August 20, 1999

Treatment for ADHD may reduce substance abuse risk

Boys with attention-deficit hyperactivity disorder (ADHD) who are treated with medications – usually stimulant drugs like Ritalin – are one-third as likely to develop substance abuse or dependence as are boys with ADHD who receive no treatment, according to an MGH study. The report in the August issue of Pediatrics contradicts a common fear that stimulant treatment could open the door to future drug abuse.

"Because the mainstay of ADHD treatment has been potentially addictive, stimulant drugs, there has been a mythology that the use of these medications could 'prime' children to become addicts in the future or could develop a 'culture of drug taking'," says Joseph Biederman, MD, director of the MGH Pediatric Psychopharmacology Unit and lead author of the study. "We have found that the opposite is the case – children who are medically treated for ADHD have a smaller risk of drug abuse than do those who are not treated."

The study analyzed information from interviews with 212 teenage boys and their mothers over four years: 56 with ADHD who took medication, 19 non-medicated participants with ADHD, and 137 participants without ADHD. Analysis of the results showed that boys with ADHD who had not been treated with medication were three times more likely to meet criteria for substance abuse than were those whose ADHD was treated. The risk of substance abuse among those taking medications for ADHD was virtually identical to the risk seen among those without ADHD.

The study's co-authors were Timothy Wilens, MD, Thomas Spencer, MD, and Stephen Faraone, PhD, of the MGH Pediatric Psychopharmacology Unit, and Eric Mick of the Harvard School of Public Health.