Madeline J. Cohen · December 2013
82 GEO. WASH. L. REV. 174 (2013)
A disturbing trend is emerging in pediatric medicine. Physicians are now prescribing Adderall, an amphetamine-based stimulant intended to treat attention deficit hyperactivity disorder (“ADHD”), to healthy children. Physicians are prescribing the drug to enhance academic performance. This practice can harm otherwise healthy children. It also helps divert more Adderall into the black market for amphetamines that pervades middle school, high school, and college campuses.
Adderall and other amphetamine-based medications have a high potential for abuse and may lead to physical and psychological dependence. Other adverse effects of these drugs include weight loss, insomnia, psychosis, and even sudden death in some children. Furthermore, the long-term effects of these amphetamines on children have not been studied and some physicians worry that the drugs may hinder brain development.
The current legal framework governing prescription drugs has failed to protect healthy children from the dangerous effects of unneeded amphetamines. The Controlled Substances Act classifies amphetamines as Schedule II drugs, and thus prohibits an individual from obtaining them without a written prescription. The Act, however, gives physicians wide latitude to prescribe controlled substances for any “legitimate medical purpose.” In addition, the Act does not require physicians, when prescribing a controlled substance, to report their diagnosis or medical purpose before writing the prescription. The law thus does little to deter physicians from prescribing amphetamine-based ADHD medication to children without ADHD.
States also have broad authority to regulate physicians and the prescription of medications, but current state laws address broad categories of drugs and are not finely tailored to prevent the off-label prescription of amphetamines to minors. Although some states have attempted to target controlled-substance abuse, most schemes lack an effective enforcement mechanism to find and punish physicians and pharmacies that violate the law.
This Note proposes a model state statute that will protect minors from the hazards of overprescribed amphetamine-based medications by (1) requiring prescribers to certify a diagnosis of ADHD before prescribing an amphetamine- based ADHD medication to a minor, (2) requiring the state to maintain a prescription-monitoring database to track off-label prescriptions, and (3) mandating minimum penalties for those who violate the statute.
