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Stimulant medication and substance use outcomes: a meta-analysis
Kathryn L Humphreys1, Timothy Eng, Steve S Lee
1Department of Psychology, University of California, Los Angeles, CA 90095, USA. k.humphreys@ucla.edu
JAMA Psychiatry
|June 12, 2013
Summary
Childhood stimulant medication for attention-deficit/hyperactivity disorder (ADHD) does not increase the risk of later substance use disorders. This meta-analysis found no significant difference in substance outcomes between treated and untreated children.
Area of Science:
- Neuroscience
- Psychiatry
- Public Health
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder treated with psychostimulant medication.
- Controversy exists regarding whether stimulant treatment increases the risk of future substance use disorders.
- Previous research has yielded conflicting results on the long-term effects of stimulant medication on substance use.
Purpose of the Study:
- To conduct a meta-analysis of longitudinal studies examining the association between childhood stimulant medication treatment and later substance use and abuse or dependence.
- To synthesize evidence on the relationship between ADHD treatment and the risk of developing substance use disorders in adulthood.
Main Methods:
- Systematic literature search of studies published between 1980 and 2012 using review articles, PubMed, and listservs.
- Inclusion of longitudinal studies where medication treatment preceded substance outcome assessment.
- Extraction of odds ratios for various substance outcomes (alcohol, marijuana, nicotine, etc.) from 15 studies, encompassing 2565 participants.
Main Results:
- Random-effects models were used to estimate the overall association between stimulant treatment and substance outcomes.
- Analyses revealed comparable outcomes for substance use and abuse or dependence across all substance types between children with and without a history of medication treatment.
- No significant difference in the risk of substance use disorders was observed based on childhood stimulant medication history.
Conclusions:
- Childhood treatment for ADHD with stimulant medication neither protects against nor increases the risk of developing later substance use disorders.
- These findings contribute to the understanding of the long-term safety profile of psychostimulant treatment in ADHD.
- The results suggest that the benefits of stimulant treatment for ADHD outweigh potential risks related to substance use disorders.
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