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ADHD medication overdose and misuse: the NSW Poisons Information Centre experience, 2004–2014

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In 1984, dexamphetamine became available in Australia as a subsidised medicine for treating attention deficit hyperactivity disorder (ADHD). Immediate release and long-acting methylphenidate, atomoxetine and modafinil have since been added to the Pharmaceutical Benefits Scheme. Apart from atomoxetine (a noradrenaline re-uptake inhibitor), these medications are all psychostimulants. With the exception of dexamphetamine, the rates of prescribing of these medications continues to grow significantly in Australia and elsewhere.1,2 This can largely be attributed to the increasing acceptance of ADHD as a diagnosis.3,4 However, these trends in prescribing are occurring amid increasing concerns about the diversion and misuse of these drugs.5 Further, there is increasing public anxiety about prescription stimulant dependence and misuse, including warnings about illicit injection of methylphenidate (Ritalin) following two recent deaths in Tasmania.6 This is in the context of much wider concerns about the relatively high prevalence of methamphetamine dependence in Australia7 and the increased use of methamphetamine by existing drug users,8 which may be related to recent…