In attempting to reduce the nonmedical use of
controlled substances, a reasonable step is to educate the physicians prescribing
controlled substances, including the prescription stimulants used to treat
ADHD, as well as patients and family members, about the risks of nonmedical use and the dangers of giving or selling these medicines to persons for whom they were not prescribed. Patients who find benefits in the use of such medicines have a significant interest in protecting their continued access to them. Such access is potentially threatened by concerns about widespread nonmedical use. Physicians can help protect the appropriate medical use of prescription stimulants by considering the abuse potential of various medicines used to treat patients with
ADHD, especially when these patients also have a history of nonmedical
substance use. In addition, we suggest that today there is an opportunity to add a new and perhaps more hopeful paradigm: the wider use of drug delivery systems that make products less attractive to drug abusers. This new
drug abuse prevention paradigm holds great promise for efforts to reduce the nonmedical use of prescription
controlled substances, including the prescription stimulants used to treat
ADHD. To achieve the full potential of this new paradigm to reduce
prescription drug abuse, it will be necessary to develop standards to assess the relative abuse resistance of various
drug formulations and delivery systems, as well as meaningful incentives to foster the development of these abuse-resistant delivery systems for
controlled substances.