R. Cavanah


Supplementary Material



Publication History

Received: 02 January 2024
Received: 10 April 2024

Accepted: 19 May 2024

Article published online:
31 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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