Expert Commentary

Treating ADHD may prevent drug abuse

Kids with attention-deficit hyperactivity disorder (ADHD) are more likely to develop drug problems, but standard treatments may reduce the risk, a new paper finds.

teenager on wall
(Redd Angelo/Unsplash)

People with attention-deficit hyperactivity disorder (ADHD) can rush from idea to idea and have difficulty completing tasks, overlook details, fail to meet deadlines or be easily distracted. They are also more likely to abuse drugs and alcohol, research has shown.

Worldwide, about 3.4 percent of young people are affected by the disorder, which is formerly known as ADD and often follows them into adulthood.

Treatment has been available for decades, thanks to drugs like Adderall, an amphetamine, and methylphenidate (often sold as Ritalin). But prescribing pills to children is not without controversy.

A new paper comes down firmly on one side of the debate, looking at how standard ADHD medications may reduce substance abuse.

An academic study worth reading: “ADHD Medication and Substance-Related Problems,” in The American Journal of Psychiatry, 2017.

Study summary: A team led by Patrick Quinn of Indiana University hypothesized that ADHD sufferers who receive medication may be less likely to develop substance-abuse problems.

They looked at a dataset of almost 3 million American adolescents and adults who had received an ADHD diagnosis or drug treatment between 2005 and 2014. The researchers focused on the subset of this vast population (about 85 percent) that had received an ADHD medication (usually a stimulant) for at least a month over this period. They also studied those who had been taken to the emergency room for drug or alcohol abuse (about 2 percent of the total). The researchers call an emergency room visit a “substance-related event.”

Key takeaways:  

  • People diagnosed with ADHD were about three times more likely to have a substance-related problem than the population at large. ADHD patients who had received treatment were less likely to have a problem than patients who hadn’t.
  • Male patients who were receiving ADHD medication in a given month were 35 percent less likely to have a substance-related problem in that month; females were 31 percent less likely.
  • In another model — comparing individuals when they received medication to themselves when they did not — males were 55 percent less likely and females were 43 percent less likely to have a substance-related event.
  • Two years after taking ADHD medication, male patients were 19 percent less likely, and female patients 14 percent less likely, to experience a substance-related event than the population at large. The same trend persisted to three years, though it was diminished, especially in females. 

Helpful resources:

The National Institutes of Health, the U.S. government research body, has a resource page on ADHD. The Centers for Disease Control and Prevention describes steps in a diagnosis.

The American Psychiatric Association, which calls ADHD “one of the most common mental disorders affecting children,” describes symptoms and treatment here and publishes a guide for parents here.

Other research:

  • A 2017 study in JAMA Psychiatry found ADHD patients who take medication are significantly less likely to have car crashes.
  • An ADHD diagnosis before age 15 is a strong indicator of a future drug-use disorder, according to this 2015 paper in Psychological Medicine.
  • Teenagers from affluent suburban homes are more likely to abuse alcohol and drugs than the national average, according to a paper we reviewed in 2017. Parental attentiveness is key to prevention.
  • Our 2017 roundup on the popular pesticide chlorpyrifos includes research that finds the chemical may contribute to ADHD.

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