Table 5

Proposed recommendations to prevent non-medical use of methylphenidate (MPH) and challenges associated with prevention.

A. Proposed recommendations to prevent non-medical use of MPH

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Diagnosing ADHD more carefully [37,38,50]

Supervising of students with stimulant prescriptions [33,47]

Teaching students effective study skills and stress management [17,37]

Informing students and staff of the dangers of abusing prescription drugs [18,33,34,37]

Criminalizing non-approved uses of medications [3,48]

Prohibiting prescription of drugs for lifestyle purposes by doctors [48]

Obliging manufacturers to declare safety data for unapproved uses to the FDA [48]

Subsidizing cognition enhancing drugs to allow equal access [40,48]

Establishing a "ceiling" as the maximum cognitive enhancement permissible [48,53]

Ensuring prescription compliance and responsible prescription practices [49,52]

Prescribing preparations that are less easily abused [41,51]

Identifying persons who are liable to abuse medication [49]

Educating healthcare providers dealing with university populations as to the abuse potential of stimulants [51,52]

B. Identified challenges in the prevention of non-medical use of MPH

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Logistical problems of enforcing a ban [37,38,54]

Perceived safety of MPH makes convincing students about its dangers more difficult [35,37]

Abundance of MPH in healthcare system [50]

Misuse of MPH bypasses traditional sources of information on indications and risks when taking a prescription medication [37]

Difficult to propose a ban on cognitive enhancers because of their routine use in treatment [40,48,53]

Ban is liable to encourage a black market and be just as coercive as social pressure [40,48,53]

FDA has little experience in assessing social cost/benefit of a drug and thus is unfit to take charge of such regulation [53]

None identified

Forlini and Racine BMC Medical Ethics 2009 10:9   doi:10.1186/1472-6939-10-9

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