To assess the risk for substance use disorders (SUD) associated with previous exposure to psychotropic medication in a longitudinal study of boys with attention-deficit/hyperactivity disorder (ADHD).
The cumulative incidence of SUD throughout adolescence was compared in 56 medicated subjects with ADHD, 19 nonmedicated subjects with ADHD, and 137 non-ADHD control subjects.
Unmedicated subjects with ADHD were at a significantly increased risk for any SUD at follow-up compared with non-ADHD control subjects (adjusted OR: 6.3 [1.8–21.6]). Subjects with ADHD medicated at baseline were at a significantly reduced risk for a SUD at follow-up relative to untreated subjects with ADHD (adjusted OR: 0.15 [0.04–0.6]). For each SUD subtype studied, the direction of the effect of exposure to pharmacotherapy was similar to that seen for the any SUD category.
Consistent with findings in untreated ADHD in adults, untreated ADHD was a significant risk factor for SUD in adolescence. In contrast, pharmacotherapy was associated with an 85% reduction in risk for SUD in ADHD youth.
Comments
Response to Dr. Brozovich''s query
We thank Dr. Brozovich for pointing out our error. We made a mistake rounding. The rate should, in fact, be 74% and not 75%.
Sincerely,
Eric Mick, Sc.D
small error
An excellent article that will be very helpful in easing the fears of parents that medication for ADHD might be leading their child toward substance abuse. There is one small error that I noticed when I was studying Table 1. The table reports the incidence of SUD among non- medicated ADHD as 14 out of 19 subjects and indicates that this is equivalent to 75%. Fourteen divided by 19 is .7368... which rounds to .74 and thus represents 74%. This small error may not be of any significance but I felt the authors might want to correct it if they are presenting the data at workshops or professional meetings.