Stimulant treatment for ADHD has no
effect on risk of future substance abuse
MGH study looks at young adults
10 years after diagnosis
BOSTON - March 1, 2008 - 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, established in 1811, is the original
and largest teaching hospital of Harvard Medical School. The MGH
conducts the largest hospital-based research program in the United
States, with an annual research budget of more than $500 million
and major research centers in AIDS, cardiovascular research, cancer,
computational and integrative biology, cutaneous biology, human
genetics, medical imaging, neurodegenerative disorders, regenerative
medicine, systems biology, transplantation biology and photomedicine.
Media Contacts: Sue
McGreevey, MGH Public Affairs
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