Academic literature on the topic 'Prescription Stimulant Medication'

Background: Although large datasets document that stimulants decrease the risk for many adverse ADHD-associated outcomes, compliance with stimulants remains poor. Aims: This study examined the effectiveness of a novel ADHD-centric text messaging-based intervention aimed to improve adherence to stimulant medications in children with ADHD. Methods: Subjects were 87 children aged 6–12, who were prescribed a stimulant medication for ADHD treatment. Prescribers gave permission to contact their patients for participation in the study. Subjects were primarily from the primary care setting with a subsample of psychiatrically referred subjects for comparison. Age- and sex-matched comparators were identified (3:1) from the same pool of prescriber-approved subjects that did not participate. Timely prescription refills (within 37 days) were determined from prescription dates documented in patients’ electronic medical record. Results: Eighty-five percent of SMS intervention patients refilled their prescriptions in a timely manner compared with 62% of patients receiving treatment as usual (OR = 3.46, 95% CI: 1.82, 6.58; p < 0.001). The number needed to treat statistic was computed as five, meaning for every five patients who receive the SMS intervention, we can keep one adherent to their stimulant treatment. Conclusions: These preliminary findings support the potential utility of a readily accessible technology to improve the poor rate of adherence to stimulant treatment in children with ADHD. To the best of our knowledge, this study is the first digital health intervention aimed at improving adherence to stimulant medication for children with ADHD. These results support the need for further examination of this technology through more definitive randomized clinical trials.

ObjectiveTo assess the 5-year changes in the adult medical use of central nervous system (CNS) stimulants with higher risk of dependence and evaluate the population characteristics of users and their medical and/or neurological conditions.DesignCross-sectional study.SettingAnnual US Medical Expenditure Panel Survey, a stratified random sample of approximately 30 000 persons designed to produce national population estimates. It focuses on reported medical spending, medical services used, health status and prescription medications.ParticipantsAdults age 19 years and older who reported obtaining one or more prescriptions for amphetamine or methylphenidate products during two survey years, 2013 and 2018.Main outcomes measuresPrescriptions obtained, the specific stimulant product and annual treatment days of drug supplied.ResultsIn 2018, an estimated 4.1 million US adults (95% CI 3.4 million to 4.8 million) reported prescriptions for CNS stimulants, having filled a mean of 7.3 (95% CI 6.8 to 7.8) prescriptions with a mean of 226 (95% CI 210 to 242) days’ supply. Compared with 2013, the estimated number of adults reporting using CNS stimulants in 2018 increased by 1.8 million (95% CI 1.0 million to 2.7 million) or 79.8%. Most 2018 adult stimulant users reported taking psychoactive medication for one or more mental, behavioural or neurodevelopment disorders. Overall, 77.8% (95% CI 72.6% to 83.0%) reported some medication for adult attention deficit disorder, 26.8% (95% CI 22.2% to 31.5%) took medication for anxiety, 25.1% (95% CI 19.9% to 30.3%) for depression and 15.3% (95% CI 9.8% to 20.8%) indicated drug treatment for other mental or neurological disorders. Adult CNS stimulant use was higher in females, in younger age cohorts and among individuals of white race/ethnicity.ConclusionsAdult medical use of prescription stimulants increased markedly in 5 years and occurred in a population often reporting multiple mental or neurological disorders. Further action is needed to understand and manage this new resurgence in drugs with high risks of dependence.

Objective: Misuse of prescription stimulant medication is a prevalent problem on American college campuses; however, few studies have been conducted beyond the United States. Although Iceland has the highest methylphenidate prescription rates in the world, prevalence of stimulant misuse within the Icelandic college student population remains to be investigated. Method: We examined the prevalence of prescription stimulant misuse among N = 521 college students in Iceland, using an online survey. Results: Overall prevalence of lifetime stimulant misuse was approximately 13%; 11% among participants without a prescription for stimulant medication, and 42% among participants holding a prescription. The primary reported reason for misuse was academic enhancement; risk factors included male sex, anxiety symptoms, and ADHD symptomatology. Conclusion: The present findings have implications for public health policy in Iceland, particularly as it relates to the college population. Prevention and intervention programs that provide college students with safer strategies to manage academic demands are warranted.

Objective: Despite the limited effectiveness of ADHD medications on healthy cognition, prescription stimulants’ cognitive enhancement use is increasing. This article examines enhancement users’ attention, motivation, and study habits. Method: A total of 61 users of unprescribed stimulants and 67 controls (no history of prescription stimulant use) completed tests of objectively measured and subjectively reported attention. Self-reports on study habits, as well as motivation during laboratory attention testing, were also administered. Results: Our data replicated previous findings of relatively lower self-reported attention functioning in users. Extending past research, we showed that user-control differences in attention were still present but less pronounced on objective measures than on self-report. In addition, we obtained evidence of lower motivation during cognitive testing and less optimal study habits among users, as compared with their non-using peers. Conclusion: Unprescribed stimulant use is more strongly related to compromised study habits, low motivation, and a subjective perception of attention problems than to objective attention performance.

Objective: Stimulant medications are considered an effective treatment for attention deficit hyperactivity disorder (ADHD), and their prescription is consistently on the rise. However, research showed a limited adherence to ADHD medication regimens. This study explores the experiences of using stimulant medication from the understudied perspective of adolescents. Method: Fourteen semistructured interviews were conducted with adolescents diagnosed as having ADHD, and the data was analyzed according to the principles of qualitative interpretative phenomenological analysis. Results: Participants were passive actors in the diagnostic process. Following the medical treatment, half of the interviewees described improvement in their concentration while studying and during exams. However, most of the interviewees discussed the difficulties of taking medication especially in terms of emotional side effects, identity loss, and interpersonal relationships. Those who reached high school stopped, fully or selectively, taking the medication on their own initiative. Conclusion: The results of this study points to the importance of considering the burden of treatment for children and adolescents who take stimulant medications.

Objective: To examine the relationship between ADHD medications, study habits, and academic achievement of ADHD-diagnosed undergraduates. Method: A total of 92 students with a self-reported ADHD diagnosis and a current prescription for ADHD medication were compared with 143 control students in a survey of academic performance. Results: Most ADHD students took stimulant medication and said the drugs helped them, yet believed they were worse than other students at planning and completing assignments and avoiding distractions. Although most study habits of ADHD students did not differ from controls, their high school and college GPA (grade point average), and ACT scores were significantly lower, and they withdrew from significantly more classes than did control students. Interestingly, preliminary data suggested that good study habits alone, even without stimulants, could overcome the achievement disparity of ADHD students. Conclusion: As previously shown for children and adolescents, stimulant medications alone did not eliminate the academic achievement deficit of ADHD undergraduates.

While treatment of patients with attention-deficit hyperactivity disorder (ADHD) is based on a multimodal approach that combines medication with specific psychological interventions, pharmacotherapy alone is generally considered an essential and cost-effective element. This paper aims to comprehensively and critically review factors involved in prescribing and medication use in individuals diagnosed with ADHD, focusing on the difficulties facing patients with ADHD seeking treatment, as well as the safety and tolerability aspects of ADHD pharmacotherapies, with particular attention on the cardiovascular adverse events and the potential risk of misuse or diversion of ADHD medications. A comprehensive and systematic literature search of PubMed/MEDLINE database was conducted to identify studies published in peer-reviewed journals until 1 August 2016. Children, adolescents and adults often encounter significant difficulties in the process of accessing specialist assessment and treatment for ADHD as a consequence of disparities in service organization and available treatment provision. Despite the well-established efficacy and overall safety profile, ADHD medications are not exempt from adverse events. The cardiovascular safety of pharmacotherapies used for treating individuals with ADHD has raised particular concerns; however there is little evidence of serious cardiovascular adverse events, including no serious corrected QT (QTc) abnormalities associated with stimulants, atomoxetine or α2-adrenergic receptor agonists. Although the abuse of prescription stimulant drugs, particularly, short-acting stimulants is a prevalent and growing problem, nonmedical use of prescription stimulants within the clinical context is very limited. In addition, nonstimulant ADHD medications lack any reinforcing effects and consequently any abuse potential.

OBJECTIVE This study examines off-label medication prescribing use and trends in children on Medicaid with ADHD with particular focus on the very young (under age 6 years). METHODS This was an observational cohort study and retrospective analysis of ADHD medication prescriptions from Oregon Medicaid records (N = 83,190) in 2012. Manufacturer prescribing information was used to determine off-label designation. Children ages 3 to 18 years at the time of prescription who had continuous Medicaid enrollment of at least 10 months during the index year of 2012 were included in the sample frame. RESULTS Children with ADHD were prescribed off-label medications primarily at the ages of 5 years and younger. Among children ages 3 to 5 years, 91.4% of prescriptions were off-label. After the age of 5 years, the percentage of off-label prescriptions dropped notably to 21%, reflecting the increase in availability of approved medications for the treatment of ADHD starting at age 6 years. In the 3- to 5-year-old age group, specific off-label and concerning medication-related observations included a high frequency of alpha agonist (e.g., guanfacine, clonidine) prescribing; the prescribing of untested formulations such as clonidine patches; prescribing of atomoxetine; and prescribing of large doses of stimulant medications. CONCLUSIONS Most ADHD drugs prescribed for very young children are off-label, which is concerning owing to lack of safety and efficacy data in this vulnerable population.

AbstractObjectives: The prescription of stimulant medication to children with attention deficit hyperactivity disorder remains topical. Few reports target children's views about taking long-term medication. The aim was to assess child and parent views of stimulant medication. To compare attitudes to medication between two groups of children, those with attention deficit hyperactivity disorder taking stimulant medication and those with epilepsy taking anti-epileptic medication.Method: Forty children (n = 40) with attention deficit hyperactivity disorder on stimulant medication, and 40 children (n = 40) with epilepsy on anti-epileptic medication formed the study population. A semi-structured interview was carried out with each child and parent. Each parent completed the Dosage and Side-effects Questionnaire and the Attitude to Medication Questionnaire. Each child completed the Attitude to Medication Questionnaire.Results: Sixty per cent of children (n = 24) with attention deficit hyperactivity disorder and 62.5% (n = 25) of those with epilepsy knew the name and purpose of their medication. Forty per cent (n = 16) of children in the stimulant group and 32.5% (n = 13) in the anti-epileptic group reported themselves as being non-compliant with medication. In both groups children reported positive aspects to taking medication. More children with epilepsy reported negative aspects. Only 32.5% (n = 13) of children with attention deficit hyperactivity disorder said that they would tell a friend about their medication, while 55% (n = 22) of the children with epilepsy indicated that they would do so. In both groups parents were better informed than their children were about the purpose of the medication. Parents of children with attention deficit hyperactivity disorder tended to be more positive about medication than their children and than the parents in the comparison group.Conclusions: The majority of children and their parents express positive views about the stimulant medication. Children's views about medication compliance and side-effects should be sought, as they may differ significantly from those of their parents. Where parents have noticed positive changes, but children have not, this information can be used therapeutically to help children feel more in control of their behaviour.

Class of 2016 Abstract
Objectives: To first educate undergraduates involved in social sororities about prescription stimulant medications and to evaluate the effectiveness of an educational intervention in influencing the attitudes and beliefs regarding prescription stimulant medication use of undergraduates involved in social sororities. Methods: The intervention, an educational session, was presented to undergraduates involved in social sororities. The questionnaire collected demographic data regarding gender, age, ethnicity, race, undergraduate year, grade point average, type of sorority member, history of an attention-deficit/hyperactivity disorder (ADHD) diagnosis, and previous or current non-medical use of prescription stimulants. The participants’ attitudes and beliefs on nine statements regarding prescription stimulants were queried pre- and post-intervention using a four-point Likert scale ranging from strongly disagree to strongly agree. To analyze changes in attitudes and beliefs, Mann-Whitney test was used. Results: One hundred sixty-three sorority members participated in the study. The average age of participants was 19 years with the majority of respondents identifying as an active sorority member (81%) and in their first year of undergraduate study (69%). There was a statistically significant change in beliefs regarding the safety (p < 0.01) and health risks (p = 0.02) associated with prescription stimulants. There was no significant difference in topics relating to addiction, legal issues of taking someone else’s prescription medications, emotional and academic outcomes from the use of prescription stimulants. Conclusions: The educational program presented by pharmacy students was effective in changing the beliefs and attitudes regarding safety and health risks of prescription stimulants among undergraduate students involved in social sororities.

Class of 2017 Abstract
Objectives: To first educate undergraduates involved in social sororities about prescription stimulant medications and to evaluate the effectiveness of an educational intervention in influencing the attitudes and beliefs regarding prescription stimulant medication use of undergraduates involved in a social sorority. Methods: The intervention, an educational session, was presented to undergraduates involved in social sororities. Questionnaire that included demographic data of gender, age, ethnicity, race, undergraduate year, grade point average, type of member, history of an attention-deficit/hyperactivity disorder (ADHD) diagnosis, and previous or current non-medical use of prescription stimulants were collected. The participants’ beliefs on nine statements regarding prescription stimulants were queried pre- and post-intervention using a four-point Likert scale ranging from strongly disagree to strongly agree. To analyze change in attitudes and beliefs, Mann-Whitney test was used. Results: One hundred sixty-three sorority members participated in the study. The average age of participants was 19 years with the majority of respondents identifying as an active sorority member (81%) and in their first year of undergraduate study (69%). There was a statistically significant change in beliefs regarding the safety (p < 0.01) and health risks (p = 0.02) associated with prescription stimulants. There was no significant difference in topics relating to addiction, legality, emotional and academic outcomes from the use of prescription stimulants. Conclusions: The education session was effective in changing participants’ beliefs on safety and health risks of nonmedical use of prescription stimulants.

The goal of this study was to determine the extent, motivations, and justifications of nonmedical prescription stimulant use among the population at a large public university in the North Texas region. Participants consisted of 526 undergraduate students enrolled at the studied university during the spring and summer 2014 semesters. The findings of the study suggest that the nonmedical use by students was higher than the findings in much of the current literature, but was within the parameters established in the literature. The primary motivation for nonmedical use was academic in nature and was justified by moderation of nonmedical use to strategic academic times.

The illicit use of prescription stimulants (IUPS) is a critical Public Health problem in the college population that represents a unique form of substance use. Namely, the primary motives for IUPS by college students are academic in nature (e.g., Teter, McCabe, LaGrange, Cranford, & Boyd, 2006), which may explain why usage rates as high as 43% have been reported on college campuses (Advokat, Guidry, & Martino, 2008). As the field of IUPS is in its infancy, the IUPS-literature lacks 1) a consistent definition of "illicit use of prescription stimulants", 2) an instrument designed to assess the multiple influences on IUPS behavior, and 3) a theoretical lens (Bavarian, 2010a). Accordingly, the goal of this study was to address these research gaps by examining IUPS at one university located in the Pacific Northwest using the theory of triadic influence (TTI; Flay & Petraitis, 1994; Flay, Snyder, & Petraitis, 2009), an integrated, ecological approach to explaining and predicting health behaviors. The study included five phases of research. The first phase began with a systematic approach to measurement development resulting in a 97-item preliminary instrument, the Behaviors, Expectancies, Attitudes and College Health Questionnaire (BEACH-Q). The measure was reviewed by the dissertation committee, leading to revisions in content and structure. During phase II, the BEACH-Q was evaluated by a convenience sample of five health and measurement professionals, and results suggested good content validity of the instrument (i.e. 35 of the 37 TTI-based covariates received a median rating between "agree" and "strongly agree", and 34 received a mean rating between "agree" and "strongly agree"). In phase III (instrument review by a convenience sample of six undergraduates), all 37 covariates received a median and mean rating between "agree" and "strongly agree", confirming good face validity. In phase IV, one undergraduate classroom was selected to participate in a pilot test of the BEACH-Q, using test-retest methodology. Results from the pilot (N = 39) showed that the instrument had moderate to high internal consistency reliability and modest to high stability reliability. In phase V, the final 96-item version of the BEACH-Q was administered throughout campus using one-stage cluster sampling, with classrooms as the sampling unit and students as the observation unit (N = 520 students in 20 classrooms, eligible student response rate = 96.30%). The prevalence of IUPS during college self-reported by the phase V sample was 25.58%, and the probability of engaging in IUPS did not differ between classrooms (Median Odds Ratio = 1.00). In crude logistic regressions, 24 out of 37 hypothesized theoretical covariates were significantly associated with IUPS in the expected direction, suggesting predictive validity of the BEACH-Q. Nested logistic regression analyses illustrated that, for the full multivariate model including ultimate, distal, and proximal covariates, the following measures in the intrapersonal stream were significantly associated with IUPS during college: race/ethnicity, year in school, academic concern, academic grades, diagnosis with Attention Deficit Disorder, and IUPS avoidance self-efficacy. Significant social situation/context stream covariates in the full model included: residence, varsity sports participation, perceptions of IUPS by friends, family, and faculty, endorsement of IUPS by friends, and perceived prevalence of IUPS among friends. With respect to the sociocultural environment stream, in the full multivariate model, the following covariates were found to be significantly associated with IUPS: financial-related stress, participation in religious activities, positive IUPS expectancies, prescription stimulant knowledge and perceived costs/benefits of IUPS. Lastly, intention to engage in IUPS (an immediate precursor) was positively associated with IUPS. Structural equation modeling was used to test models of IUPS for each of the three streams, as well as one integrated model that included covariates from each stream. The models all demonstrated good model fit, and provided insight into the factors that influence (and suggest the mechanisms of causation) intentions to engage in, and ultimately the behavior of, IUPS. In the intrapersonal stream model, inattention was positively associated with academic concern and inversely associated with avoidance self-efficacy, and avoidance self-efficacy was inversely associated with intentions to engage in IUPS. Moreover, intentions to engage in IUPS and avoidance self-efficacy were both significantly associated with IUPS. In the social situation/context stream model, living on-campus was negatively associated with friends' endorsement of IUPS which was positively associated with perceived prevalence of IUPS among friends, and perceived prevalence was positively associated with intentions to engage in IUPS; all of the direct paths to IUPS, excepting the path from perceived prevalence of IUPS among friends, were significant. In the sociocultural environment model, perception of course demand was significantly associated with both the perception that professors give the most attention to top academic students and attitudes about the impact of prescription stimulants on academics, and these attitudes had a positive association with intentions to engage in IUPS. Moreover, the direct paths from attitudes and intentions to IUPS were significant. The mixed model, including participation in religious activities (sociocultural environment stream), friends' endorsement of IUPS (social situation/context stream), and avoidance self-efficacy (intrapersonal stream), also had significant paths from ultimate to distal to proximal to immediate precursor, and significant direct paths to IUPS. This study successfully achieved its goals. First, the instrument developed was theory-driven, broadly defined IUPS, and was psychometrically strong. The cross-sectional study illustrated that IUPS was prevalent on the campus under investigation, as one in four students had engaged in the behavior during college. Associations of use with theoretical correlates were tested for, and structural equation modeling was used to support one premise of the TTI (i.e. that behavior is multifaceted, and covariates from different streams may interact to influence behavior). The findings also suggest that prevention and intervention plans should be multifaceted in nature. Given that this study's cross-sectional nature limited the ability to make causal inferences, future research involving the BEACH-Q should use longitudinal designs.
Graduation date: 2012

The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in correctional settings is in itself problematic and quite contentious; treating the disorder more so. Community prevalence studies estimate that 2.5% to 4% of adults in the United States and worldwide meet diagnostic criteria for ADHD. Some research findings suggest that ADHD occurs at far greater prevalence rates among criminal justice populations than in the population at large. The nature of the condition, its assessment, and its management combine to create a perfect storm of potentially vexing challenges for the prison psychiatrist. This chapter reviews those diagnostic and treatment challenges, including the risk of diversion and misuse of controlled substances among inmates. An assessment and treatment model is presented that takes into account and minimizes risk while helping ensure access to care in appropriately selected cases. Some inmates have a compelling need for treatment, potentially including stimulant medications. Neither unbridled use nor complete elimination of stimulants makes good clinical or administrative sense for correctional systems. An approach that relies on current impairment in significant functional areas, meaningful involvement in treatment, and absence of active misuse of substances will allow access to medication for those with verifiable need while lessening the risks associated with prescription of controlled substances in jails and prisons. The issues of differential diagnosis in a population with epidemic substance abuse, the challenges of appropriate management, and an evidence-based treatment model are discussed in this chapter.

This chapter covers energy modalities and aromatherapy. The first part introduces subtle energy and biofield therapy as a complementary therapy for senior patients to stimulate innate healing forces and promote health and relaxation. Biofield therapies combine the use of touch and intention to help the older patient mitigate symptoms and improve functional status. They are safe and have no unwanted side effects. Reiki, internal qi gong therapy, and aromatherapy can be taught for self-care, further empowering the healing process and increasing exposure to the modality. Essential oil use can be an effective option or adjunct in the treatment of many geriatric health care needs. Advantages of using essential oils include flexibility in delivery methods, low cost compared with many prescription medications, and a high safety profile when used properly.

Stimulants are sympathomimetic substances that include cocaine, amphetamines, and cathinones. Approximately 1% of Americans have used illicit stimulants in the past month, and nearly 25,000 deaths were attributed to stimulant overdose in 2017. Acute effects include tachycardia, elevated blood pressure, and euphoria. High doses of stimulants may lead to cardiac arrhythmias, severe hypertension, agitation, myocardial infarction, aortic dissection, stroke, hyperthermia, or rhabdomyolysis. Abstinence after regular use of stimulants may lead to dysphoria, fatigue, insomnia, and agitation. People who use stimulants may present with acute effects or medical complications. Cocaine metabolites and amphetamines can be detected in urine for a few days after use. The most serious complications of acute use are cardiovascular (especially myocardial infarction and stroke) and psychiatric (agitation and delirium); the risk of hyperthermia is also increased. A number of psychosocial modalities appear to reduce stimulant use among selected individuals, including individual and group counseling, cognitive–behavioral therapy, contingency management, and community reinforcement. No medication has been consistently shown to reduce complications and use of stimulants, although prescription stimulants and topiramate show some promise for treating cocaine use disorder. Syringe exchange programs and safe consumption sites are associated with decreased stimulant use-related complications. Caffeine has mild stimulant effects and may lead to a mild dependence syndrome.

Problems of mental health and behaviour in children are multidisciplinary in nature and optimal treatment is often multimodal. This article focuses on aspects of psychopharmacology that has special relevance in children and adolescents, especially the recent controversies. In general, this article provides information about classes of medication and not detailed information about specific medicines. Treatment recommendations of the specific disorders have been dealt within the appropriate chapters. The use of psychotropic medication in children is higher in the United States than in many other countries, and polypharmacy is common. About 1 per cent of overall medical consultations visits by children and adolescents in 2003–2004 in the US resulted in a second-generation antipsychotic (SGA) prescription. The majority of the visits involving antipsychotics were by Caucasian boys aged over nine years, visiting specialists, without private insurance, with a diagnosis of bipolar disorder, psychosis, depression, disruptive disorder, or anxiety. >Pre-school (2 to 4 year olds) psychotropic medication use, between 1995 and 2001 increased across the US for stimulants, antipsychotics, and antidepressants, while the use of anxiolytics, sedatives, hypnotics and anticonvulsants remained stable across these years, suggesting non-psychiatric medical usage. Ethnicity may influence differential prescription rates; for example, as compared to Caucasian youths, African-American youths are less likely to be prescribed psychotropic medications especially methylphenidate.

A variety of prescription and over-the-counter drugs are used for purposes other than intended. Approximately 2% of Americans report current nonmedical use of a prescription drug. Opioids are the class most commonly used for purposes other than intended. Other drugs include sedatives (primarily benzodiazepines); stimulants; and a variety of agents, including clonidine, muscle relaxants, tricyclic antidepressants, bupropion, antiemetics, gabapentinoids, and atypical antipsychotics. Over-the-counter drugs associated with nonmedical use include dextromethorphan, loperamide, and antihistamines. The most prominent risk factor for nonmedical use is a history of a substance use disorder. A number of aberrant behaviors are indicative of nonmedical use. Screening instruments may help gauge risk. The most serious complication is overdose, particularly opioid overdose. Strategies to address nonmedical prescription drug use include limiting the prescribing of controlled substances, monitoring patients who are prescribed these medications, and providing treatment for those who have a substance use disorder.

Based on the estimates of the 2007 National Survey on Drug Use and Health (NSDUH), 9.5% of women of child-bearing age (ages 15–44 years)—almost six million—use illicit drugs annually (SAMHSA 2007). A lower proportion of use is estimated among pregnant women (5.2%), but this rate is high enough to make illicit drug use during pregnancy a major public health concern. However, among 15- to 17-year-olds, the rate of illicit drug use during pregnancy is 22.6%, higher than the rate of use (13.3%) in those not pregnant in same age range (SAMHSA 2007). The commonly used illicit substances by women of child-bearing age include marijuana and hashish, cocaine, heroin, hallucinogens, and psychotherapeutic agents including pain relievers, tranquilizers, stimulants, and sedatives. Of interest is the increasing nonmedical use of prescription medications; rate of use of pain relievers among women of child-bearing age is 2.6%, higher than the reported rates of cocaine (1.0%) and heroin (0.1%) use. The use of hallucinogens and inhalants is more common among teens (SAMHSA 2007). The rates and types of substance used vary among different sociodemographic characteristics such as marital status, level of education, employment status, method of hospital payment, and ethnicity (NIH 1996). In 2006–2007, the annual rate of drug use during pregnancy was highest among non-Hispanic white women (6.2%), slightly higher than in the non- Hispanic African American women (5.7%). An earlier survey on drug use during pregnancy found that the rate of cocaine use was highest among African Americans (4.5%) and in the those older than 25 years of age, whereas the younger age group had the highest rate of marijuana use (3.5%) (NIH 1996). In utero exposure to illicit substances may be associated with adverse effects on the developing brain through various mechanisms, with resultant physical and or cognitive and behavioral abnormalities. This chapter focuses on cognitive and behavioral outcomes in childhood and adolescence following prenatal illicit drug exposure. However, it is essential to realize that most women who use drugs are polydrug users; that is, they also use tobacco and/or alcohol, or a combination of other illicit drugs.