ADHD and substance use disorders: developmental aspects and the impact of stimulant treatment

Adolescents and adults with substance use disorders often demonstrate symptoms of inattention, impulsivity, and hyperactivity. These core symptoms of ADHD may contribute to the development of substance use disorders by promoting antisocial behavior and substance use; conversely, substance use itself can adversely affect these symptoms. Common deficits in self-regulatory processes could underlie the developmental progression of these disorders, deficits further worsened by ongoing substance use. Some investigators have questioned whether stimulant treatment itself could promote substance abuse, while others have argued that such treatment reduces substance abuse. With an increased awareness of the phenomenon of adult ADHD and its relevance to substance-abusing persons, there is an increased awareness of the potential benefit of ADHD treatment on substance abuse treatment outcome. Consideration of an individual's developmental relationship between attention deficit/hyperactivity symptoms and substance use can inform treatment planning among patients seeking substance abuse treatment.