Each year, the ³Ô¹ÏÍøÕ¾ Drug and Alcohol Research Centre at UNSW Sydney surveys hundreds of people who regularly use drugs in Australia to in substance use around the country.
Authors
Rachel Sutherland
Research Fellow, ³Ô¹ÏÍøÕ¾ Drug and Alcohol Research Centre, UNSW Sydney
Amy Peacock
Senior Research Fellow, ³Ô¹ÏÍøÕ¾ Drug and Alcohol Research Centre, UNSW Sydney
Caroline Salom
Research Social Scientist, Institute for Social Science Research, The University of Queensland
Jodie Grigg
Research Associate at the ³Ô¹ÏÍøÕ¾ Drug Research Institute, Curtin University
Raimondo Bruno
Associate Professor, School of Psychological Sciences, University of Tasmania
Today, we’ve released the , which canvassed 740 people from Australian capital cities who regularly use ecstasy or other illicit stimulants.
While the focus of this research is largely on illegal drugs and markets, we also monitor trends in the use of pharmaceutical stimulants, such as ADHD drugs, without a prescription.
This year, 54% of the people we spoke to had used pharmaceutical stimulants in the previous six months when it was not prescribed to them. This was the highest percentage we’ve seen since we started asking people about this type of drug use in 2007.
What are pharmaceutical stimulants?
Pharmaceutical stimulants include the drug methylphenidate (brand names Concerta and Ritalin), as well as dexamphetamine and lisdexamfetamine (Vyvanse).
These medicines are commonly prescribed to treat (ADHD) and , a chronic neurological disorder that causes excessive sleepiness and sudden bouts of sleep during the day.
These medications work in different ways depending on the type. But they treat ADHD by increasing the levels of important chemicals (neurotransmitters) in the brain, including dopamine and noradrenaline.
However, as with many pharmaceutical substances, people also use these stimulants when they’re not prescribed them. There are a someone might choose to use these medicines without a prescription.
Studies of have shown these substances are often used to increase alertness, concentration and memory. Studies among broader populations have shown they may also be used , or to .
Worldwide, including , there have been in the prescribing of ADHD medications in recent years, likely due to increasing identification and diagnosis of ADHD. As prescriptions increase, there is increased potential for these substances to be diverted to illicit drug markets.
What we found
Non-prescribed use of pharmaceutical stimulants has tripled since monitoring began, from 17% of those surveyed in 2007 to 54% in 2024. It has been similarly high in recent years (52% in 2022 and 47% in 2023).
Frequency of use has remained relatively low. Respondents have typically reported using non-prescribed pharmaceutical stimulants monthly or less frequently.
In this survey, participants most commonly reported using dexamphetamine, followed by methylphenidate and lisdexamfetamine. Most (79%) reported it was “easy” or “very easy” to obtain these substances, similar to 2022 and 2023.
Of course, given our research looks at people who regularly use drugs, the use of pharmaceutical stimulants without a prescription doesn’t reflect use in the general population.
In the 2022-23 , a general population survey of Australians aged 14 years and older, 2.1% of the population (equating to roughly 400,000 people) reported having used pharmaceutical stimulants for non‑medical purposes in the previous year. This was similar to the percentage of people reporting ecstasy use.
What are the risks?
Pharmaceutical stimulants are considered to have a relatively safe toxicity profile. However, as with all stimulants, these substances increase activity of the , which controls various functions in the body during times of stress. This in turn increases heart rate, blood pressure and breathing rate.
These changes can cause acute cardiac events (such as arrhythmias, or irregular heartbeat) and, with repeated use of high doses, chronic changes in .
Recent Australian studies have documented an involving these substances, although a notable proportion of these appear to be intentional poisoning. Of poisonings that only involved pharmaceutical stimulants, the drugs were mostly taken orally, with a median dose more than ten times a typical prescribed dose. The most common symptoms were hypertension (high blood pressure), tachycardia (increased heart rate) and agitation.
In our survey, those who had used pharmaceutical stimulants most commonly swallowed them in tablet form and generally took a dose slightly higher than what’s typically prescribed.
However, about one in four reported snorting as a route of administration. This can result in physical harms such as damage to the sinuses, and can heighten potential risks from the drug because it may in the body.
Some pharmaceutical stimulants are ““, released into the body over a day. So there may also be a risk of premature re-dosing if people unknowingly use these formulations more than once a day. That is, if people don’t experience the within the expected time frame, they may take another dose, which can increase the risk of adverse effects.
Finally, non-prescribed pharmaceutical stimulants may have adverse effects when taken alongside other drugs. This can include a “masking effect” (for example, the stimulant may mask the signs of ).
So what should we do?
Pharmaceutical stimulants are an important medicine to treat ADHD and narcolepsy, and when used as prescribed are relatively safe. However, there are additional risks when people use these substances without a prescription.
Harm reduction campaigns highlighting these risks, including differences across formulations, may be useful. Continual monitoring, alongside more in-depth investigation of associated harms, is also crucial.
You can access free and confidential advice about alcohol and other drugs by calling the ³Ô¹ÏÍøÕ¾ Alcohol and Other Drug Hotline on 1800 250 015.
