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Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication

Molina BSG, Hinshaw SP, Arnold LE, Swanson JM, Pelham WE, Hechtman L, Hoza B, Epstein JN, Wigal T, Abikoff HB, Greenhill LL, Jensen PS, Wells KC, Vitiello B, Gibbons RD, Howard A, Houck PR, Hur K, Lu B, Marcus S.

A study by Brooke Molina, PhD, et al. revealed a significantly higher prevalence of substance abuse and cigarette use by adolescents with attention deficit hyperactivity disorder (ADHD) histories than in those without ADHD.  The results revealed that, contrary to previous findings, current medications for ADHD do not counter the risk for substance abuse and substance use disorder (SUD) among teenagers.

This study is the first to examine teenage substance abuse and treatment for ADHD in a large multi-site sample.  It is also the first to recognize that increased use of cigarettes in teenagers with ADHD histories commonly occurs with use of other substances such as alcohol and marijuana. Researchers studied nearly 600 adolescents over an eight-year period from childhood through adolescence to test the hypothesis that children with ADHD have increased risk of substance use and abuse or dependence in adolescence.  Dr. Molina and colleagues also examined substance abuse patterns, the effects of ADHD medications over time, and the relationship between medication and substance use.

The authors suggest that future research needs to determine ways to help teenagers with ADHD-related impairments, such as impulsive decision-making, poor school performance, and difficulties making healthy friendships, that increase their risk of substance abuse.  They note that strategies are needed for helping them accomplish these goals while decreasing the ADHD-related risk of drug abuse.

Contributors:
Brooke Molina, PhD (Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA)
Stephen Hinshaw, PhD (University of California–Berkeley)
L. Eugene Arnold, MD & Bo Lu, PhD (Ohio State University)
James Swanson, PhD & Timothy Wigal, PhD (University of California–Irvine)
William Pelham, PhD (Florida International University)
Lily Hechtman, MD (McGill University)
Betsy Hoza, PhD (University of Vermont)
Jeffery Epstein, PhD (University of Cincinnati)
Howard B. Abikoff, PhD (New York University)
Laurence Greenhill, MD & Sue Marcus, PhD (Columbia University)
Peter Jensen, MD (REsource for Advancing Children’s Health (REACH) Institute and the Mayo Clinic)br /> Karen Wells, PhD (Duke University)
Benedetto Vitiello, MD (National Institute of Mental Health)

Robert Gibbons, PhD (University of Chicago)
Andrea Howard, PhD (University of North Carolina)
Patricia R. Houck, MSH (University of Pittsburgh Medical Center)
Kwan Hur, PhD (Hines Veterans Affairs Hospital and the University of Illinois–Chicago)

This study was published online in the Journal of the American Academy of Child and Adolescent Psychiatry.

Click here for a link to the abstract.