{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:51:29Z","timestamp":1773287489990,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,1,9]],"date-time":"2018-01-09T00:00:00Z","timestamp":1515456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["AHRQR24 HS022418"],"award-info":[{"award-number":["AHRQR24 HS022418"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["5K08DA031245"],"award-info":[{"award-number":["5K08DA031245"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AHRQR24 HS022418"],"award-info":[{"award-number":["AHRQR24 HS022418"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["NIDA 5K08DA031245"],"award-info":[{"award-number":["NIDA 5K08DA031245"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Non\u2010medical use of prescribed stimulant medications is a growing concern. This study's aims were to ascertain the demographics of stimulant medication users compared with non\u2010users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cox proportional hazards regression in a retrospective cohort adjusted by baseline covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>United States, national administrative database of the Veterans Affairs (VA) health\u2010care system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adult incident users of stimulant medications (<jats:italic>n<\/jats:italic>\u00a0=\u00a078\u2009829) from fiscal years (FY) 2001 to 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Primary outcomes were time\u2010to\u2010event: (1) occurrence of AUD diagnosis and (2) death. Baseline covariates included demographic information, Food and Drug Administration (FDA)\u2010approved indications for stimulant use, substance use disorders (SUD) and depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Stimulant users compared with non\u2010users were younger, more likely to be non\u2010Hispanic white and female. Incident stimulant medication users increased threefold from FY2001\u2013FY2012 and eightfold among adults aged 18\u201344\u00a0years. Nearly one in 10 incident users in FY2012 had a comorbid baseline SUD. Off\u2010label use was common\u2014nearly three of every five incident users in FY2012. Comorbid SUDs among incident stimulant medication users were risk factors for occurrence of AUD during follow\u2010up, with adjusted hazard ratio (AHR) estimates ranging from 1.54 to 2.83 (<jats:italic>P<\/jats:italic>s\u00a0&lt;\u00a00.05). Increased mortality risk was observed with occurrence of AUD during follow\u2010up [AHR\u00a0=\u00a01.55, 95% confidence interval (CI)\u00a0=\u00a01.13\u20132.14, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.007], while on\u2010label prescribing was protective against death (AHR\u00a0=\u00a00.686, 95% CI\u00a0=\u00a00.63\u20130.75, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a US national cohort of adult incident stimulant medication users in the Veterans Affairs health\u2010care system, measured from fiscal years 2001 to 2012, comorbid substance use disorders were common and were risk factors for development of an amphetamine use disorder (AUD). Increased mortality risk among incident users of stimulant medications was observed among both those who developed an AUD later and those whose use was defined as off\u2010label.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14122","type":"journal-article","created":{"date-parts":[[2017,12,7]],"date-time":"2017-12-07T15:46:03Z","timestamp":1512661563000},"page":"857-867","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration"],"prefix":"10.1111","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6514-5441","authenticated-orcid":false,"given":"Arthur N.","family":"Westover","sequence":"first","affiliation":[{"name":"Department of Psychiatry UT Southwestern Medical Center  Dallas TX USA"},{"name":"Department of Clinical Sciences UT Southwestern Medical Center  Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Nakonezny","sequence":"additional","affiliation":[{"name":"Department of Psychiatry UT Southwestern Medical Center  Dallas TX USA"},{"name":"Department of Clinical Sciences UT Southwestern Medical Center  Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan A.","family":"Halm","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences UT Southwestern Medical Center  Dallas TX USA"},{"name":"Division of General Internal Medicine, Department of Internal Medicine UT Southwestern Medical Center  Dallas TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryon","family":"Adinoff","sequence":"additional","affiliation":[{"name":"Department of Psychiatry UT Southwestern Medical Center  Dallas TX USA"},{"name":"VA North Texas Health Care System Dallas VAMC  TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2014.10.019"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.26.2.450"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1087054715605915"},{"key":"e_1_2_8_5_1","unstructured":"Express Scripts.Turning attention to ADHD: U.S. medication trends for attention deficit hyperactivity disorder. The Express Scripts Lab: Express Scripts;2014."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.12m07975"},{"key":"e_1_2_8_7_1","volume-title":"Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health","author":"Substance Abuse and Mental Health Services Administration (SAMHSA)","year":"2015"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.14m09291"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2013.09.005"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2011.01.021"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2005.15.764"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.07091486"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2012.12.014"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.1273"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.1182"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.26.10.1501"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2012.759858"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2006.07.010"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2007.01758.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.14m09559"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2007.05.010"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2012.12.004"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2008.06.005"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00238-X"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e31815a56f1"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2002.00079.x"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.05.028"},{"key":"e_1_2_8_28_1","volume-title":"Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment","author":"Galea S.","year":"2012"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fadd.14122","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.14122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T06:06:12Z","timestamp":1695535572000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.14122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,9]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1111\/add.14122"],"URL":"https:\/\/doi.org\/10.1111\/add.14122","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,9]]},"assertion":[{"value":"2016-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-11-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}