Sunday, November 03, 2002
ADHD Teens No More Likely to Abuse Drugs
Substance Use Equivalent To Others with Psychiatric Disorders
By Paula Moyer
WebMD Medical News Reviewed By Brunilda Nazario, MD advertisement
Oct. 30, 2002 (San Francisco) -- When young people are diagnosed with attention deficit hyperactivity disorder (ADHD), they are typically prescribed a stimulant medication such as Ritalin, the mainstay of ADHD therapy.
This treatment and the condition itself often raise questions in parents' minds. Is stimulant therapy safe? Will this treatment put my child at risk of future drug abuse? Will ADHD itself increase the risk that my child will be involved in drug abuse?
New research presented at the 49th annual meeting of the American Academy of Child and Adolescent Psychiatry may shed some light on these questions. Among young people who have mental health problems, those with ADHD seem to have the same likelihood to be involved with substance abuse as other young people with psychiatric disorders -- but no more, according to Melissa D. Rowland, MD.
"Among psychiatrically hospitalized young people, those with ADHD had similar patterns of substance abuse to those without ADHD," she tells WebMD. "However, they were less likely to smoke cigarettes and more likely to get into fights at the beginning of the study." She is a professor of psychiatry at the Medical University of South Carolina.
"Encouragingly, after those with ADHD had been on stimulant therapy for four months, their cigarette use and dangerous behaviors were reduced even further," she said. She says these findings should be encouraging news for parents.
Rowland and colleagues wanted to know how frequently drug use and high-risk behavior occurred in ADHD youth compared to young people who had serious mental health problems but did not have ADHD. They also wanted to know if stimulant medications had an effect on substance abuse and risk-taking behaviors. The study was funded by the National Institute on Drug Abuse and the National Institute of Mental Health.
The participants were 156 adolescents who had been admitted to a psychiatric hospital. They were evaluated at the time of their admission and four months later.
Among the 156 patients, 52 were diagnosed with ADHD. At the time of admission those with ADHD reported similar drug use to those without ADHD. The participants with ADHD were less likely to smoke but more likely to get into fights than those without ADHD. However, overall, they were involved in significantly fewer dangerous behaviors of other types.
At follow-up, 40 of the 52 patients with ADHD were receiving stimulants. That group showed a trend toward less cigarette use and significant reductions in dangerous behaviors compared with the 12 patients with ADHD who were not taking stimulants. It was encouraging to see that stimulant use may be associated with these beneficial outcomes, as well as addressing ADHD symptoms directly, Rowland says.
More research needs to be done to see if these findings are valid, says Judy McNeil Linger, MD, who was not involved in the study.
"It is an interesting study with surprising results, because past research on young people with ADHD has shown that they are more likely to be involved in substance abuse," says Linger, medical director of the Child-Adolescent Program in the Center for Emotional And Behavioral Health at Indian River Memorial Hospital in Vero Beach, Fla.
"I would need to see a similarly designed study with similar findings before I would embrace these findings," she said. "One of the concerns about ADHD and stimulant treatment is diversion, or the risk that people other than the patient will use the medication. Therefore, in addition, I would also like to see research on the feasibility of other drug classes, such as certain antidepressants, for the treatment of ADHD." © 2002 WebMD Inc. All rights reserved.