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Cited by 136Attention Deficit Hyperactivity DisorderSubstance Abuse Treatment and OutcomesSmoking Behavior and Cessation

Effect of Prior Stimulant Treatment for Attention-Deficit/Hyperactivity Disorder on Subsequent Risk for Cigarette Smoking and Alcohol and Drug Use Disorders in Adolescents

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Wilens, Timothy E., Adamson, Joel, Monuteaux, Michael C., Faraone, Stephen V., Schillinger, Mary, Westerberg, Diana, Biederman, Joseph·2008·Archives of Pediatrics & Adolescent Medicine
DOI 10.1001/archpedi.162.10.916PMC PMC2760975
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Abstract

OBJECTIVE: To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and substance use disorders (SUDs) in adolescents with attention-deficit/hyperactivity disorder (ADHD). DESIGN: Case-controlled, prospective, 5-year follow-up study. SETTING: Massachusetts General Hospital, Boston. PARTICIPANTS: Adolescents with and without ADHD from psychiatric and pediatric sources. Blinded interviewers determined all diagnoses using structured interviews. Intervention Naturalistic treatment exposure with psychostimulants for ADHD. MAIN OUTCOME MEASURES: We modeled time to onset of SUDs and smoking as a function of stimulant treatment. RESULTS: We ascertained 114 subjects with ADHD (mean age at follow-up, 16.2 years) having complete medication and SUD data; 94 of the subjects were treated with stimulants. There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUDs associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.13-0.60; chi(2)(113) = 10.57, P = .001) and cigarette smoking (HR, 0.28; 95% CI, 0.14-0.60; chi(2)(111) = 10.05, P = .001) that were maintained when controlling for conduct disorder. We found no effects of time to onset or duration of stimulant therapy on subsequent SUDs or cigarette smoking in subjects with ADHD. CONCLUSION: Stimulant therapy does not increase but rather reduces the risk for cigarette smoking and SUDs in adolescents with ADHD.

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  • The finding that earlier initiation of treatment was associated with lower SUD odds was replicated in four other studies.

    “This finding was replicated in four other studies, suggesting that earlier initiation of treatment may lead to better outcomes for SUD (Wilens et al. 2008; Dalsgaard et al. 2014; Levy et al. 2014; McCabe et al. 2016).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Wilens et al. 2008

    The Results (Onset and Duration; page unavailable) report no effect of the age at which stimulant treatment began on subsequent SUD. Although the paper found lower SUD risk among stimulant-treated girls overall, it does not replicate the claimed finding that earlier initiation was associated with lower SUD odds. (LLM, conf=0.90)

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  • Earlier initiation of treatment may lead to better outcomes for SUD.

    “This finding was replicated in four other studies, suggesting that earlier initiation of treatment may lead to better outcomes for SUD (Wilens et al. 2008; Dalsgaard et al. 2014; Levy et al. 2014; McCabe et al. 2016).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Wilens et al. 2008

    The Results (Onset and Duration; page unavailable) report no effect of age at initiation of stimulant therapy on subsequent SUD in adolescent girls with ADHD. The study found a protective association for stimulant treatment overall, but not better SUD outcomes with earlier initiation. (LLM, conf=0.88)

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  • Treatment with stimulants can help lessen the likelihood of other psychiatric comorbidities during adolescence, including cigarette use and substance abuse.

    “some studies suggest that treatment with stimulants can help to lessen the likelihood of other psychiatric comorbidities during adolescence [49], including cigarette use and substance abuse [50].”

    From Advances in understanding and treating ADHD (2011) · cites this paper as [50]

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Research works printed but not linked: 2

  1. [2]Faraone SV The Worldwide Prevalence of ADHD: Is it an American Condition? World Psychiatry 2003 2 2 104 113 16946911 PMC1525089
  2. [6]Weiss G Attention-Deficit Disorder Child and Adolescent Psychiatric Clinics of North America 1992 W.B. Saunders Company Philadelphia

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Authors
Wilens, T. E., Adamson, J., Monuteaux, M. C., Faraone, S. V., Schillinger, M., Westerberg, D., & Biederman, J.
Affiliations
  • Harvard University (US)
  • SUNY Upstate Medical University (US)
ORCID
Venue
Archives of Pediatrics & Adolescent Medicine
Publisher
American Medical Association (AMA)
Published
2008-10-06
Volume
162
Issue
10
Pages
916
ISSN
1072-4710 (ISSN-L)
DOI
10.1001/archpedi.162.10.916
PMC
PMC2760975
OpenAlex
W2134650812
Cited by
136
References
38
Citations by year
2025: 3 · 2024: 3 · 2023: 7 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 4 · 2017: 9 · 2016: 7 · 2015: 5 · 2014: 13 · 2013: 14 · 2012: 15
FWCI
8.43
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (K24DA016264, DA R01 DA14419, R01DA014419)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
attention deficit hyperactivity disorder, stimulant medication, psychostimulants, adolescent substance use disorders, cigarette smoking, alcohol consumption, drug use, conduct disorder, family history of ADHD
MeSH terms
Adolescent, Adolescent Behavior, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Attitude to Health, Female, Follow-Up Studies, Humans, Male, Prospective Studies, Smoking, Time Factors, Comorbidity, Incidence, Confidence Intervals, Proportional Hazards Models, Case-Control Studies, Sex Distribution, Risk Assessment, Substance-Related Disorders, Alcohol-Related Disorders

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