Childhood ADHD Linked to Later Risk of Drug Abuse
Study Shows Kids With ADHD May Have Increased Risk for Drug and Alcohol Problems as Young Adults
Role of Medication
The exact role that ADHD treatment, such as stimulant drugs, may play in reducing the risk of substance abuse among people with ADHD is not clear from this study.
The study found that medication treatment did not affect the risk for substance abuse, but more studies would be needed to look at these issues directly to draw any firm conclusions, Wilens says.
Jon Shaw, MD, a professor of psychiatry of the University of Miami School of Medicine, says that these findings mirror what he sees in practice. "This confirms what we know clinically and really replicates previous studies that show us that ADHD is a risk factor for substance abuse later in life."
"It used to be believed that psychostimulants in and of themselves increase the risk for substance abuse among people taking them. But 10 to 15 studies show us that the use of stimulants does not increase this risk," he says.
The increased risk for substance abuse likely has more to do with the nature of ADHD, he says.
"ADHD children are very impulsive and don't learn well from experience and don't respond to the usual contingencies of reward and punishment," Shaw says. "If they have the impulse, they have the proclivity to act on it."
In addition, he says, "many people with ADHD may be self-medicating with marijuana and other substances to mitigate their own inner restlessness and turmoil."
Treating ADHD is essential, Shaw says. "ADHD leads to academic problems and children with untreated ADHD often become targets of teachers who find them disruptive, and it cascades downhill from there."
Stephen Grcevich, MD, a child and adolescent psychiatrist at Family Center by the Falls in Chagrin Falls, Ohio, says that adults with ADHD should be watched closely for signs of substance abuse.
"Kids who were identified as having symptoms of ADHD and conduct disorder should be watched carefully as there may be a role for primary prevention and/or early intervention in terms of substance abuse," he says.