Does attention-deficit hyperactivity disorder impact the developmental course of drug and alcohol abuse and dependence?
Abstract
Background The co-occurrence of attention-deficit hyperactivity disorder (ADHD) and psychoactive substance use disorder (PSUD) in adults has been the focus of much clinical and scientific inquiry. In this study we examine the effects of ADHD on the transitions from substance abuse to dependence and between different classes of agents of abuse. Methods An ADHD sample of 239 consecutively referred adults of both genders with a clinical diagnosis of childhood-onset and persistent DSM-III-R ADHD confirmed by structured interview were compared with 268 non-ADHD healthy adults. Results ADHD was associated with a twofold increased risk for PSUD. ADHD subjects were significantly more likely than comparisons to make the transition from an alcohol use disorder to a drug use disorder (hazard ratio = 3.8) and were significantly more likely to continue to abuse substances following a period of dependence (hazard ratio = 4.9). Conclusions ADHD is associated with a sequence of PSUD in which early alcohol use disorder increases the risk for subsequent drug use disorder, and early substance dependence increases the risk for subsequent substance abuse. If confirmed such developmental pathways might lead to preventive and early intervention strategies aimed at reducing the risk for PSUD in ADHD subjects.
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Childhood attention deficit hyperactivity disorder is significantly associated with adolescent and adult substance use disorders.
“Numerous studies have shown that childhood attention deficit hyperactivity disorder (ADHD) is significantly associated with adolescent and adult substance use disorders (SUD) (1–8).”
From Age of methylphenidate treatment initiation in children with ADHD and later substance abuse: prospective follow-up into adulthood. (2008) · cites this paper as [2]
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- Authors
- Biederman, J., Wilens, T. E., Mick, E., Faraone, S. V., & Spencer, T.
- Affiliations
- Harvard University (US)
- Corresponding author
- Biederman, Joseph
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 1998-08
- Volume
- 44
- Issue
- 4
- Pages
- 269-273
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W1992853415
- Cited by
- 315
- References
- 6
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 8 · 2020: 9 · 2019: 4 · 2018: 5 · 2017: 11 · 2016: 7 · 2015: 11 · 2014: 15 · 2013: 17 · 2012: 16
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (RO1MH41314, K20MHO1175)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- attention deficit hyperactivity disorder, substance use disorders, alcoholism, drug use disorders, substance dependence, comorbidities, childhood-onset ADHD
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Female, Humans, Male, Massachusetts, Prospective Studies, Statistics as Topic, Comorbidity, Age of Onset, Disease Progression, Substance-Related Disorders
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