Predictors of treatment response in adolescents with comorbid substance use disorder and attention-deficit/hyperactivity disorder
Open accessAbstract
Attention-Deficit/Hyperactivity Disorder (ADHD) frequently co-occurs with substance use disorder (SUD) and is associated with poor substance-use treatment outcomes. A trial evaluating osmotic-release oral system methylphenidate (OROS-MPH) for adolescents with ADHD and SUD, concurrently receiving behavioral therapy, revealed inconsistent medication effects on ADHD or SUD. Clinical care for this population would be advanced by knowledge of treatment outcome predictors. Data from the randomized placebo-controlled trial (n = 299) were analyzed. Significant treatment predictors included: 1) Substance use severity, associated with poorer ADHD and SUD outcomes, 2) ADHD severity, associated with better ADHD and SUD outcomes, 3) comorbid conduct disorder, associated with poorer ADHD outcomes, and 4) court-mandated status, associated with better SUD outcomes but poorer treatment completion. An interaction effect showed that OROS-MPH improved SUD outcomes in adolescents with comorbid conduct disorder compared to placebo. While severe SUD may require more intensive psychosocial treatment, OROS-MPH may improve substance treatment outcomes in adolescents with co-morbid attention and conduct problems.
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In the trial of Riggs et al. (2011), comorbid CD in adolescents with ADHD and SUD did not moderate the effect of OROS-MPH versus placebo on ADHD outcomes.
“In addition, in the trial of Riggs et al. (2011), comorbid CD in adolescents with ADHD and SUD (one-third of the study sample) did not moderate the effect of OROS-MPH vs. placebo on ADHD outcomes [85].”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [85]
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- Authors
- Tamm, L., Trello-Rishel, K., Riggs, P., Nakonezny, P. A., Acosta, M., Bailey, G., & Winhusen, T.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- The University of Texas Southwestern Medical Center (US)
- University of Colorado Anschutz (US)
- National Development and Research Institutes (US)
- Brown University (US)
- University of Cincinnati (US)
- Corresponding author
- Tamm, Leanne
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 44
- Issue
- 2
- Pages
- 224-230
- ISSN
- 0740-5472 (ISSN-L)
- PMC
- PMC3499678
- OpenAlex
- W2126570875
- Cited by
- 52
- References
- 65
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 5 · 2012: 2
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (U10DA013035, K24DA022412, U10DA013732, U10DA013716, U10DA020024, U10 DA012732, UG1DA020024, K12DA000357)
- 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, treatment outcome predictors, conduct disorder, substance use severity, ADHD symptom severity, court-ordered treatment, treatment completion, behavior therapy
- MeSH terms
- Administration, Oral, Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Behavior Therapy, Female, Humans, Male, Methylphenidate, Osmosis, Severity of Illness Index, Drug Delivery Systems, Treatment Outcome, Diagnosis, Dual (Psychiatry), Conduct Disorder, Substance-Related Disorders, Mandatory Programs
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