When ADHD and substance use disorders intersect: relationship and treatment implications.
Timothy E Wilens1, Steven Fusillo
1Pediatric Psychopharmacology Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. twilens@partners.org
Current Psychiatry Reports
|October 5, 2007
Summary
Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance use disorders (SUDs). Treating childhood ADHD lowers adult SUD risk, but adult ADHD and SUDs require integrated treatment beyond medication alone.
Area of Science:
- Neuroscience
- Psychiatry
- Developmental Psychology
Background:
- Growing recognition of the significant overlap between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs).
- Understanding the complex developmental trajectory linking these two conditions is crucial for effective intervention.
Purpose of the Study:
- To elucidate the developmental relationship between ADHD and SUDs.
- To review the impact of ADHD on SUD development and vice versa.
- To assess the efficacy of current treatment strategies.
Main Methods:
- Review of existing literature on the comorbidity of ADHD and SUDs.
- Analysis of developmental pathways and risk factors.
- Evaluation of treatment outcomes for ADHD and SUDs.
Main Results:
- ADHD, with or without comorbid psychopathology, significantly increases the risk for developing SUDs in adulthood.
- Approximately 20% of adults diagnosed with SUDs also have ADHD.
- Pharmacological treatment of ADHD in children is associated with reduced risk of adult smoking and SUDs.
- Monotherapy with medication for adults with co-occurring ADHD and SUDs is insufficient for managing either condition.
- Stimulant diversion remains a notable concern, especially among adolescents and young adults.
Conclusions:
- ADHD is a critical risk factor for SUD development, necessitating early intervention.
- Integrated treatment approaches are essential for adults with comorbid ADHD and SUDs.
- Addressing stimulant diversion is vital in managing at-risk populations.
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