ADHD Drugs Won't Raise Risk of Substance Abuse

SATURDAY, March 1 (HealthDay News) -- Parents of children who are prescribed psychostimulants for attention deficit-hyperactivity disorder (ADHD) might have one less thing to worry about now that a new study concludes these kids are no more likely than their peers to abuse drugs and alcohol as young adults.

The report, which was funded by the National Institutes of Health, is published in the March issue of the American Journal of Psychiatry.

"The results should reassure clinicians who might be hesitant to treat ADHD because of concerns about future substance abuse," said study co-author Michael C. Monuteaux, assistant director of research at the pediatric psychopharmacology program at Massachusetts General Hospital.

Past research looking for a link between ADHD medications and substance abuse has produced conflicting conclusions.

"Some previous studies showed an increased risk of substance abuse associated with stimulant treatment, and other studies showed both no association and also a protective effect from treatments," Monuteaux said. "But those studies had some methodological limitations, and not all of them followed their samples well into late adolescence and early adulthood."

The Massachusetts General Hospital investigators designed their study to overcome the shortcomings of previous studies. They followed their research subjects up to a median age of about 22, included an assessment for psychiatric problems such as conduct disorder that are associated with substance abuse, and applied rigorous methods to accurately analyze data.

The research study team interviewed 112 young men (ranging in age from 16 to 27) a decade after they had been diagnosed with ADHD about their use of alcohol, tobacco and a variety of psychoactive drugs. Seventy-three percent of the subjects had been treated with stimulants at some time, and 22 percent were currently taking the stimulant medications.

The study found no relationship between having ever received stimulant treatment and the risk of future alcohol or other substance abuse. The age at which stimulant treatment began and how long it continued also had no impact on substance use.

"This study is a continuing effort to explicate the factors that mediate risk. It is methodologically sound and suggests that, as always, things are more complicated than we want them to be. The study demonstrates that the use psychostimulants for ADHD children do not increase the risk for substance abuse in adulthood, but it also suggests there is no protective effect, said Dr. Jon A. Shaw, director of the Division of Child and Adolescent Psychiatry and Behavioral Science at the University of Miami.

Symptoms of ADHD include impulsiveness, hyperactivity and inattention. According to a study published last fall in the Archives of Pediatrics & Adolescent Medicine, almost 9 percent of American children have ADHD, but only 32 percent of them are getting the medication they need.

"There is sufficient evidence that parents should be reassured that the use of psychostimulant medication for the treatment of ADHD in children and adolescents does not increase the risk for substance abuse in later life and remains the most effective treatment for this condition," Shaw said.

More information

For more on ADHD, visit the National Institute for Mental Health.

SOURCES: Michael C. Monuteaux, Sc.D., assistant director, research, pediatric psychopharmacology program, Massachusetts General Hospital, Boston; Jon A. Shaw, M.D., professor and director, Division of Child and Adolescent Psychiatry and Behavioral Science, University of Miami; March 2008, American Journal of Psychiatry

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