Academic journal article Ethical Human Psychology and Psychiatry

Does Early Exposure to Stimulants Lead to Substance Use Disorders Later On?

Academic journal article Ethical Human Psychology and Psychiatry

Does Early Exposure to Stimulants Lead to Substance Use Disorders Later On?

Article excerpt

Attention deficit/hyperactivity disorder (ADHD) denotes childhood problems of hyperactivity, inattention, and impulsivity, leading to impairments in daily functioning, scholastic performance, and relationships with peers. Although the rationale for stimulant medication is to reduce the morbidity associated with having ADHD, critics have argued that methylphenidate and other prescribed stimulant drugs (PSDs) are overly prescribed and inherently dangerous. Researchers have also raised concerns that PSDs might prime the central nervous system, thus rendering individuals more susceptible to substance use disorders (SUDs) later in life. There is also a strong comorbidity between ADHD and SUDs in adulthood. If many adults with SUDs were prescribed stimulants for ADHD as children or during adolescence, this could suggest that taking these drugs during these critical developmental periods increase the risks for SUDs later on. Research articles (i.e., both animal and human data) were reviewed to ascertain if any associations exist between PSDs and brain and behavioral changes. Review articles, meta-analyses, clinical trials, and clinical data were examined to assess associations between PSDs during childhood and adolescence and the development of SUDs in adolescence and adulthood. Contentious evidence does suggest that PSDs are not likely responsible for substance use and SUDs in adolescence, although it remains equivocal if PSDs offer any protection against substance use and abuse in adolescence. Although PSDs do reduce symptoms of ADHD that may interfere with learning in childhood, the evidence raises the possibility that these drugs might be responsible for substance use and SUDS in some adults.

Keywords: attention deficit/hyperactivity disorder; methylphenidate; prescribed stimulant drugs; substance use disorders

Attention deficit/hyperactivity disorder (ADHD) denotes childhood problems of hyperactivity, inattention, and impulsivity, leading to impairments in daily functioning, scholastic performance, and relationships with peers. Approximately 3%-5% of children receive a diagnosis of ADHD (Woodard, 2006). Some 2.8% of youth (aged 5-18 years of age) in the United States received prescribed stimulant drugs (PSDs) in mid-1995 (Safer, Zito, & Fine, 1996). In a publication 10 years later, the prevalence of stimulant use among youth younger than 19 years of age was reported to be about 2.9%, amounting to some 2.2 million youth on PSDs in the United States (Zuvekas, Vitiello, & Norquist, 2006). Thus, it appears that about 3% of all youth diagnosed with ADHD in the United States are on PSDs. The estimated prevalence of PSDs for the treatment of ADHD in Canada, by contrast, is believed to be less than 3% despite the fact that there has been a notable increase in using PSDs for the disorder, that is, 43% of children were prescribed PSDs in 2000, which increased to 59% in 2007 (Brault & Lacourse, 2012).

Although the rationale for stimulant medication is to reduce the morbidity associated with having ADHD, critics have argued that methylphenidate (MPH) and other PSDs are overly prescribed and inherently dangerous (Safer, 2000). Drawing largely on doubleblind, placebo-controlled clinical trials, and on animal laboratory research, Breggin (2008) asserts that when children take PSDs, they have a notable increase in abnormal behaviors (e.g., hyperalertness and overfocusing on activities) as a result of central nervous toxicity.

Other researchers have also raised concerns that PSDs might prime the central nervous system, thus rendering individuals more susceptible to substance use disorders (SUDs) later in life (Lambert, 2005; Lambert, McLeod, & Schenk, 2006). There is a strong comorbidity between ADHD and SUDs in adulthood. The results of a prospective outcome study found that ADHD individuals were more likely than non-ADHD controls to have SUDs in adolescence and alcohol and drug dependence in adulthood (Levy et al. …

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