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Stimulant treatment for ADHD has no effect on risk of future substance abuse
March 03, 2008MGH study looks at young adults 10 years after diagnosis
A new study finds that the use of stimulant drugs to treat children with ADHD has no effect on their future risk of substance abuse. The report, which will appear in the American Journal of Psychiatry and has been issued online, assessed more than 100 young men 10 years after they had been diagnosed with ADHD and is the most methologically rigorous analysis of any potential relationship between stimulant treatment and drug abuse.
"Because stimulants are controlled drugs, there has been a concern that using them to treat children would promote future drug-seeking behavior," says Joseph Biederman, MD, director of Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital (MGH), the study's lead author. "But our study found no evidence that prior treatment with stimulants was associated with either increased or decreased risk for subsequent drug or alcohol abuse."
Earlier studies examining whether stimulant treatment could increase substance abuse risk have had conflicting results, but they had several limitations, the authors note. Some only looked at adolescents, although young adults are at the highest risk of substance abuse. Others did not control for conditions such as conduct disorder that are know to be associated with substance abuse or may have looked at the impact on use of only a particular substance. The current study, designed to address those shortcomings, analyzed patterns of substance use in a group of young men 10 years after their original diagnosis with ADHD.
Of the 112 study participants, who ranged in age from 16 to 27 at the time of their reassessment, 73 percent had been treated with stimulants at some time, and 22 percent were currently receiving stimulant treatment. Study participants were interviewed using standard tools for assessment of psychiatric disorders and additional questions about their use of alcohol, tobacco products and a wide variety of psychoactive drugs. Study results, controlled for the presence of conduct diagnosis in the original diagnosis, showed no relationship between whether a participant ever received stimulant treatment and the risk of future tobacco use or alcohol or other substance abuse. The age at which stimulant treatment began and how long it continued also had no effect on substance use.
Earlier studies from the MGH Psychopharmacology group had suggested that stimulant treatment might actually reduce the risk of substance abuse in ADHD patients, who are at elevated risk to begin with, but that result did not hold up in the current analysis, which included some of the same participants. The researchers note that those shorter-term studies only followed participants into adolescence and that treatment may delay rather than totally prevent future substance use, something that should be investigated in the future.
"Our current results, combined with other investigations, should help reduce the concerns that clinicians and parents may have about the use of stimulants to treat ADHD in children," says Biederman, a professor of Psychiatry at Harvard Medical School. The current study was supported in part by grants from the National Institutes of Health, including the National Institute for Drug Abuse. Co-authors of the article are Michael Monuteaux, ScD, Thomas Spencer, MD, Timothy Wilens, MD, Heather MacPherson and Stephen Faraone, PhD, of the Research Program in Pediatric Psychopharmacology and Adult ADHD at MGH.
Massachusetts General Hospital
Earlier studies examining whether stimulant treatment could increase substance abuse risk have had conflicting results, but they had several limitations, the authors note. Some only looked at adolescents, although young adults are at the highest risk of substance abuse. Others did not control for conditions such as conduct disorder that are know to be associated with substance abuse or may have looked at the impact on use of only a particular substance. The current study, designed to address those shortcomings, analyzed patterns of substance use in a group of young men 10 years after their original diagnosis with ADHD.
Of the 112 study participants, who ranged in age from 16 to 27 at the time of their reassessment, 73 percent had been treated with stimulants at some time, and 22 percent were currently receiving stimulant treatment. Study participants were interviewed using standard tools for assessment of psychiatric disorders and additional questions about their use of alcohol, tobacco products and a wide variety of psychoactive drugs. Study results, controlled for the presence of conduct diagnosis in the original diagnosis, showed no relationship between whether a participant ever received stimulant treatment and the risk of future tobacco use or alcohol or other substance abuse. The age at which stimulant treatment began and how long it continued also had no effect on substance use.
Earlier studies from the MGH Psychopharmacology group had suggested that stimulant treatment might actually reduce the risk of substance abuse in ADHD patients, who are at elevated risk to begin with, but that result did not hold up in the current analysis, which included some of the same participants. The researchers note that those shorter-term studies only followed participants into adolescence and that treatment may delay rather than totally prevent future substance use, something that should be investigated in the future.
"Our current results, combined with other investigations, should help reduce the concerns that clinicians and parents may have about the use of stimulants to treat ADHD in children," says Biederman, a professor of Psychiatry at Harvard Medical School. The current study was supported in part by grants from the National Institutes of Health, including the National Institute for Drug Abuse. Co-authors of the article are Michael Monuteaux, ScD, Thomas Spencer, MD, Timothy Wilens, MD, Heather MacPherson and Stephen Faraone, PhD, of the Research Program in Pediatric Psychopharmacology and Adult ADHD at MGH.
Massachusetts General Hospital
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Early parenting plays key role in infants' physiological response to stress
In infancy, genes are the key influence on a child's ability to deal with stress. But as early as 6 months of age, parenting plays an important role in changing the impact of genes that may put infants at risk for responding poorly to stress.
New study on rural HIV care has economic and health implications
An Indiana University study found that HIV care providers in rural Indiana report significant stigma and discrimination in the rural medical referral system surrounding issues of HIV and substance abuse. Providers felt that these factors impeded their ability to offer quality care to their patients.
Why delaying gratification is smart: A neural link between intelligence and self-control
If you had a choice between receiving $1,000 right now or $4,000 ten years from now, which would you pick? Psychologists use the term "delay discounting" to describe our inability to resist the temptation of a smaller immediate reward in lieu of receiving a larger reward at a later date.
Abuse of painkillers can predispose adolescents to lifelong addiction
No child aspires to a lifetime of addiction. But their brains might. In new research to appear online in the journal Neuropsychopharmacology this week, Rockefeller University researchers reveal that adolescent brains exposed to the painkiller Oxycontin can sustain lifelong and permanent changes in their reward system - changes that increase the drug's euphoric properties and make such adolescents more vulnerable to the drug's effects later in adulthood.
College freshmen: pain killers and stimulants less risky than cocaine; more risky than marijuana
First year college students believe that occasional nonmedical use of prescription pain killers and stimulants is less risky than cocaine, but more risky than marijuana or consuming five or more alcoholic beverages every weekend.
Study suggests sports stadiums serve alcohol to minors and intoxicated fans
In a novel study looking at the propensity of illegal alcohol sales at sports stadiums, researchers reported that nearly one in five people posing as underage drinkers, and three out of four seemingly intoxicated "fans" were able to buy alcohol at professional sporting events. They also found that location mattered: sales were more likely if the attempt took place in the stadium stands rather than at a concession booth.
Suicidal thoughts among college students more common than expected
More than half of 26,000 students across 70 colleges and universities who completed a survey on suicidal experiences reported having at least one episode of suicidal thinking at some point in their lives. Furthermore, 15 percent of students surveyed reported having seriously considered attempting suicide and more than 5 percent reported making a suicide attempt at least once in their lifetime.
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