Misuse of attention/hyperactivity drugs among adolescents in Estonia: motivations, risks and access

Background

Misuse of psychotropic prescription drugs, including attention or hyperactivity drugs (AHDs), among adolescents is a growing public health concern and poses significant health risks. This study aimed to describe the prevalence and patterns of AHD misuse, including sources, motivations, and perceptions of risk and accessibility.

Methods

Nationally representative data were drawn from the 2024 European School Survey Project on Alcohol and Other Drugs (ESPAD) survey of 15–16-year-old students in Estonia (n = 2,015). Descriptive analyses were conducted to estimate the lifetime prevalence of AHD misuse, as well as sources, motivations, and perceptions of risk and accessibility. Results are presented as prevalence rates (%) with 95% confidence intervals (CIs).

Results

Misuse of AHDs was reported by 4.4% (95% CI 3.6–5.4) of adolescents, and was more common among boys (5.1%, 3.8–6.6) than girls (3.7%, 2.6–5.1). AHDs used for misuse were most often obtained from a family member or friend (37.1%, 27.1–48.0) or from home (34.8%, 25.0–45.7). Among AHD misusers, the main motivations for prescription drug misuse were to help with falling asleep (42.7%, 32.2–53.6), to manage anxiety or depression (40.4%, 30.2–51.4), and to improve mood (37.1%, 27.1–48.0). Over half of AHD misusers perceived occasional AHD misuse as posing low or no health risk (55.4%, 44.1–66.3), and AHDs were commonly considered easy to obtain (51.7%, 40.8–62.4), whereas only 11.2% (5.5–19.7) considered AHDs impossible to access without a doctor’s authorization.

Conclusions

Misuse of AHDs among Estonian adolescents, although relatively low, remains a concern. Prescription drugs used for misuse are mainly obtained through social networks and from home, with driven by sleep problems and anxiety. Low perceived health risk and high perceived accessibility may facilitate AHD misuse, highlighting the need to improve risk awareness, ensure safe storage, and strengthen mental health support.

Key messages

• Misuse of attention or hyperactivity drugs affects 4.4% of Estonian adolescents, slightly more often boys, with access mainly through social networks and home.

• Prescription drug misuse is commonly reported for sleep problems and anxiety, alongside low perceived risk and high accessibility, highlighting the need for prevention and mental health support.