1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-11-05-b 10.15844/pedneurbriefs-11-1-9 Attention Deficit Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant ADHD and Psychoactive Substance Abuse http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 01 1997 01 05 2016 11 1 5 6 Copyright: © 1997 The Author(s) 1997 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study

The effect of attention-deficit hyperactivity disorder (ADHD) compared to psychiatric comorbidity, familiality, and adversity, as risk factors for psychoactive substance use disorder (PSUD) was evaluated at the Department of Psychiatry, Massachusetts General Hospital, Boston, MA.

 Attention-Deficit Hyperactivity Disorder Psychoactive Substance Use Disorder Conduct Disorders

The effect of attention-deficit hyperactivity disorder (ADHD) compared to psychiatric comorbidity, familiality, and adversity, as risk factors for psychoactive substance use disorder (PSUD) was evaluated at the Department of Psychiatry, Massachusetts General Hospital, Boston, MA. Using baseline and 4-year follow-up data from 140 ADHD and 120 normal control subjects, the rates of alcohol or drug abuse or dependence (PSUD) were 15%, with no differences between groups. Conduct and bipolar disorders were predictive of PSUD, but these associations were independent of ADHD. Oppositional defiant disorder, uncomplicated by conduct disorder, did not predict PSUD. Family history of substance dependence and antisocial disorders was associated with PSUD in controls but less so in ADHD probands. Family history of ADHD was not associated with risk of PSUD. [1]

COMMENT. Adolescents with or without ADHD have a similar risk of psychoactive substance use disorders (PSUD), with a frequency of 15%. However, children with ADHD may be at higher risk for early-onset addictions than controls. PSUD in adolescents is associated with a history of conduct and bipolar disorders, but not oppositional defiant disorder, major depression, or anxiety disorders. The risk of PSUD is increased in adults with ADHD, and a sharp increase in PSUD may be expected in adolescent ADHD subjects as they become adults.

Comorbid ADHD and substance abuse. Comorbidity of ADHD among adolescents in treatment for substance abuse is reported from the National Center for Post Traumatic Stress Disorder, Veteran’s Affairs Medical Center, West Haven, CT [2]. Attempts to self-medicate symptoms of ADHD may underlie substance use and abuse, especially in previously untreated adolescents. Prescribed medical treatment for ADHD may decrease drug craving in adults with ADHD and improve functioning.

ADHD and cigarette smoking. ADHD, particularly when associated with conduct disorders, is a significant risk factor for early cigarette smoking in children and adolescents in a study at the Massachusetts General Hospital, Boston. [3]

Biederman J Wilens T Mick E Faraone SV Weber W Curtis S Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study J Am Acad Child Adolesc Psychiatry 1997 Jan 36 1 21 29 10.1097/00004583-199701000-00013 9000777 Horner BR Scheibe KE Prevalence and implications of attention-deficit hyperactivity disorder among adolescents in treatment for substance abuse J Am Acad Child Adolesc Psychiatry 1997 Jan 36 30 36 10.1097/00004583-199701000-00014 9000778 Milberger S Biederman J Faraone SV Chen L Jones J ADHD is associated with early initiation of cigarette smoking in children and adolescents J Am Acad Child Adolesc Psychiatry 1997 Jan 36 37 44 10.1097/00004583-199701000-00015 9000779