The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index; none of the 17 sources its claims cite is checked for support yet.
Stimulant Medication and Substance Use Outcomes: A Meta-analysis
Open accessAbstract
Meta-analysis of longitudinal studies of childhood stimulant treatment and later substance outcomes.
Overview
Integrity signals
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Claims the paper makes
19 Own result · 12 Sources not found · 5 Own interpretation · 4 Own method
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“this study suggests that the likelihood of substance initiation did not differ according to medication status.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The percentage of children with ADHD treated with stimulant medication (number who received medication/total number of children with ADHD) was negatively associated with pooled effect size (t = −4.25, P =.003, adjusted R2 = 89.05).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MODERATORS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results suggested comparable outcomes between children with and without cation treatment history for any substance use and abuse or dependence outcome across all substance types.”
- Also stated in: § DISCUSSION · hedged
“Across 5 types of substance (ie, alcohol, cocaine, marijuana, nicotine, and nonspecific drugs) for lifetime use and abuse or dependence, results indicated that substance outcomes were comparable to those individuals who did and did not receive medication.”
§ Stimulant Medication and Substance Use Outcomes > Abstract > Results:
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § DISCUSSION · hedged
In the paper
“For nicotine use, after the removal of Huss,32 the effect sizes were no longer significantly heterogeneous (Q = 4.29, P =.12).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > LEAVE-ONE-OUT SENSITIVITY ANALYSES
What the sources say
- Not matchedcites Huss,32
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When both moderators were in the same model, only the percentage treated remained a significant predictor of between-study variance.”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MODERATORS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No single study unduly influenced the OR estimates of the association between stimulant medication treatment and alcohol abuse or dependence (pooled OR estimates, 0.70–0.96; all 95% CIs included 1).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > LEAVE-ONE-OUT SENSITIVITY ANALYSES
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, as the number of years between initial assessment and the substance use follow-up assessment increased, ORs were larger (t = −4.25, P =.003, adjusted R2 = 28.91).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MODERATORS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The present findings do not support the sensitization hypothesis7,34 as an additional factor in the decision-making process in the treatment of ADHD”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
What the sources say
- Not matchedcites [7]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [34]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“First, although the current meta-analysis improved substantially on the heuristic meta-analysis of Wilens et al,12 it is still relatively modest in terms of the number of studies included.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
What the sources say
- Not matchedcites [12]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“These findings diverge from the only meta-analysis on this topic conducted 10 years ago in which stimulant treatment for ADHD significantly reduced later substance problems.12”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
What the sources say
- Not matchedcites [12]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
- It may state two separate claims as one. 22
- The quote only partly states this claim. 1
- Probably not a substantial claim. 2
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The random-effects model estimated comparable odds of marijuana abuse or dependence for children who did vs did not receive medication (OR, 0.97; 95% CI, 0.59−1.59; P =.87); however, significant heterogeneity was observed across the studies (Q = 15.68, P=.047).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MARIJUANA
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The random-effects meta-analysis found that children who did and did not receive medication treatment were comparable in alcohol use (OR, 0.99; 95% CI, 0.61−1.62; P =.97), and no significant heterogeneity was observed across studies (Q = 2.82, P =.42).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > ALCOHOL
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The random-effects regression estimated that children with or without medication treatment were largely comparable to alcohol abuse or dependence (OR, 0.80; 95% CI, 0.46−1.38; P =.42), although significant variability was seen in effect sizes (Q = 33.87, P <.001).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > ALCOHOL
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the random-effects model estimated that children who received medication treatment were comparable to children who did not receive medication treatment in the development of cocaine abuse or dependence (OR, 1.10; 95% CI, 0.51−2.38; P =.81). No significant heterogeneity in ORs was noted (Q = 8.17, P =.23).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > COCAINE
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“When the model was reanalyzed with the study by Wilens et al36 removed, no significant heterogeneity was found, and the estimated effect was 1.01 (95% CI, 0.70−1.44), suggesting that the study by Wilens et al36 contributed to the heterogeneous pooled effect size.”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > LEAVE-ONE-OUT SENSITIVITY ANALYSES
What the sources say
- Not matchedcites Wilens et al36
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The random-effects model for all studies estimated that children who received medication treatment were comparable to those who did not (OR, 0.85; 95% CI, 0.51−1.40; P =.52), although once again significant heterogeneity was observed (Q = 15.99, P =.01).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > NONSPECIFIC DRUG
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the random-effects model estimated that children with ADHD who received stimulant medication were largely comparable to children not treated with stimulant medication, although the precision of the estimate is limited (OR, 1.55; 95% CI, 0.73−3.30; P =.26). However, there was evidence of significant heterogeneity (Q = 10.72, P =.01).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > NICOTINE
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“For marijuana abuse or dependence, pooled OR estimates ranged from 0.96 to 1.23, and all 95% CIs included 1. The effect size was no longer heterogeneous (P >.05) after the individual removal of 3 studies.27,32,35”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > LEAVE-ONE-OUT SENSITIVITY ANALYSES
What the sources say
- Not matchedcites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [32]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [35]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The random-effects model estimated that children with a history of stimulant medication treatment were comparable to those without (OR, 1.01; 95% CI, 0.68−1.50; P =.95). No significant heterogeneity was observed (Q = 1.85, P =.60).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MARIJUANA
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results were largely consistent with the above analyses, and in all cases the 95% CI included 1.”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > PUBLICATION BIAS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The random-effects model for all studies estimated that children with ADHD who received stimulant medication were similar to children who did not receive stimulant medication in the likelihood of ever having used a nonspecific drug (OR, 1.27; 95% CI, 0.88−1.82; P =.52). No significant heterogeneity was detected across the 3 studies (Q = 0.39, P =.82).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > NONSPECIFIC DRUG
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No significant publication bias was found for all other substance outcomes.”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > PUBLICATION BIAS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“Notably, the same study36 removed during the sensitivity analysis appeared to be driving this sex effect.”
- Also stated in: § MODERATORS · plain
“When we reanalyzed the percentage of male participants without the study by Wilens et al,36 sex was no longer associated with effect size (t =−0.02, P =.99).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MODERATORS
What the sources say
- Not matchedcites Wilens et al,36
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § MODERATORS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The overall random-effects model estimated that children who received stimulant medication were comparable to children who did not receive medication treatment in developing later nicotine dependence (OR, 1.34; 95% CI, 0.90−1.99; P =.15). No significant heterogeneity was observed (Q = 7.87, P =.16).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > NICOTINE
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The bias statistic from the Egger test for marijuana use had a modest association (t = −4.00, P =.06) because the largest study reported a relatively larger effect (stimulant medication treatment was associated with higher rates of ever having used marijuana) than the 3 other studies.”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > PUBLICATION BIAS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The random-effects model estimated that children treated with stimulant medication may have higher odds of having used cocaine compared with those who did not receive stimulant medication, but the precision of the estimate is limited, and the 95% CI included 1 (OR, 2.21; 95% CI, 0.87−5.65; P =.10). No significant heterogeneity was observed (Q = 3.27, P=.20).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > COCAINE
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Sensitivity analysis for nonspecific drug abuse or dependence found pooled OR estimates ranged from 0.76 to 1.01, and all 95% CIs included 1. The effect sizes were no longer heterogeneous (P >.05) after the removal of one study.36”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > LEAVE-ONE-OUT SENSITIVITY ANALYSES
What the sources say
- Not matchedcites [36]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These results provide an important update and suggest that treatment of attention-deficit/hyperactivity disorder with stimulant cation neither protects nor increases the risk of later substance use disorders.”
- Also stated in: § DISCUSSION · plain
“The present findings do not support the sensitization hypothesis7,34 as an additional factor in the decision-making process in the treatment of ADHD, although, importantly, the present findings do not support the role of a protective effect for medication treatment for ADHD in both substance use initiation or substance use disorders across a number of substance types.”
§ Stimulant Medication and Substance Use Outcomes > Abstract > Conclusions:
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § DISCUSSION · plain
In the paper
“Given that medication treatment may be biased toward more severe cases,45 the present findings may indeed represent a protective effect if the group treated with stimulant medication had forgone that medication and developed substance use problems at a higher rate.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
What the sources say
- Not matchedcites [45]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As the proportion of those with ADHD who received stimulant medication increased, the OR decreased significantly. In other words, studies with a smaller proportion of individuals treated with stimulant medication were more likely to have those youth meet diagnostic criteria for alcohol abuse or dependence.”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MODERATORS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Crucially, findings from the current meta-analysis, based on a larger sample of studies (including several unpublished studies), suggest no increased or reduced risk of treatment with stimulant medication on later alcohol and substance outcomes and that this pattern was robust to all substance types.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Although these efforts resulted in the addition of several studies with unpublished data, several investigators did not respond to or declined these requests.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, the inference that stimulant medication treatment is unrelated to later substance outcomes is based on correlational data. That is, in the absence of random assignment to different treatment groups (eg, with and without stimulant medication), observed group differences may reflect unmeasured confounds.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Fourth, the issue of comorbidity in ADHD is likely to be salient15 Several studies included in the meta-analysis characterized comorbidity among ADHD probands, but few compared whether substance use outcomes based on stimulant medication status differed by comorbidity status or type.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
What the sources say
- Not matchedcites [15]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We were unable to thoroughly assess the potential role of age of medication use onset, along with other important and relevant medication-related information thoroughly (type of medication, dosages, medication discontinuation, and treatment adherence) and, importantly, current treatment status.”
§ Stimulant Medication and Substance Use Outcomes > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, in the meta-analysis of 15 longitudinal studies by Humphreys et al. (2013), the studies on ADHD-children with and without stimulant medication showed inconsistent outcomes with positive, neutral, and negative outcomes, but overall, they had a similar risk of developing SUD later in life [55].”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [55]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“For example, follow-up data from the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder and a meta-analysis showed no medication associations with substance use or problems (16, 17).”
From ADHD Medication and Substance-Related Problems (2017) · cites this paper as [16]
The cited source says what the claim attributes to it.
In the citing paper
“At the same time, conclusions from observational studies have been constrained by the possibility of confounding from differences between patients who are and are not treated pharmacologically (i.e., confounding by indication) (16).”
From ADHD Medication and Substance-Related Problems (2017) · cites this paper as [16]
The cited source says what the claim attributes to it.
In the citing paper
“A meta-analysis found that stimulants did not increase the risk for alcohol (11 studies, over 1,300 participants, nicotine (6 studies, 884 participants), cocaine (7 studies, 950 participants), or cannabis abuse or dependence (9 studies, over 1,100 participants) (Humphreys et al., 2013).”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Humphreys et al., 2013
The cited source says what the claim attributes to it.
In the citing paper
“A meta-analysis found that stimulants did not increase the risk for alcohol (11 studies, over 1,300 participants, nicotine (6 studies, 884 participants), cocaine (7 studies, 950 participants), or cannabis abuse or dependence (9 studies, over 1,100 participants) (Humphreys et al., 2013).”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Humphreys et al., 2013
The cited source says what the claim attributes to it.
In the citing paper
“A meta-analysis found that stimulants did not increase the risk for alcohol (11 studies, over 1,300 participants, nicotine (6 studies, 884 participants), cocaine (7 studies, 950 participants), or cannabis abuse or dependence (9 studies, over 1,100 participants) (Humphreys et al., 2013).”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Humphreys et al., 2013
The cited source says what the claim attributes to it.
In the citing paper
“A meta-analysis found that stimulants did not increase the risk for alcohol (11 studies, over 1,300 participants, nicotine (6 studies, 884 participants), cocaine (7 studies, 950 participants), or cannabis abuse or dependence (9 studies, over 1,100 participants) (Humphreys et al., 2013).”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Humphreys et al., 2013
The cited source says what the claim attributes to it.
In the citing paper
“Moreover, this review did not consider possible differences in ADHD-severity and comorbid CD between ADHD children that were or were not treated with stimulants.”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [55]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Stimulant Medication and Substance Use Outcomes > RESULTS > NICOTINE
“However, there was evidence of significant heterogeneity (Q = 10.72, P =.01).”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > LEAVE-ONE-OUT SENSITIVITY ANALYSES
“the overall estimate from the meta-analysis (Q = 1.55)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MODERATORS
“as the number of years between initial assessment and the substance use follow-up assessment increased, ORs were larger”
§ Stimulant Medication and Substance Use Outcomes > RESULTS > MODERATORS
“(t = −4.25, P =.003, adjusted R2 = 28.91)”
Citations
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“Moreover, this effect was evident for nicotine and cocaine abuse or dependence, a particularly important consideration given that these outcomes were particularly sensitive to early ADHD in a recent meta-analysis.(38) These findings diverge from the only meta-analysis on this topic conducted 10 years ago in which stim…”
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“Fifth, there is evidence that age of treatment initiation is a relevant construct in later substance outcomes because one study found that children who began taking stimulant medication before 8 years of age did not differ in nonalcoholic substance use compared with those without medication treatment, whereas those wh…”
BackgroundAltered responsiveness to cocaine in rats exposed to methylphenidate during development
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“However, the use of stimulant medication to treat ADHD remains controversial given concerns about its potential for abuse(3-5) and possible role in sensitizing patients to later substance problems.(6,7) Treatment with stimulant medication may be related to substance problems for several reasons.”
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Self-citationLearning disabilities : implications for psychiatric treatment
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“Fourth, the issue of comorbidity in ADHD is likely to be salient.(15) Several studies included in the meta-analysis characterized comorbidity among ADHD probands, but few compared whether substance use outcomes based on stimulant medication status differed by comorbidity status or type.”
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BackgroundMethodInfluential
Cited by
Sorted by citations
Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., Newcorn, J. H., Gignac, M., Al Saud, N. M., Manor, I., et al. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.01.022 · Cited by 1,545
“A meta-analysis found that stimulants did not increase the risk for alcohol (11 studies, over 1300 participants, nicotine (6 studies, 884 participants), cocaine (7 studies, 950 participants), or cannabis abuse or dependence (9 studies, over 1100 participants) (Humphreys et al., 2013).”
Visser, S. N., Danielson, M. L., Bitsko, R. H., Holbrook, J. R., Kogan, M. D., Ghandour, R. M., Perou, R., & Blumberg, S. J. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.09.001 · Cited by 1,263
“There has been concern and conflicting evidence about the risk of ADHD medication use and later substance use disorders among adolescents and young adults(41-43); however, a recent meta-analysis of this research suggests that ADHD medication neither protects against nor increases the risk of substance use disorders.(4…”
Humphreys, K. L., LeMoult, J., Wear, J. G., Piersiak, H. A., Lee, A., & Gotlib, I. H. (2020) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2020.104361 · Cited by 640
“These moderators were selected on the basis of both recommendations from experts in meta-analysis (Lipsey & Wilson, 2001) and of prior work by the authors (Humphreys, Eng, & Lee, 2013; LeMoult et al., 2019; Muscatell, Humphreys, & Brosso, 2018).”
MethodSelf-citationMisuse of Stimulant Medication Among College Students: A Comprehensive Review and Meta-analysis
Benson, K., Flory, K., Humphreys, K. L., & Lee, S. S. (2015) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-014-0177-z · Cited by 328
“While there is meta-analytic evidence that stimulant medication in itself does not increase risk for substance use disorders (Humphreys et al. 2013) and the use of stimulant medication to treat ADHD may even reduce drug use (Schoenfelder et al.”
BackgroundSelf-citationChildhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis.
Groenman, A. P., Janssen, T. W. P., & Oosterlaan, J. (2017) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2017.05.004 · Cited by 335
Metadata
- Authors
- Humphreys, K. L., Eng, T., & Lee, S. S.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Humphreys, Kathryn L.
- Lee, Steve S.
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2013-07-01
- Volume
- 70
- Issue
- 7
- Pages
- 740
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC6688478
- OpenAlex
- W2151244707
- Cited by
- 221
- References
- 45
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 9 · 2023: 15 · 2022: 13 · 2021: 14 · 2020: 21 · 2019: 16 · 2018: 10 · 2017: 24 · 2016: 14 · 2015: 25 · 2014: 25 · 2013: 14
- FWCI
- 15.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R03AA020186)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- stimulant medication, attention deficit hyperactivity disorder, substance use disorders, substance abuse, substance dependence, alcohol consumption, cocaine use, cannabis use, nicotine use, iatrogenic disease, lifetime substance use
- MeSH terms
- Adolescent, Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Longitudinal Studies, Male, Odds Ratio, Substance-Related Disorders
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