As you know from a billion trend stories, CNS stimulants are back in demand now, especially for the flourishing diagnosis of ADHD. Some pharmacies consistently struggle to keep amphetamines in stock, and there are wait lists for prescription refills. The primary drugs prescribed today are dextroamphetamine (Dexedrine, Adderall) and non-amphetamine methylphenidate (Ritalin, Concerta). What these medications do, like amphetamines of old, is mimic and enhance the actions of norepinephrine (noradrenaline) and dopamine in our brains.

What the National Institute of Drug Abuse classifies as a "dramatic" return of stimulant prescriptions to the medical scene in the last two decades does feed a black market, and the ubiquity, ease of access, and the fact that they're often prescribed to children (and used safely and to good effect) seem to paint a health halo, or a picture of benignity, that for some effectively condones recreational and off-label use (especially for cognitive and physical performance enhancement).

It's with that concern in mind that the U.S. Substance Abuse and Mental Health Services Administration is looking at the effects of "nonmedical use" of CNS stimulants. In a report released on Friday they tell us that emergency department visits among young adults related to these stimulants quadrupled — from 5,600 in 2005 to almost 23,000 in 2011.

Stimulant-related ED visits among people 18 to 34

SAMHSA defined the "nonmedical use" as either taking too much, taking something that wasn't prescribed for you, or taking more than the recommended dose of an over-the-counter product. The prescriptions included amphetamine and non-amphetamine stimulants. Meth was not included.

A few months ago I wrote about SAMHSA's report that indicted energy drinks, citing a ten-fold in energy-drink related ER visits in recent years. The stimulant numbers in the current report do include some energy drinks, but SAMHSA says the drinks "had a minor effect" on these nonmedical use numbers, because they're usually classified under "adverse reactions." In 2011, for example, 70 percent of 20,000+ energy-drink related visits involved "adverse reactions."

I don't read this as an indictment of these medications, but as a solid case for their judicious and supervised use as they become increasingly prevalent. We can learn from our historic love affair with CNS stimulants. It didn't work out, and that doesn't mean we can't still be friends, but we shouldn't sleep together.

The question remains, as we're told we can't trust high doses of brightly-colored canned products like Monster, Full Throttle, CHARGE!, Hardcore Energize Bullet, Facedrink, Eruption, Crakshot, Crave, Crunk, DynaPep, Rage Inferno, SLAP, and even Venom Death Adder — and prescription stimulants are sending us to the hospital in increasing numbers — why do we young adults so demand this sort of stimulation? How does one get through the modern day, and keep up with his modern peers, without stimulants? Should everything always begin and end with coffee?