Child ADHD medication not linked to increased substance abuse, study finds

According to the results of a new study carried out by researchers at the University of Pittsburgh School of Medicine, children who take prescribed stimulant medication to manage symptoms of attention deficit hyperactivity disorder (ADHD) are not at a higher risk of developing substance abuse disorders later in life as adolescents or young adults.

Researchers believe that the results of the study, which were published in JAMA Psychiatry, a monthly, peer-reviewed medical journal, may potentially provide some reassurance to patients and clinicians who are reluctant to prescribe ADHD stimulant medication, out of the fear that this may lead to substance abuse disorders (SUD) later in life.

Brooke Molina, PhD, and professor of psychiatry, psychology and paediatrics at Pittsburgh, said: "Stimulants are the first-line treatment recommended for most individuals with ADHD — the drug class is an evidence-based treatment with few side effects. Because stimulant medications are classified by the Drug Enforcement Administration as schedule two substances with the potential for misuse, many people fear that harmful substance use could result."

To conduct the study, Molina and her colleagues assessed patients with ADHD over a sixteen-year period from childhood, through adolescence and to early adulthood, to identify any possible association between the stimulant treatment and subsequent substance abuse. This study is amongst the first to address the clinical, and psychological relationship between childhood use of ADHD stimulants and the risk of eventual SUD by consulting dozens of demographics.

Co-author and assistant professor of psychiatry at Pittsburgh, Traci Kennedy, PhD, commented: "Our study not only accounted for age but also used a statistical method that adjusted over time for the many characteristics that may distinguish treated from non-treated individuals."

Previous studies have sought to ascertain and pinpoint a solid connection between prescription stimulants for ADHD and SUD, however, an unconfirmed association between the two has proved controversial. The results of various studies have suggested a protective effect of prescription stimulant use on the risk of developing SUD later in life, whilst others failed to locate any association.

When factoring in age and other time-varying characteristics, such as behavioural problems and parental support, the researchers found no discernible evidence that prescription stimulant treatment in children provided protection against developing SUD for adolescents or young adults with ADHD. Despite this, the researchers found no association between stimulant use during childhood and increased substance misuse in the future.

Some of the participants reported an increase in heavy drinking, marijuana use, smoking and recreational use of other substances. However, an association with age was also found for stimulant treatment, with older patients being found less likely to continue taking medication.

Molina commented: "We hope the results of this study will help educate providers and patients by understanding that stimulant medication initially prescribed in childhood is not linked to harmful levels of substance use, I anticipate that parents' and patients' fears will be alleviated."

The study aims to learn if there are any differences in the characteristics and outcomes of these adults compared to people who were diagnosed and first treated with stimulants in early childhood.

I personally interviewed Janaan, a student who was diagnosed with ADHD when she was a teenager. She was kind enough to share her own experience with ADHD and substance abuse, saying: "I struggled with focusing in school as a child and would often bunk off. I turned to substances when I was sixteen and eventually left school was I was approaching eighteen, which is when I stopped taking drugs completely."

Janaan continued: "Eventually, I noticed that my concentration and ability to perform simple tasks differed to my peers. I enrolled in university and later discovered that I had ADHD. My psychiatrist explained that many people with ADHD have also abused substances, especially amphetamines. Amphetamines, in particular, made me feel focused and relaxed. I am now on lisdexamfetamine as an adult and it has done me a world of good."