Magazine article Clinical Psychiatry News

ADHD Stimulant TX May Be Protective against Drug Abuse. (Two Studies)

Magazine article Clinical Psychiatry News

ADHD Stimulant TX May Be Protective against Drug Abuse. (Two Studies)

Article excerpt

Stimulants prescribed for attention-deficit hyperactivity disorder in childhood and adolescence don't appear to increase the risk of later drug abuse.

In fact, their use may help protect against it, according to two recently published studies.

In the first, by Russell A. Barkley, Ph.D., of the University of Massachusetts Medical School, Worcester, and his associates, the 17-year prospective study that followed 147 children with attention-deficit hyperactivity disorder (ADHD) through adolescence and adulthood confirmed the results of 11 previous studies with a similar design: There is no compelling evidence that stimulant treatment of children with ADHD leads to an increased risk for addictive and/or illicit substance experimentation, use, abuse, or dependence in adolescence or adulthood (Pediatrics 111[1]: 97-109, 2003).

Patients were recruited in childhood (ages 4-12) and interviewed in adolescence (ages 12-20 years) and adulthood (ages 19-25 years). Therapeutic use of stimulants was assessed at the adolescent interview. Of the 119 patients for whom medication information was available, 98 had been treated with stimulants. Of those, 96 had received methylphenidate (80%), 24 (22%) had received pemoline, and 4 (3%) had received D-amphetamine; some had received a combination.

Dr. Barkley and his associates sought information on experimentation with and use of alcohol, tobacco, marijuana, cocaine, amphetamines or other stimulants, hallucinogens, narcotics, sedatives, and any other drugs.

There were no statistically significant correlations between stimulant treatment in childhood or in high school with drug experimentation or abuse in adolescence or adulthood, with one exception: Stimulant treatment in childhood and adolescence was found to correlate with the risk of ever trying cocaine and with greater frequency of cocaine use.

However, after controlling for severity of comorbid conduct disorder, which the researchers said is a "well-established risk factor for substance use and abuse" among ADHD patients, both correlations lost their statistical significance.

Children with ADHD who were treated with stimulants for more than 1 year were less likely to have a cocaine or hallucinogen/PCP (phencyclidine HCI) abuse disorder in young adulthood than were children who had been treated for less than 1 year. "This could suggest a potentially protective effect of stimulant treatment as a child for risk for these two drug abuse disorders," the investigators said. …

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