ADHD Drugs Don't Lead to Drug Abuse

Jan. 6, 2003 -- Contrary to fears of some parents -- and doctors -- children who take medication to treat attention deficit hyperactivity disorder (ADHD) face no greater risk of future substance abuse, according to a new study.

Researchers say this study, published in the Jan. 6 issue of Pediatrics, is now the 11th to find no evidence of the so-called "sensitization theory" suggesting that children treated with ADHD stimulant medications such as Ritalin and Adderall are more likely to smoke, drink, or take illicit drugs as teenagers or adults. Only one study documented an increased risk of later cocaine use among children who have been treated with these stimulants, which bring improvement in about 80% of children with ADHD.

"While stimulant medication is certainly not the only important intervention, it is the single most powerful intervention we have for treating ADHD," says study researcher Mariellen Fischer, PhD, of the Medical College of Wisconsin. "Putting a child on a stimulant medication is a very difficult decision for parents to make, even if the child has substantial problems at home and at school, and one of the biggest worries that comes to mind is how will this will impact their risk for later drug abuse."

That fear is largely due to earlier concerns, shared until recent years by even the National Institute of Mental Health (NIMH), that long-term stimulant use in children might alter the way the brain reacts to those and other drugs, serving as a "gateway" for later tendency to abuse or addiction. These concerns stemmed largely from research in the early 1990s that measured brain activity in lab rats who were given older stimulants that are rarely used today to treat ADHD.

"However, those researchers were administering doses that were far in excess to what would ever be used in humans," says Fischer. In her study, the researchers did not compare different types of stimulants used by their patients, since the overwhelming majority were taking Ritalin.

Still, fears of the "sensitization theory" linger. As recently as last September, a congressional subcommittee met to discuss the issue, prompted by a campaign by the Citizens Commission on Human Rights, an affiliate of the Church of Scientology. In that meeting, an NIMH official stated that recent studies suggest there is no evidence that ADHD medications increase risk of later drug abuse.

"There is an organized campaign to pass misinformation about the use of these stimulants," says E. Clarke Ross of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). "These findings are very important to families who want reassurance that ADHD treatment options are safe and effective -- and particularly that stimulant medications are safe and effective. They reinforce the fact that if you or a member of your family is on stimulant medication for ADHD, you should not fear substance abuse disorders in the future."