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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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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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“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
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“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
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“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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Metadata
- 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)
- 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)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 › Public Health, Environmental and Occupational Health › 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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