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ADHD and addictive behavior in crack-cocaine users.

G Fond1, M El-Maamar1, T Korchia1

  • 1Department de psychiatrie universitaire, CEReSS - Health Service Research and Quality of Life Center, hôpitaux universitaires de Marseille, EA 3279: Aix-Marseille université, 27, boulevard Jean-Moulin, 13005 Marseille, France; Fondation FondaMental, Créteil, France.

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|March 23, 2022
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Summary

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent in Martinique crack users, linked to greater impulsivity. However, ADHD and impulsivity do not explain addictive behaviors or legal issues in this population.

Keywords:
ADHDAddictionDepressive disordersDépressionMental healthMood disordersPsychiatriePsychiatrySanté mentaleTDAHTroubles de l’humeur

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Area of Science:

  • Neuroscience
  • Public Health
  • Psychiatry

Background:

  • Crack cocaine use presents a significant public health challenge in Martinique, characterized by poor patient outcomes.
  • Preliminary research indicates a notable prevalence of childhood Attention-Deficit/Hyperactivity Disorder (C-ADHD) among individuals who use crack cocaine.

Purpose of the Study:

  • To ascertain the prevalence of both C-ADHD and adult ADHD (A-ADHD) within the population of crack cocaine users.
  • To investigate the potential correlations between ADHD (both childhood and adult forms) and patterns of substance use behavior.

Main Methods:

  • A comprehensive study was conducted on consecutive patients at a public academic hospital serving 376,000 inhabitants.
  • Participants underwent a detailed assessment battery evaluating addictive behaviors, psychiatric comorbidities, and somatic conditions.
  • Diagnoses for C-ADHD and A-ADHD were established using the Wender-Utah Rating Scale-25 and the Brown ADD Rating Scale, respectively, with impulsivity measured by the Barratt Impulsiveness Scale (BIS-11).

Main Results:

  • Out of 111 participants, 45% were diagnosed with C-ADHD and 18% with A-ADHD.
  • Individuals with ADHD exhibited significantly higher levels of impulsivity across various BIS-11 subscales compared to those without ADHD (P<0.001–0.021).
  • Specifically, 50% of A-ADHD patients displayed high impulsivity, versus 15% of non-A-ADHD patients (P<0.001); however, ADHD was not linked to more severe addiction or legal issues.

Conclusions:

  • The prevalence of ADHD is substantial among cocaine-crack users and is associated with heightened impulsivity.
  • Neither ADHD nor impulsivity appears to be a direct explanatory factor for the severity of addictive behaviors or the occurrence of legal consequences in this cohort.