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A naturalistic study of the effects of pharmacotherapy on substance use disorders among ADHD adults

Published online by Cambridge University Press:  12 March 2007

STEPHEN V. FARAONE ,
JOSEPH BIEDERMAN ,
TIMOTHY E. WILENS  and
JOEL ADAMSON
STEPHEN V. FARAONE*
Affiliation:
Departments of Psychiatry and Neuroscience & Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
JOSEPH BIEDERMAN
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
TIMOTHY E. WILENS
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
JOEL ADAMSON
Affiliation:
Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
*
*Address for correspondence: Stephen V. Faraone, Ph.D., Department of Psychiatry, Neuroscience, and Physiology, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY 13210, USA. (Email: faraones@upstate.edu)
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Abstract

Background

Studies of adults with attention deficit hyperactivity disorder (ADHD) show an elevated prevalence of substance use disorders (SUDs) and the substance abuse literature shows that ADHD is elevated in substance users. Some researchers postulate that stimulant treatment of ADHD increases the risk for SUD in ADHD patients but follow-up studies suggest treatment protects patients from subsequent SUDs. This report uses retrospective data to assess the impact of prior ADHD pharmacotherapy on SUDs in 206 ADHD adults (n=79 late-onset ADHD, n=127 full ADHD) grouped by lifetime history of ADHD treatment (no treatment, past treatment, current and past treatment).

Method

Structured Clinical Interview for DSM-IV (SCID) data were used to establish abuse and dependence, and Drug Use Screening Inventory (DUSI) responses were used to establish prevalence of use, preference for cigarettes, alcohol and drugs of abuse, complications from use, and motivation for use (get high, change mood, sleep better).

Results

No differences were found in the prevalence of cigarette smoking, alcohol or drug abuse or dependence, as well as no significant differences in 1-month prevalence of any use or use more than 20 times. No differences were found in complications of drug or alcohol use across groups. Subjects with current treatment rated getting high as a motivating factor significantly more frequently than subjects in the past treatment group; this result lost significance when we included ADHD diagnostic category.

Conclusions

Our results are consistent across substances and ADHD diagnoses, and support the hypothesis that pharmacotherapy does not cause subsequent SUDs.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 12 , December 2007 , pp. 1743 - 1752
Copyright
Copyright © Cambridge University Press 2007

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