Child psychologists have observed a link between bullying and ADHD.

Children who have been diagnosed with ADHD, or attention deficit hyperactivity disorder, are more likely to be bullied. They’re also more likely to be bullies.

No one knows exactly what’s behind these correlations. Young people with ADHD engage in impulsive, sometimes risky, behavior, so they may be inadvertently putting themselves in the line of fire. Impulsive behavior can also include aggression.

But new research points to another layer: the stimulant medications prescribed for ADHD.

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Selling, Sharing Medication

According to a study published today in the Journal of Pediatric Psychology, teens who took ADHD medications such as Adderall (amphetamine and dextroamphetamine) were more likely to be bullied than those with ADHD who didn’t take medication.

Both were bullied more often than their peers, according to the study led by Quyen Epstein-Ngo, Ph.D., a research assistant professor at the Institute for Research on Women and Gender at the University of Michigan.

Exploring how medication may influence bullying is a useful addition to understanding ADHD and bullying in schools, according to Dr. Frances Turcotte-Benedict, MPH, an associate professor of pediatric emergency medicine at the Alpert Medical School of Brown University.

We’ve never been able to separate, what is it about ADHD?” Turcotte-Benedict said.

 Epstein-Ngo’s research methodically honed in on medication. Researchers adjusted their findings for the severity of students’ ADHD symptoms, which could skew findings.

“We’ve factored out that ADHD kids may have more difficulties with peer relationships and that might lead to bullying. We’ve factored out that some kids may have more severe symptoms and that may lead to bullying, and we’ve also factored out the fact that some kids may have additional problem behaviors,” Epstein-Ngo said.

Here’s where things got interesting. Students who had given away or sold their medications in the previous year were most likely to be the targets of bullying. That suggests, though it doesn’t prove, that bullying plays into an economy of recreational use of stimulant medications.

Of the nearly 5,000 students at five public schools who completed surveys for the study, 1 in 5 who were taking medications reported being approached to sell or share them. Half who were approached ended up selling or sharing the drugs.

Sharing the medication was linked to more bullying, not less, suggesting that these youths may become suppliers of the drugs against their will.

“Answering some of those questions is the next step,” Epstein-Ngo said. “Are kids being approached and coerced and bullied into giving their medication away, or is it that these kids with ADHD tend to be bigger risk takers, so are they getting themselves into situations where they’re more likely to be victimized?”

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Is Less Medication the Answer?

Many might conclude that the solution is medicating fewer young people. ADHD diagnoses are among those that have skyrocketed in recent years. According to National Health Interview data, 10 percent of children and teens were identified as having ADHD in 2012, up from 6 percent in 1999.

But the mediations are safe when used properly and benefit 80 percent of children diagnosed, according to the American Academy of Pediatrics.

“While we could make the argument that some kids are being overly medicated, there are kids who really need these drugs to function,” Turcotte-Benedict said.

“These are still children, from a medical and pediatric standpoint. The parents need to take more of a role in controlling these substances,” she added. “Even though they’re adolescents and we want to be teaching them responsibility, part of that is knowing when to make your leash a little bit shorter. We also see this with kids who are diabetic and don’t know how to manage their insulin.”

Parents could consider giving any medication that needs to be taken at school to the nurse, so that teens aren’t walking around with stimulants in their backpacks, Turcotte-Benedict suggested.

Epstein-Ngo says she doesn’t want her findings to be taken as support for an anti-medication stance.

“There is increased risk for these kids who are on prescription stimulants, but this is not a call to stop medication. It’s a call for more talking and more dialogue,” she said.

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