ADHD, stimulant treatment in childhood and subsequent substance abuse in adulthood - a naturalistic long-term follow-up study

Addict Behav. 2014 Jan;39(1):325-8. doi: 10.1016/j.addbeh.2013.09.002. Epub 2013 Sep 10.

Abstract

The purpose of the study was to estimate the risk of substance use disorder (SUD) and alcohol abuse in adulthood among children and adolescents with attention-deficit hyperactivity disorder (ADHD) compared to the background population. Furthermore, to examine whether the age at initiation and duration of stimulant treatment in childhood predicts SUD and alcohol abuse in adulthood. 208 youths with ADHD (183 boys; 25 girls) were followed prospectively. Diagnoses of SUD and alcohol abuse were obtained from The Danish Psychiatric Central Register. The relative risk (RR) of SUD and alcohol abuse for cases with ADHD, compared to the background population was 7.7 (4.3-13.9) and 5.2 (2.9-9.4), respectively. Female gender, conduct disorder in childhood and older age at initiation of stimulant treatment increased the risk of later SUD and alcohol abuse. Our results warrant increased focus on the possibly increased risk of substance abuse in females with ADHD compared to males with ADHD.

Keywords: ADHD; Alcohol; Attention-deficit/hyperactivity disorder; Attention-deficit/hyperactivity disorder (ADHD); CD; Conduct disorder; DCRS; DPCR; DSM; Danish Civil Registration System; Danish Psychiatric Central Register; Diagnostic and Statistical Manual of Mental Disorders; Epidemiology; HR; Hazard ratio; ICD; International Classification of Diseases; Methylphenidate; ODD; Oppositional defiant disorder; Pharmacoepidemiology; RR; Relative risk; SUD; Substance use disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Alcoholism / epidemiology*
  • Alcoholism / psychology
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / psychology
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Conduct Disorder / epidemiology*
  • Conduct Disorder / psychology
  • Dextroamphetamine / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Methylphenidate / therapeutic use
  • Prospective Studies
  • Risk Factors
  • Sex Factors
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Methylphenidate
  • Dextroamphetamine