Cited by 214Attention Deficit Hyperactivity DisorderSubstance Abuse Treatment and OutcomesOpioid Use Disorder Treatment

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The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders

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Zulauf, Courtney A., Sprich, Susan E., Safren, Steven A., Wilens, Timothy E.·2014·Current Psychiatry Reports

DOI 10.1007/s11920-013-0436-6PMC PMC4414493

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Abstract

Adolescents and young adults with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) are increasingly presenting in clinical practice. The overlap and role of treatment for these co-occurring disorders remains unclear. A review of the literature was conducted to highlight and update recent evidence on the overlap of ADHD and SUD, the role of ADHD medication on later SUD, and the treatment of ADHD and SUD in adolescents and young adults. Recent work continues to highlight the high risk for comorbid ADHD in patients with SUD; and conversely, the high risk for SUD developing in ADHD across the lifespan, particularly in the context of comorbid conduct disorder. Although the data remains discordant, it appears that ADHD pharmacotherapy does not increase the risk for SUD. Medication treatment alone does not appear to be particularly effective in treating SUD in currently active substance abusing individuals with ADHD. Structured therapies may be effective in treating adolescents and young adults with ADHD and SUD. Further controlled trials evaluating the sequence and effect of structured psychotherapies and/or ADHD pharmacotherapy on SUD relapse in these groups are warranted.

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The Biopsychosocial Perspective and Research Methods for Investigation of Substance Use Disorders
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A Biological/Genetic Perspective: The Addicted Brain
Kelly, T. H., Harvanko, A. M., Pierce, M. E., Rayapati, A. O., & Martin, C. A. (2018) · Issues in children's and families' lives · doi:10.1007/978-3-319-90611-9_3
Alcohol
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.010
The Disease Concept
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Genetic Influence on Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.007
Brain Function and Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.006
Konsummotive bei Konsumenten von amphetaminartigen Substanzen (ATS)
Thurn, D. (2020) · doi:10.20378/irb-49231
Tobacco Use and Nicotine Addiction
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.012
Behavioral, Cognitive, and Social Factors Promoting SUD
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.008
Psychopharmacology
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.005
Diagnosis of Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.003
Alcohol Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.011
Treatment of Substance Use Disorders
Duncan, P. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781139025515.017
Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung im Erwachsenenalter
Sobanski, E., Alm, B., & Thome, J. (2015) · Springer eBooks · doi:10.1007/978-3-642-45028-0_85-1 · Cited by 2
The Changing Landscape of Substance Use Disorders
(2019) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.17201
ADHD Medications
Sadek, J. R. (2020) · Springer eBooks · doi:10.1007/978-3-030-60766-1_6
Externalizing and Related Disorders
Winters, K. C., & Ingwalson, A. (2022) · Oxford University Press eBooks · doi:10.1093/med-psych/9780190678487.003.0007
Opioids and Cognition
Kleykamp, B. A., Clarke, S. B., & Acquavita, S. P. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197618431.013.11
Relationship between attention deficit-hyperactivity disorder and substance use among college students in southeastern Iran
Kodori, M., Khosravi, S., Oroomiei, N., Abdoli, M., Moradi, M., Fani, T., & Gheshlaghi, L. A. (2023) · Journal of Substance Use · doi:10.1080/14659891.2023.2293768
“Psychotherapy can be promoted in conjunction with pharmacological therapy (Arabgol et al., 2018; Zulauf et al., 2014).”
Effects of Stimulant Treatment on Changes in Brain Activation During Reward Notifications in Drug Naïve Youth With ADHD
Ivanov, I., Krone, B., Schulz, K. P., Shaik, R., Parvaz, M. A., & Newcorn, J. H. (2024) · Journal of Attention Disorders · doi:10.1177/10870547231219762
“High rates of comorbid ADHD and substance use disorders (SUD; Faraone et al., 2020; Molina et al., 2018; Wilens, 2006; Zulauf et al., 2014) are well documented, and it has been hypothesized that ADHD is an important independent risk factor for the development of SUD (Slobodin et al., 2015).”
Background
Dikkat Eksikliği ve Hiperaktivite Bozukluğu ile İlgili Her Şey
Aksu, G. G., Özbek, M. M., Aksu, H., Gökçen, C., Turğut, F. S., Tufan, A. E., Doğru, H., Dursun, O. B., Özdemir, E., Kılıçaslan, F., et al. (2022) · Akademisyen Kitabevi eBooks · doi:10.37609/akya.1366
Identifying the Dimensions and Components of the Entrepreneurship Development Model in the Country's Higher Education System
Seyedbagheri, S., Amiran, H., & Shahriari, J. E. (2023) · Iranian Journal of Educational Sociology · doi:10.61186/ijes.6.4.210
Presenting a Causal Model of Bias towards Drugs in Students based on the Academic Failure and Hyperactivity and Attention Deficit with the Mediating Role of Hopelessness Feelings
Dousti, A., Mohammadipour, M., & Mafakheri, A. (2023) · Iranian Journal of Educational Sociology · doi:10.61186/ijes.6.4.199
Effect of methylphenidate on substance use disorders in children and adolescents with attention-deficit/hyperactivity disorder: a systematic review
Coutinho, A., Cruz, D., Chen-Xu, J., & Bento, M. D. C. S. D. S. C. (2024) · Portuguese Journal of Pediatrics · doi:10.24875/pjp.23000048
Investigating self-reported compensation strategies for attention-deficit/hyperactivity disorder on Reddit: An analysis of user content from 2012-2023 with a focus on trends during COVID-19 (Preprint)Preprint
Liebrenz, M., Smith, A. J., Graña, J., & Buadze, A. (2024) · doi:10.2196/preprints.59109
Impact of Treatment with Central Nervous System Stimulant and Risk of Substance Use Disorder in Adults with Attention-Deficit/Hyperactivity Disorder
Jeun, K. J., & Al-Mamun, M. A. (2024) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-024-01324-x
“However, the scientific evidence for medical treat-ment of patients with ADHD and comorbid addictive disorders is still limited (Crunelle et al., 2018; Perugi et al., 2019; Zulauf et al., 2014).”
Genetic liability underlying reward-related comorbidity in psychiatric disorders involves the coincident functions of autism-linked ADGRL1 and hevinPreprint
Correoso‐Braña, K. G., Anésio, A., Dumas, S., Valjent, E., Heck, N., Vialou, V., & Boucard, A. A. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.07.03.601736
Attention Deficit Hyperactivity Disorder in Adults
Chutko, L. S., Surushkina, S. Y., Yakovenko, E. A., & Cherednichenko, D. V. (2024) · Neuroscience and Behavioral Physiology · doi:10.1007/s11055-024-01643-5
“These patients have an earlier age at onset of PAS use, a higher likelihood of using various substances, and higher rates of multiple drug use [23].”
Psychopharmacology for Pediatric ADHD
Schumacher, L. T., & Greenhill, L. L. (2024) · Springer eBooks · doi:10.1007/978-3-031-57472-6_8
Relationship of Amphetamines in Reducing Substance Abuse Risks Among ADHD Patients
Deng, A., & Espiridion, E. D. (2024) · Transformative Medicine · doi:10.54299/tmed/neui7615
Dual Diagnosis
Caldwell, E., Obiozor, C., Kofos, M. N., Martell, J. P., Agerwala, S. M., & Petrakis, I. L. (2025) · Elsevier eBooks · doi:10.1016/b978-0-323-95702-1.00275-x
Clinical and neuropsychological correlates of substance use disorders in a sample of Egyptian adolescents with attention-deficit hyperactivity disorder
Arafa, O. E., Eldeeb, F. A., Hodeib, H., & Seleem, M. A.-H. (2025) · The Egyptian Journal of Neurology Psychiatry and Neurosurgery · doi:10.1186/s41983-025-00953-w
“The predominance of cannabis use over other substances was previously reported in youth with ADHD in both Egyptian [48] and other cultures [49–51].”
Substance use disorder in adolescents with attention deficit hyperactivity disorder
Arafa, O. E., Eldeeb, F. A., Hodeib, H., & Seleem, M. A.-H. (2025) · Tanta Medical Journal · doi:10.4103/tmj.tmj_97_24
A Perturbação por Uso de Substâncias como Comorbilidade em Doentes com Perturbação de Hiperatividade e Défice de Atenção
Ribeiro, M. I., & França, G. (2025) · Acta Médica Portuguesa · doi:10.20344/amp.21937
The risk of alcohol use disorders in young adults with hyperactivity/inattention problems in early adolescence: UK birth cohort study.
Dachew, B., Ayano, G., & Alati, R. (2025) · Annals of Epidemiology · doi:10.1016/j.annepidem.2025.07.018
ADHD and Substance Use
Chadi, N., Green, L., & Schizer, M. A. (2025) · Springer eBooks · doi:10.1007/978-3-031-96950-8_15

Authors: Zulauf, C. A., Sprich, S. E., Safren, S. A., & Wilens, T. E.
Affiliations: Massachusetts General Hospital (US)
Corresponding author: Wilens, Timothy E.
ORCID: Sprich, Susan E.
Safren, Steven A.
Wilens, Timothy E.
Venue: Current Psychiatry Reports
Publisher: Springer Science and Business Media LLC
Published: 2014-02-15
Volume: 16
Issue: 3
Pages: 436-436
ISSN: 1523-3812 (ISSN-L)
1535-1645
DOI: 10.1007/s11920-013-0436-6
PMC: PMC4414493
OpenAlex: W2025736977
Cited by: 214
References: 94
Citations by year: 2026: 9 · 2025: 27 · 2024: 24 · 2023: 19 · 2022: 15 · 2021: 13 · 2020: 42 · 2019: 13 · 2018: 14 · 2017: 16 · 2016: 13 · 2015: 5 · 2014: 4
FWCI: 1.75
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Current Psychiatry Reports (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (K24MH094214)
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 › Opioid Use Disorder Treatment
Keywords: attention deficit hyperactivity disorder, substance use disorders, comorbidities, adolescents, young adults, ADHD medication, conduct disorder, psychotherapy, relapse prevention
MeSH terms: Adolescent, Antidepressive Agents, Attention Deficit Disorder with Hyperactivity, Central Nervous System Agents, Clinical Trials as Topic, Humans, Psychotherapy, Risk Factors, Diagnosis, Dual (Psychiatry), Adrenergic Uptake Inhibitors, Substance-Related Disorders, Young Adult

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