Stimulant ADHD medication and risk for substance abuse
Open accessAbstract
BACKGROUND: There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. METHODS: Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. RESULTS: ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. CONCLUSIONS: We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients.
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Cites
Statistics
Claims the paper makes
4 of 18 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured
- Premisecitation
ADHD itself is associated with an increased risk for substance abuse.
“especially because ADHD by itself is associated with increased risk for substance abuse (Elkins, McGue, & Iacono, 2007; Klein et al., 2012).”
Quote in the paperNot a substantial claim1 of 2 sources checked- cites Elkins, McGue, & Iacono, 2007 source
- cites Klein et al., 2012 source
The Results (Lifetime Functioning; page unavailable) report more lifetime substance use disorders among participants with childhood ADHD than among comparisons. But the Discussion (page unavailable) says conduct problems mediate that relationship and that ADHD does not predict substance disorders when conduct problems are controlled for. The increased risk is supported; “ADHD by itself” is not. (LLM, conf=0.86)
Experimental — accuracy not yet measured
- Premisecitation
ADHD medication is associated with reductions in criminality while under treatment.
“This is supported by a recent large study indicating significant associations between ADHD medication and reductions in criminality while under treatment (Lichtenstein et al., 2012).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Lichtenstein et al., 2012 source
- Findingown data
Among individuals with ADHD, stimulant ADHD medication at Jan 1 2006 was not associated with an increased rate of substance abuse during 2009.
“ADHD medication was not associated with increased rate of substance abuse.”
- Also stated in: § Results · plain
“Those on medication did not have increased rates of substance abuse during follow-up”
- Also stated in: § Discussion · hedged
“found no indication of increased substance abuse at follow-up”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
After controlling for age, sex, and medication in 2009, the substance abuse rate during 2009 was 48% lower among individuals with ADHD prescribed stimulant ADHD medication in 2006 than among those not prescribed (HR=0.52, 95% CI 0.42-0.66).
“After controlling for age, sex and medication in 2009, the substance abuse rate was decreased 48% (Hazard Ratio [HR]=0.52, 95% confidence interval [95% CI]: 0.42–0.66).”
Quote in the paperSubstantial claim - Findingown data
The long-term association between stimulant ADHD medication and substance abuse remained when controlling for other common psychotropic drugs.
“Further, the long-term association remained when we controlled for other common psychotropic drugs.”
Quote in the paperSubstantial claim
- Findingown data
In between-individual analyses, concomitant substance abuse was less common during periods with stimulant ADHD medication than during periods without, with a hazard ratio of 0.57 (95% CI 0.51-0.64).
“Concomitant substance abuse was less common during periods with stimulant ADHD medication according to the between-individual analyses; the hazard ratio was 0.57 (95% CI: 0.51–0.64; Table 3) suggesting that medication decreased the substance abuse rate 43%.”
Quote in the paperSubstantial claim - Findingown data
Each additional year of stimulant ADHD medication before follow-up was associated with a 13% lower rate of substance abuse registrations during 2009, after controlling for all confounders before 2006 (HR=0.87, 95% CI 0.80-0.94).
“For each year an individual was taking stimulant ADHD medication before follow-up there was a 13% (HR=0.87, 95%CI: 0.80–0.94) decrease in the rate of substance abuse registrations during 2009, after controlling for all confounders before 2006 (Table 2).”
Quote in the paperSubstantial claim - Findingown data
There was no evidence of an association between SSRI prescription (instead of ADHD medication) and substance abuse in stratified Cox regression (HR=1.04, 95% CI 0.96-1.12).
“In contrast, there was no evidence of an association when we investigated SSRI instead of ADHD medication using stratified Cox regression (HR=1.04, 95% CI: 0.96–1.12).”
Quote in the paperSubstantial claim - Findingown data
In within-individual analyses, stimulant ADHD medication was associated with a 27% lower rate of concomitant substance abuse (HR=0.73, 95% CI 0.68-0.77), after adjusting for confounders that do not vary with time.
“The hazard ratio for this within-individual risk was 0.73 (95% CI: 0.68–0.77); thus even within individuals (i.e., after adjusting for confounders that do not vary with time, such as genes and childhood environment), stimulant ADHD medication reduced the concomitant substance abuse rate by about 27%.”
Quote in the paperSubstantial claim - Interpretationown data
The results are not consistent with reverse causation as an explanation for the inverse association between stimulant ADHD medication and substance abuse.
“However, we do not think that our results are consistent with this hypothesis for the following reasons.”
Quote in the paperSubstantial claim - Interpretationcitation
Concurrent non-pharmacological treatments are an unlikely source of bias because combined treatment provides only modest advantages over pharmacological treatment only.
“Because combined treatment provides only modest advantages over pharmacological treatment only (The MTA Cooperative Group, 1999), concurrent non-pharmacological treatments are an unlikely source of bias.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites The MTA Cooperative Group, 1999
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
The study cannot address whether the associations are the same in other cultures.
“Nevertheless, we cannot address whether the associations are the same in other cultures, and thus generalizations should be made with caution.”
Quote in the paperNot a substantial claim - Interpretationown data
It is unlikely that selection for ADHD treatment in 2006 would be associated with drug abuse in 2009 without being mediated by drug abuse in 2006-2008.
“The results suggest it is unlikely that a selection for ADHD-treatment in 2006 would be associated with drug abuse in 2009, without being mediated by drug abuse in 2006–2008.”
Quote in the paperSubstantial claim - Interpretationown data
Concerns over long-term risks for substance abuse following ADHD medication probably have been overstated.
“In summary, although we argue that concerns over long-term risks for substance abuse following ADHD medication probably have been overstated, the decision to prescribe stimulant ADHD treatment should, as in all clinical practice, take into account individuals factors and potential adverse effects.”
Quote in the paperSubstantial claim - Interpretationreasoning
The results primarily concern severe drug abuse because substance abuse was indexed by substance-related hospitalizations, deaths, and convictions.
“Thus, our results primarily concern severe drug abuse.”
- Also stated in: § Discussion · plain
“First, we used substance-related hospitalizations, deaths and convictions from medical and legal records to index substance abuse. While having the important advantage of not requiring accurate respondent recall and reporting, it included mainly severe cases of substance use outcomes.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Study design and conductreasoning
The within-individual analysis adjusts for all confounders that are constant within each individual during follow-up.
“This method adjusts for all confounders that are constant within each individual during follow-up.”
Quote in the paperSubstantial claim - Premisecitation
There have been reports of abuse and misuse of stimulant ADHD medication.
“and there have been reports of abuse and misuse of stimulant ADHD medication (Kollins, MacDonald, & Rush, 2001; Wilens et al., 2008).”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationown data
The data suggest a long-term protective effect of stimulant ADHD medication on substance abuse.
“We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse.”
- Also stated in: § Discussion · hedged
“Rather the results suggested a decrease in substance abuse up to four years after medication and that the longer the duration of ADHD medication the lower the rate of substance abuse.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · hedged
- Premisecitation
Many studies find no or possibly protective effects of ADHD medication on substance use.
“Although many studies seem to find no or possibly protective effects of ADHD medication on substance use (Barkley, Fischer, Smallish, & Fletcher, 2003; Biederman et al., 2008; Faraone & Wilens, 2007; Mannuzza, et al., 2008; Wilens, Faraone, Biederman, & Gunawardene, 2003), they have had limited sample sizes and data are as yet inconclusive.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Barkley, Fischer, Smallish, & Fletcher, 2003 source
- cites Biederman et al., 2008 source
- cites Faraone & Wilens, 2007
- Rests on an assumption: Prior studies on ADHD medication and substance use have had limited sample sizes.
- Interpretationown data
The study's 4-year follow-up limits the generalizability of its effects over the life course.
“However, it has only 4 year follow-up, which limits its generalizability of effects over the life course.”
Quote in the paperNot a substantial claim - Premisecitation
Stimulant medications raise dopamine concentration in the nucleus accumbens, a brain region implicated in substance abuse and the proposed neural mechanism for ADHD treatment.
“One reason for the persistent concern for subsequent substance abuse derives from the fact that stimulant medications increase dopamine concentration in the nucleus accumbens (a brain region implicated in substance abuse and the proposed neural mechanism for ADHD treatment) (Wise, 2002; Volkow & Swanson, 2003).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Randomized controlled trials indicate that ADHD medication improves ADHD symptoms in the short term.
“Randomized controlled studies suggest that ADHD medication have beneficial short-term effects on symptoms of ADHD (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters, Becker, Kilian, Fegert, & Weinmann, 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young, Sarkis, Qiao, & Wietecha, 2011).”
Quote in the paperNot a substantial claim0 of 3 sources checked
- Classified as probably not a substantial claim. 8
- The quote only partly states this claim. 1
- May combine two claims. 8
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationBehavior sensitization, an increased response to an addictive substance after repeated exposure, has been observed in humans.
“Behavior sensitization – a phenomenon of increased response to an addictive substance after repeated exposure - has been observed in humans (Boileau et al., 2008)”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Boileau et al., 2008 source
The Results and discussion passages concern VMAT2 binding and dopamine measures in human methamphetamine users, not an increased behavioral response after repeated exposure. A search for behavioral sensitization found only a reference to behaviorally sensitizing doses in an animal study; our copy does not establish that behavioral sensitization has been observed in humans. Page numbers were not available in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe findings are congruent with previous studies.
“our findings are congruent with previous studies (Wilens, et al., 2003; Winters et al., 2011).”
Quote in the paperNot a substantial claim1 of 2 sources checkedThe quote only partly states this claim.
Findingown dataThe rate of substance abuse during 2009 was 31% lower among individuals with ADHD prescribed stimulant ADHD medication in 2006 than among those not prescribed, after controlling for age, sex, medication in 2009, socioeconomic status, prior substance abuse, psychiatric disorder, and criminal convictions before 2006 (HR=0.69, 95% CI 0.57-0.84).
“Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84).”
- Also stated in: § Results · plain
“The association remained decreased at 31% when we controlled for other potential confounders (SES, substance abuse, psychiatric disorder, and criminal convictions before 2006; HR=0.69, 95% CI: 0.57–0.84).”
Quote in the paperSubstantial claim- Also stated in: § Results · plain
May combine two claims.
Findingown dataThe study found no indication of long-term increase in substance abuse among youth, and found a decrease in abuse rate in youth and adults.
“but we found no indication of long-term increase in substance abuse in this group. Rather, consistent with a previous meta-analysis, we found a decrease in the abuse rate in youth (Wilens, et al., 2003), and also a decrease in adults.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wilens, et al., 2003 source
May combine two claims.
Findingown dataSimilar results were evident regardless of the class of substance abused and irrespective of the order of change in medication status.
“Similar results were evident regardless of the class of substance abused (eTable 3), and irrespective of the order of change in medication status (eTable 4).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe inverse association between stimulant ADHD medication and substance abuse was observed across different cohorts and exposures, including separate analyses of males and females, inclusion of non-stimulant ADHD medication, exclusion of never-treated individuals, and among those with a drug abuse diagnosis at baseline.
“Decrease in substance abuse rates associated with ADHD medication were observed also when using different cohorts or exposures, that is, when we analyzed males and females separately (eTable 1), included non-stimulant ADHD medication, excluded individuals who were never treated, and did separate analyses for those with a drug abuse diagnosis already at baseline (eTable 2).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataIn a cohort of children with ADHD aged 15 years or younger on Jan 1 2006, stimulant ADHD medication was not associated with an increased rate of substance abuse; the negative association was stronger than in the overall cohort (HR=0.38, 95% CI 0.23-0.64).
“We performed analyses on a cohort of 17,328 children with ADHD who were 15 years old or younger 1/1/2006. There was no indication that stimulant ADHD medication increased the rate of abuse in this cohort but rather, there appeared to be an even stronger negative association (HR=0.38, 95% CI: 0.23–0.64; Table 2).”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataIn both males and females, those taking stimulant medication were younger and less likely to be employed or married than non-users.
“In both males and females, those taking stimulant medication were younger at start of follow-up, and less likely to be employed or married compared to non-users; these differences may be explained overall by stimulant users being younger than non-users.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Interpretationown dataThe findings are based on Swedish population data, and generalizations to other cultures or countries should be made with caution.
“Second, the findings were based on Swedish population data, and generalizations to other cultures/countries should be made with caution.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
Interpretationnone givenUnmeasured confounders can never be fully ruled out in this research design.
“Nevertheless, unmeasured confounders can never be fully ruled out in this research design.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataThe results are most congruent with the hypothesis that longer stimulant ADHD medication use lowers substance abuse risk, partly through less chance of short-term substance-related and psychiatric problems.
“Together these results are most congruent with the first hypothesis; that is, the longer an individual takes the medication, the lower the risk for substance abuse, to some extent due to less chance of short-term substance-related and psychiatric problems.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductreasoningThe study analyzed a subsample of patients who had been medicated at least once during follow-up to rule out confounding by unmeasured conditions.
“Second, some patients may have been not medicated because they were different (e.g., with comorbid conditions not suitable for stimulant medication) from those medicated; therefore, we analyzed a subsample of patients who had been on medication at least once during follow-up to rule out the potential confounding effect of such unmeasured conditions.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductreasoningThe analysis included only unplanned hospital visits to avoid misclassifying planned treatments as events.
“We included only unplanned hospital visits to avoid misclassifying planned treatments (e.g., regular hospital visits in treatment programs) as events.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe study performed sensitivity analyses with SSRIs to address possible non-specific beneficial effects of being prescribed medication.
“We also performed sensitivity analyses with individuals who were prescribed selective serotonin reuptake inhibitors (SSRIs; instead of ADHD medication). This analysis was one approach to deal with the possible non-specific beneficial effects of being prescribed medication, such as regular reviews by healthcare staff and links to other medical and social services.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim. May combine two claims.
Study design and conductown dataThe study controlled for age, sex, medication in 2009, and other covariates including socioeconomic status, prior substance abuse, psychiatric disorder, and criminal convictions before 2006.
“We also controlled for previous substance abuse, other psychiatric diagnosis (other than substance abuse and ADHD), criminal conviction (other than for substance abuse), and psychotropic medications other than ADHD medication.”
- Also stated in: § Results · plain
“The association remained decreased at 31% when we controlled for other potential confounders (SES, substance abuse, psychiatric disorder, and criminal convictions before 2006; HR=0.69, 95% CI: 0.57–0.84).”
Quote in the paperSubstantial claim- Also stated in: § Results · plain
The paper relies on this without support.
Prior studies on ADHD medication and substance use have had limited sample sizes.
“Although many studies seem to find no or possibly protective effects of ADHD medication on substance use (Barkley, Fischer, Smallish, & Fletcher, 2003; Biederman et al., 2008; Faraone & Wilens, 2007; Mannuzza, et al., 2008; Wilens, Faraone, Biederman, & Gunawardene, 2003), they have had limited sample sizes and data are as yet inconclusive.”
The paper relies on this without support.
The Swedish national registers used in the study provide complete and accurate coverage of ADHD diagnoses, stimulant prescriptions, and substance abuse outcomes.
“The National Patient Register (NPR) has nationwide coverage for psychiatric in-patient care and information on psychiatric out-patient visits to specialist physicians (not general practitioners) since 2001 with diagnoses based on the International Classification of Diseases (ICD)(Organization, 1992).”
“We also used the Prescribed Drug Register, which includes information on all prescribed medical drugs since July 2005 (Wettermark et al., 2007).”
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 study extends prior Swedish findings of lower substance-related problem risk with stimulant medication by showing within-individual links to both lower concurrent and lower long-term event risk.
“They extend a finding of associations between stimulant medication and lower risk of substance-related problems in Sweden by demonstrating within-individual associations with not only lower concurrent risk but also lower long-term risk of substance-related events (19).”
From ADHD Medication and Substance-Related Problems (2017) · cites this paper as [19]
The Results report a within-individual association between stimulant medication and lower concurrent substance-abuse rates in the Swedish cohort. The Discussion reports a lower long-term risk association over four years, but explicitly says a within-individual analysis was not possible for the long-term outcome. Thus, the claim incorrectly describes the long-term association as within-individual. (LLM, conf=0.91)
Experimental — accuracy not yet measuredThere is growing evidence that initiation of ADHD stimulant therapy in secondary school or later may represent a sensitive developmental period that deserves greater clinical and research attention.
“There is growing evidence that initiation of ADHD stimulant therapy in secondary school or later may represent a sensitive developmental period that deserves greater clinical and research attention.26,29,30”
From Is Age of Onset and Duration of Stimulant Therapy for ADHD Associated with Cocaine, Methamphetamine, and Prescription Stimulant Misuse? (2024) · cites this paper as [26]
The Introduction (page unavailable) reports a proposed sensitive developmental period for youths using stimulant ADHD medication and calls for more evidence. It does not identify initiation in secondary school or later as that period. The Discussion (page unavailable) also reports no indication of increased long-term substance abuse among youths, so the paper does not establish the cited claim about later initiation. (LLM, conf=0.83)
Experimental — accuracy not yet measuredStimulant use in childhood has neutral or protective effects on subsequent drug and alcohol use disorders.
“neutral or protective effects on sub sequent drug and alcohol use disorders 172-175 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [175]
The Discussion reports no increased substance-abuse rate among medicated youth and a decrease over the study’s four-year follow-up. But it describes observational associations, not established effects, and its recorded outcomes primarily capture severe substance abuse rather than drug and alcohol use disorders generally. (LLM, conf=0.87)
Experimental — accuracy not yet measuredFindings from national registry studies indicate that the use of medication, particularly stimulants, might have protective effects on substance abuse, suicidal and delinquent behaviour.
“might have protective effects on substance abuse, suicidal and delinquent behaviour 175,214,232,233 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [175]
The Results and Discussion report an association between stimulant ADHD medication and lower rates of substance abuse in Swedish registry data. The Introduction mentions a separate study reporting reduced criminality during treatment, but this paper does not report a protective association for suicidal behaviour. Its own criminal-conviction data are used chiefly to measure substance-related outcomes, not delinquent behaviour generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCentral stimulants reduce behaviors related to emotional impulsivity and instability in ADHD such as suicide rate, drug use and criminal behavior, possibly indicating a specific effect on emotional dysregulation in ADHD.
“Interestingly, central stimulants also reduce behaviors related to emotional impulsivity and instability in ADHD such as suicide rate (Chen et al., 2014), drug use (Chang et al., 2014) and criminal behavior (Lichtenstein et al., 2012)—possibly indicating a specific effect on emotional dysregulation in ADHD.”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Chang et al., 2014
The Chang et al. citation is attached to drug use, not to the sentence’s separate citations for suicide or criminal behavior. The Discussion reports an association between stimulant ADHD treatment and lower rates of substance abuse, but does not establish that stimulants cause the reduction. It also cautions that the recorded outcomes primarily concern severe substance abuse. (LLM, conf=0.86)
Experimental — accuracy not yet measured
More recent studies report that medication treatment is linked to lower substance-related risk.
“In fact, several more recent studies have found that medication treatment is associated with decreased substance-related risk (18–20).”
From ADHD Medication and Substance-Related Problems (2017) · cites this paper as [19]
Experimental — accuracy not yet measuredThat study also reported a long-term link between medication and lower later substance-related problem risk, using statistical covariates rather than within-individual comparisons.
“That study additionally found a long-term association between medication and lower risk for later substance-related problems, using statistical covariates but not within-individual comparisons.”
From ADHD Medication and Substance-Related Problems (2017) · cites this paper as [19]
In the Swedish population, Chang and colleagues observed lower substance-related problem risk among ADHD patients prescribed stimulants.
“Notably, Chang and colleagues (19) found that risk of substance-related problems was lower when ADHD patients in the Swedish population were prescribed stimulant medications.”
From ADHD Medication and Substance-Related Problems (2017) · cites this paper as [19]
There is evidence that stimulant therapy for ADHD is not associated with an increase in the risk for overall SUD, especially for longer duration stimulant medication treatment.
“While there is evidence that stimulant therapy for ADHD is not associated with an increase in the risk for overall SUD, 6 especially for longer duration stimulant medication treatment, [26][27][28]”
From Is Age of Onset and Duration of Stimulant Therapy for ADHD Associated with Cocaine, Methamphetamine, and Prescription Stimulant Misuse? (2024) · cites this paper as [26]
Chang et al. (2014) found that a longer duration of medication was associated with lower rates of substance-related events.
“Moreover, a longer duration of medication was associated with lower rates of events [60].”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [60]
Chang et al. (2014) found stimulant ADHD medication to be associated with a 31% lower rate of substance-related events three years later.
“Chang et al. (2014) studied linked national registers that included nearly 39,000 patients with ADHD, and found stimulant ADHD medication to be associated with a 31% lower rate of substance-related events three years later.”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [60]
Chang et al. (2014) found a 13% reduction in SUD risk for every year of stimulant treatment.
“Similarly, Chang et al. (2014) found a 13% reduction in SUD risk for every year of stimulant treatment (Chang et al. 2014).”
From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Chang et al. 2014
Findings from national registry studies indicate that the use of medication, particularly stimulants, reduces the risk of accidents and trauma-related emergency department admissions.
“findings from national registry studies indicate that the use of medication, particularly stimulants, reduces the risk of accidents and traumarelated emergency department admissions”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [175]
The Methods > Measures section defines the outcomes as substance-related hospital visits, deaths, and convictions; the Results report lower substance-abuse rates associated with stimulant medication. Searches for accidents, injuries, trauma, and emergency department visits found no passage addressing whether medication reduces accidents or trauma-related admissions. Page numbers were not available in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measured
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“…short-term effects on ADHD symptoms (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters et al., 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young et al., 2011), and similar to a study on drug-related criminality…”
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“neural mechanism for ADHD treatment) (Volkow & Swanson, 2003;Wise, 2002).”
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“Rather, consistent with a previous meta-analysis, we found a decrease in the abuse rate in youth (Wilens et al., 2003) and also a decrease in adults.”
Misuse and Diversion of Stimulants Prescribed for ADHD: A Systematic Review of the Literature
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“Behavior sensitization – a phenomenon of increased response to an addictive substance after repeated exposure – has been observed in humans (Boileau et al., 2008), and there have been reports of abuse and misuse of stimulant ADHD medication (Kollins, MacDonald, & Rush, 2001; Wilens et al., 2008).”
Clinical and Functional Outcome of Childhood Attention-Deficit/Hyperactivity Disorder 33 Years Later
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InfluentialSelf-citationElkins, I. J., McGue, M., & Iacono, W. G. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.10.1145 · Cited by 480 · see citing works
Variables That Affect the Clinical Use and Abuse of Methylphenidate in the Treatment of ADHD
Volkow, N. D., & Swanson, J. M. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.11.1909 · Cited by 475 · cited 1× · see citing works
“…the persistent concern for subsequent substance abuse derives from the fact that stimulant medications increase dopamine concentration in the nucleus accumbens (a brain region implicated in substance abuse and the proposed neural mechanism for ADHD treatment) (Volkow & Swanson, 2003;Wise, 2002).”
Banaschewski, T., Coghill, D., Santosh, P., Zuddas, A., Asherson, P., Buitelaar, J., Danckaerts, M., Döpfner, M., Faraone, S. V., Rothenberger, A., et al. (2006) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-006-0549-0 · Cited by 375 · see citing works
Assessing the abuse potential of methylphenidate in nonhuman and human subjects: a review
Kollins, S. H., MacDonald, E. K., & Rush, C. R. (2001) · Pharmacology Biochemistry and Behavior · doi:10.1016/s0091-3057(01)00464-6 · Cited by 365 · see citing works
Newcorn, J. H., Kratochvil, C. J., Allen, A. J., Casat, C. D., Ruff, D. D., Moore, R. J., Michelson, D., & Atomoxetine/Methylphenidate Comparative Study Group (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.05091676 · Cited by 336 · cited 2× · see citing works
“…have beneficial short-term effects on symptoms of ADHD (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters, Becker, Kilian, Fegert, & Weinmann, 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young, Sarkis, Qiao, & Wietecha, 2011).”
Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2003) · Pediatrics · doi:10.1542/peds.111.1.97 · Cited by 274 · see citing works
Mannuzza, S., Klein, R. G., Truong, N. L., Moulton, J. L., Roizen, E. R., Howell, K. H., & Castellanos, F. X. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07091465 · Cited by 263 · cited 3× · see citing works
“…et al., 2011), where researchers and clinicians have proposed that risk for substance abuse might be particularly pronounced for youths who use stimulant ADHD medication during a sensitive developmental period (Fischer & Barkley, 2003; Mannuzza, Klein, & Moulton, 2003; Mannuzza et al., 2008).”
Biederman, J., Monuteaux, M. C., Spencer, T., Wilens, T. E., MacPherson, H. A., & Faraone, S. V. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.07091486 · Cited by 239 · cited 2× · see citing works
“Although many studies seem to find no or possibly protective effects of ADHD medication on substance use (Barkley, Fischer, Smallish, & Fletcher, 2003; Biederman et al., 2008; Faraone & Wilens, 2007; Mannuzza et al., 2008; Wilens, Faraone, Biederman, & Gunawardene, 2003), they have had limited sample sizes and data ar…”
Beyond polemics: science and ethics of ADHD
Singh, I. (2008) · Nature reviews. Neuroscience · doi:10.1038/nrn2514 · Cited by 233 · cited 5× · see citing works
“…be beneficial, there has been a persistent concern that treatment with stimulant medication could lead to long-term development of substance abuse (Singh, 2008; Winhusen et al., 2011), and our previous study did not explore long-term associations with drug abuse and only addressed drug-related…”
InfluentialStimulant Medication and Substance Use Outcomes
Humphreys, K. L., Eng, T., & Lee, S. S. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.1273 · Cited by 211 · cited 1× · see citing works
“In this report, we have investigated almost 40,000 individuals with ADHD over 4 years, and found no indication of increased substance abuse at follow-up, which is consistent with a recent meta-analysis (Humphreys et al., 2013).”
Genetic and Familial Environmental Influences on the Risk for Drug Abuse
Kendler, K. S., Sundquist, K., Ohlsson, H., Palmér, K., MAES, H. H. M., Winkleby, M. A., & Sundquist, J. (2012) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.2112 · Cited by 199 · cited 1× · see citing works
“Several studies have used Swedish national registers to study substance abuse (Kendler et al., 2012).”
BackgroundThe Global Market For ADHD Medications
Scheffler, R. M., Hinshaw, S. P., Modrek, S., & Levine, P. (2007) · Health Affairs · doi:10.1377/hlthaff.26.2.450 · Cited by 197 · see citing works
Graham, J., & Coghill, D. (2008) · CNS Drugs · doi:10.2165/00023210-200822030-00003 · Cited by 185 · cited 1× · see citing works
“However, the possible beneficial effects on short-term behavior have to be carefully weighed against potential adverse effects (Graham & Coghill, 2008; Singh, 2008).”
Alcohol use disorders in EU countries and Norway: An overview of the epidemiology
Rehm, J. T., Room, R., van den Brink, W., & Jacobi, F. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.005 · Cited by 167 · see citing works
Zetterqvist, J., Asherson, P., Halldner, L., Långström, N., & Larsson, H. (2013) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12004 · Cited by 155 · cited 2× · see citing works
“Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health. prescriptions of ADHD medication, unless prescriptions occurred more than 6 months apart (Lichtenstein et al., 2012; Zetterqvist et al., 2012).”
Self-citationKoesters, M., Becker, T., Kilian, R., Fegert, J., & Weinmann, S. (2009) · Journal of Psychopharmacology · doi:10.1177/0269881108092338 · Cited by 142 · cited 1× · see citing works
“…to have advantageous short-term effects on ADHD symptoms (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters et al., 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young et al., 2011), and similar to a study on drug-related…”
Evolution of the treatment of attention-deficit/hyperactivity disorder in children: A review
Findling, R. L. (2008) · Clinical Therapeutics · doi:10.1016/j.clinthera.2008.05.006 · Cited by 129 · cited 2× · see citing works
“ADHD medication has been shown to have advantageous short-term effects on ADHD symptoms (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters et al., 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young et al., 2011), and similar to…”
Faraone, S. V., & Upadhyaya, H. P. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.1107e28 · Cited by 110 · see citing works
Use of ADHD drugs in the Nordic countries: a population-based comparison study
Zoëga, H., Furu, K., Halldórsson, M., Thomsen, P. H., Sourander, A., & Martikainen, J. E. (2010) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01607.x · Cited by 107 · cited 1× · see citing works
“Although the prevalence of ADHD diagnosis and medication varies between countries and over time, Sweden does not appear to be unusual in rates of ADHD and ADHD medication (Scheffler, Hinshaw, Modrek, & Levine, 2007; Zoega et al., 2011).”
Adler, L. A., Zimmerman, B., Starr, H. L., Silber, S., Palumbo, J., Orman, C., & Spencer, T. (2009) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181a390ce · Cited by 106 · cited 2× · see citing works
“ADHD medication has been shown to have advantageous short-term effects on ADHD symptoms (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters et al., 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young et al., 2011), and similar to…”
Findling, R. L., Bukstein, O. G., & Melmed, R. D. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0120 · Cited by 100 · cited 2× · see citing works
“…suggest that ADHD medication have beneficial short-term effects on symptoms of ADHD (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters, Becker, Kilian, Fegert, & Weinmann, 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young,…”
Boileau, I., Rusjan, P., Houle, S., Wilkins, D., Tong, J., Selby, P., Guttman, M., Saint-Cyr, J. A., Wilson, A. A., & Kish, S. J. (2008) · The Journal of Neuroscience · doi:10.1523/jneurosci.3008-08.2008 · Cited by 100 · cited 2× · see citing works
“Behavior sensitization – a phenomenon of increased response to an addictive substance after repeated exposure – has been observed in humans (Boileau et al., 2008), and there have been reports of abuse and misuse of stimulant ADHD medication (Kollins, MacDonald, & Rush, 2001; Wilens et al., 2008).”
Mannuzza, S., Klein, R. G., & Moulton, J. L. (2003) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/104454603322572606 · Cited by 83 · cited 1× · see citing works
“Critics of ADHD medication have been specifically concerned about the risk for youth (Fischer & Barkley, 2003; Mannuzza et al., 2003, 2008), but we found no indication of long-term increase in substance abuse in this group.”
Faraone, S., & Wilens, T. (2007) · PubMed · Cited by 75 · see citing works
Svanborg, P., Thernlund, G., Gustafsson, P. A., Hägglöf, B., Poole, L., & Kadesjö, B. (2009) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-008-0725-5 · Cited by 71 · cited 2× · see citing works
“…have beneficial short-term effects on symptoms of ADHD (Adler et al., 2009; Banaschewski et al., 2006; Findling, 2008; Findling et al., 2008; Koesters, Becker, Kilian, Fegert, & Weinmann, 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young, Sarkis, Qiao, & Wietecha, 2011).”
Once-Daily Treatment With Atomoxetine in Adults With Attention-Deficit/Hyperactivity Disorder
Young, J. L., Sarkis, E. H., Qiao, M., & Wietecha, L. A. (2011) · Clinical Neuropharmacology · doi:10.1097/wnf.0b013e31820c00eb · Cited by 62 · cited 1× · see citing works
“…et al., 2006; Findling, 2008; Findling et al., 2008; Koesters et al., 2009; Kooij et al., 2010; Newcorn et al., 2008; Svanborg et al., 2009; Young et al., 2011), and similar to a study on drug-related criminality (Lichtenstein et al., 2012), our data suggest a concomitant association…”
Winhusen, T. M., Lewis, D. F., Riggs, P., Davies, R. D., Adler, L. A., Sonne, S. C., & Somoza, E. C. (2011) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2011.0014 · Cited by 53 · cited 4× · see citing works
“Among these, there have been concerns over the long-term effects on the development of substance abuse (Humphreys, Eng, & Lee, 2013; Singh, 2008; Winhusen et al., 2011), where researchers and clinicians have proposed that risk for substance abuse might be particularly pronounced for youths who use…”
InfluentialChildhood stimulant treatment and risk for later substance abuse.
Fischer, M., & Barkley, R. A. (2003) · PubMed · Cited by 48 · see citing works
Winters, K. C., Lee, S., Botzet, A., Fahnhorst, T., Realmuto, G. M., & August, G. J. (2011) · Journal of Child & Adolescent Substance Abuse · doi:10.1080/1067828x.2011.598834 · Cited by 22 · cited 1× · see citing works
“Nevertheless, it is reassuring that we found commensurate results when using duration of stimulant ADHD medication as the exposure, and that our findings are congruent with previous studies (Wilens et al., 2003; Winters et al., 2011).”
Result
Flagged first, then by citations
Research works printed but not linked: 3
- Official Statistics of Sweden, 2011, Kriminalstatistik 2010 [Criminal statistics]
- Swedish National Institute of Public Health, 2008, Alcohol Statistics 2007
- WHO., 1992, ICD‐10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines
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 · see citing works
“Over 40 % of crashes by male patients would have been avoided if they had been receiving treatment during the entire period (Chang et al., 2014b).”
InfluentialSelf-citationAttention-deficit/hyperactivity disorder
Faraone, S. V., Asherson, P., Banaschewski, T., Biederman, J., Buitelaar, J. K., Ramos-Quiroga, J. A., Rohde, L. A., Sonuga-Barke, E. J. S., Tannock, R., & Franke, B. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.20 · Cited by 1,479 · see citing works
Attention-deficit hyperactivity disorder
Posner, J., Polanczyk, G. V., & Sonuga-Barke, E. (2020) · The Lancet · doi:10.1016/s0140-6736(19)33004-1 · Cited by 835 · see citing works
Updated European Consensus Statement on diagnosis and treatment of adult ADHD
Kooij, J. J. S., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balázs, J., Thome, J., Dom, G., Kasper, S., Nunes Filipe, C., et al. (2019) · European Psychiatry · doi:10.1016/j.eurpsy.2018.11.001 · Cited by 686 · see citing works
“These studies show that during periods of receiving medications for ADHD there are marked reductions in transport accidents and mortality rates [132,229], criminal convictions [230], suicidal behavior [231], violent reoffending [230], depression [232] and substance misuse [233].”
BackgroundLive fast, die young? A review on the developmental trajectories of ADHD across the lifespan
Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., et al. (2018) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2018.08.001 · Cited by 643 · see citing works
Self-citationAdult attention-deficit hyperactivity disorder: key conceptual issues
Asherson, P., Buitelaar, J., Faraone, S. V., & Rohde, L. A. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30032-3 · Cited by 347 · see citing works
Storebø, O. J., Pedersen, N., Ramstad, E., Kielsholm, M. L., Nielsen, S. S., Krogh, H. B., Moreira-Maia, C. R., Magnusson, F. L., Holmskov, M., Gerner, T., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012069.pub2 · Cited by 321 · see citing works
Evidence-based pharmacological treatment options for ADHD in children and adolescents
Mechler, K., Banaschewski, T., Hohmann, S., & Häge, A. (2022) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2021.107940 · Cited by 293 · see citing works
A literature review and meta-analysis on the effects of ADHD medications on functional outcomes
Boland, H., DiSalvo, M., Fried, R., Woodworth, K. Y., Wilens, T., Faraone, S. V., & Biederman, J. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.01.006 · Cited by 240 · see citing works
ADHD Medication and Substance-Related Problems
Quinn, P. D., Chang, Z., Hur, K., Gibbons, R. D., Lahey, B. B., Rickert, M. E., Sjölander, A., Lichtenstein, P., Larsson, H., & D’Onofrio, B. M. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.16060686 · Cited by 187 · see citing works
Self-citationTop-Down Dysregulation—From ADHD to Emotional Instability
Petrovic, P., & Castellanos, F. X. (2016) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2016.00070 · Cited by 179 · see citing works
“…central stimulants also reduce behaviors related to emotional impulsivity and instability in ADHD such as suicide rate (Chen et al., 2014), drug use (Chang et al., 2014) and criminal behavior (Lichtenstein et al., 2012)—possibly indicating a specific effect on emotional dysregulation in ADHD.”
BackgroundChang, Z., Ghirardi, L., Quinn, P. D., Asherson, P., D’Onofrio, B. M., & Larsson, H. (2019) · Biological Psychiatry · doi:10.1016/j.biopsych.2019.04.009 · Cited by 175 · see citing works
“We conducted a qualitative systematic review on studies that investigated the effects of ADHD medication on behavioral and neuropsychiatric outcomes using linked prescription databases from the last ten years, and identified 40 studies from Europe, North America, and Asia.”
InfluentialSelf-citationChang, Z., Quinn, P. D., Hur, K., Gibbons, R. D., Sjölander, A., Larsson, H., & D’Onofrio, B. M. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.0659 · Cited by 166 · see citing works
“Age at start of follow-up, median (IQR), y 27 (20-40) 32 (22-44)”
Self-citationGlewwe, P. W., West, K. L., & Lee, J. (2017) · Journal of Policy Analysis and Management · doi:10.1002/pam.22043 · Cited by 164 · see citing works
Sun, S., Kuja-Halkola, R., Faraone, S. V., D’Onofrio, B. M., Dalsgaard, S., Chang, Z., & Larsson, H. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.1944 · Cited by 155 · see citing works
Self-citationChang, Z., D’Onofrio, B. M., Quinn, P. D., Lichtenstein, P., & Larsson, H. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2016.02.018 · Cited by 154 · see citing works
Self-citationButwicka, A., Långström, N., Larsson, H., Lundström, S., Serlachius, E., Almqvist, C., Frisén, L., & Lichtenstein, P. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-2914-2 · Cited by 162 · see citing works
“Indeed, both ADHD and intellectual disability frequently co-occur with ASD (Hofvander et al. 2009; Buck et al. 2014) and are linked to substance userelated problems (Carroll Chapman and Wu 2012; Lee et al. 2011; Chang et al. 2014).”
BackgroundSelf-citationAttention-Deficit/Hyperactivity Disorder
Banaschewski, T., Becker, K., Döpfner, M., Holtmann, M. H., Rösler, M., & Romanos, M. (2017) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2017.0149 · Cited by 188 · see citing works
Weibel, S., Menard, O., Ionita, A., Boumendjel, M. D., Cabelguen, C., Kraemer, C., Micoulaud‐Franchi, J., Bioulac, S., Perroud, N. A., Sauvaget, A., et al. (2019) · L Encéphale · doi:10.1016/j.encep.2019.06.005 · Cited by 191 · see citing works
Coghill, D., Banaschewski, T., Soutullo, C. A., Cottingham, M. G., & Zuddas, A. (2017) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-017-0986-y · Cited by 130 · see citing works
“Recent evidence from observational and registry studies indicates that pharmacological treatment of ADHD is associated with increased achievement and decreased absenteeism at school [16], a reduced risk of trauma-related emergency hospital visits [58], reduced risks of suicide and attempted suicide [28], and decreased…”
BackgroundKrinzinger, H., Hall, C. L., Groom, M. J., Ansari, M., Banaschewski, T., Buitelaar, J. K., Carucci, S., Coghill, D., Danckaerts, M., Dittmann, R., et al. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.09.023 · Cited by 117 · see citing works
The Risk of Treatment-Emergent Mania With Methylphenidate in Bipolar Disorder
Viktorin, A., Rydén, E., Thase, M. E., Chang, Z., Lundholm, C., D'Onofrio, B. M., Almqvist, C., Magnusson, P. K. E., Lichtenstein, P., Larsson, H., et al. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.16040467 · Cited by 113 · see citing works
Self-citationAlcohol use disorders and ADHD.
Luderer, M., Ramos Quiroga, J. A., Faraone, S. V., Zhang-James, Y., & Reif, A. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.07.010 · Cited by 102 · see citing works
Direct medical costs of ADHD and its comorbid conditions on basis of a claims data analysis
Libutzki, B., Ludwig, S., May, M., Jacobsen, R. H., Reif, A., & Hartman, C. A. (2019) · European Psychiatry · doi:10.1016/j.eurpsy.2019.01.019 · Cited by 94 · see citing works
Mohr-Jensen, C., Müller Bisgaard, C., Boldsen, S. K., & Steinhausen, H.-C. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.11.016 · Cited by 96 · see citing works
Functional Impairments Associated With ADHD in Adulthood and the Impact of Pharmacological Treatment
Kosheleff, A. R., Mason, O. W., Jain, R., Koch, J., & Rubin, J. (2023) · Journal of Attention Disorders · doi:10.1177/10870547231158572 · Cited by 95 · see citing works
McCabe, S. E., Dickinson, K., West, B. T., & Wilens, T. E. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2016.03.011 · Cited by 82 · see citing works
Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD)
Storebø, O. J., Storm, M. R. O., Ribeiro, J. P., Skoog, M., Groth, C., Edemann-Callesen, H., Schaug, J. P., Rasmussen, P. D., Huus, C.-M. L., Zwi, M., et al. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009885.pub3 · Cited by 86 · see citing works
Man, K. K. C., Häge, A., Banaschewski, T., Inglis, S. K., Buitelaar, J. K., Carucci, S., Danckaerts, M., Dittmann, R., Falissard, B., Garas, P., et al. (2023) · The Lancet Psychiatry · doi:10.1016/s2215-0366(23)00042-1 · Cited by 88 · see citing works
The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder
(2024) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000001299 · Cited by 78 · see citing works
Attention-Deficit/Hyperactivity Disorder and Risk for Substance Use Disorders in Relatives
Skoglund, C., Chen, Q., Franck, J., Lichtenstein, P., & Larsson, H. (2015) · Biological Psychiatry · doi:10.1016/j.biopsych.2014.10.006 · Cited by 70 · see citing works
Self-citationAsherson, P. J., Leaver, L., Adamou, M., Arif, M., Askey, G., Butler, M., Cubbin, S., Newlove‐Delgado, T., Kustow, J., Lanham-Cook, J., et al. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04290-7 · Cited by 74 · see citing works
“Evidence suggests broader health-related benefits of engaging with treatment for ADHD, including lower risks of serious transport accidents [35], depression [36], suicidality [37], and substance use disorders [38], and improved seizure control in patients with ADHD and epilepsy [39].”
BackgroundEmilsson, M., Gustafsson, P. A., Öhnström, G., & Marteinsdóttir, Í. (2016) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-016-0919-1 · Cited by 70 · see citing works
“However, medical treatment for individuals with ADHD is reported to reduce the risk of substance abuse [9], comorbid psychiatric disorders [10] and criminality [11].”
BackgroundPolyzoi, M., Ahnemark, E., Medin, E., & Ginsberg, Y. (2018) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s155838 · Cited by 69 · see citing works
Schein, J., Adler, L. A., Childress, A., Gagnon-Sanschagrin, P., Davidson, M., Kinkead, F., Cloutier, M., Guérin, A., & Lefebvre, P. (2022) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2021.21290 · Cited by 56 · see citing works
Zhang, L., Zhu, N., Sjölander, A., Nourredine, M., Li, L., Garcia‐Argibay, M., Kuja‐Halkola, R., Brikell, I., Lichtenstein, P., D'Onofrio, B. M., et al. (2025) · BMJ · doi:10.1136/bmj-2024-083658 · Cited by 59 · see citing works
“14 15 In particular, studies using within individual designs have linked use of drugs for ADHD to reduced risks of suicidal behaviours, 16-18 substance misuse, 19 20 accidental injuries, 21 transport accidents, 22 23 and criminality.”
Self-citationLopresti, A. L. (2015) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-015-0170-5 · Cited by 47 · see citing works
ADGRL3 (LPHN3) variants predict substance use disorder
Arcos‐Burgos, M., Velez, J. I., Martinez, A. F., Ribasés, M., Ramos‐Quiroga, J. A., Sánchez‐Mora, C., Vanesa Richarte, B., Roncero, C., Cormand, B., Noèlia Fernàndez-castillo, A., et al. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0396-7 · Cited by 45 · see citing works
The use of stimulant medications for non-core aspects of ADHD and in other disorders.
Sinita, E., & Coghill, D. (2014) · Neuropharmacology · doi:10.1016/j.neuropharm.2014.06.014 · Cited by 40 · see citing works
Attention-deficit/hyperactivity disorder medication and seizures
Wiggs, K. K., Chang, Z., Quinn, P. D., Hur, K., Gibbons, R. D., Dunn, D., Brikell, I., Larsson, H., & D'Onofrio, B. M. (2018) · Neurology · doi:10.1212/wnl.0000000000005213 · Cited by 44 · see citing works
Self-citationChildhood attention-deficit/hyperactivity disorder
Verkuijl, N., Perkins, M., & Fazel, M. (2015) · British medical journal · doi:10.1136/bmj.h2168 · Cited by 19 · see citing works
Villemonteix, T., Brito, S. A. D., Kavec, M., Balériaux, D. F., Metens, T., Slama, H., Baijot, S., Mary, A., Peigneux, P., & Massat, I. (2015) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2015.04.015 · Cited by 41 · see citing works
“In humans, most studies seem to find no or possibly protective effects of ADHD medication on substance abuse (Humphreys et al., 2013; Chang et al., 2014).”
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“For individuals with ADHD, however, stimulant therapy was found to decrease the rates of smoking and other SUDs later in life (Chang, Lichtenstein, Halldner, et al., 2014; Quinn et al., 2017; Schoen-felder, Faraone, & Kollins, 2014; Wilens, Faraone, Biederman, & Gunawardene, 2003).”
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“There is evidence of potential beneficial effects of stimulant medications in individuals with ADHD on a number of serious health-related problems (Chang et al., 2019; Chang et al., 2014; Chen et al., 2014; Ruiz-Goikoetxea et al., 2018), including subsequent drug abuse and injuries (Chang et al.”
BackgroundSelf-citationAssociation Between Stimulant Treatment and Substance Use Through Adolescence Into Early Adulthood.
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Attention deficit hyperactivity disorder
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“Proposed Therapeutic Approaches via Gut Microbiota Modulation Considering the inadequacy of present medications and correlations between ADHD and gut microbiota, novel therapies can be suggested by modulating the gut microbiota composition (Chang et al., 2014; Faraone et al., 2008; Gillies et al., 2012; Posner et al.,…”
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“ADHD medication is also associated with reduced risk of depression [51], suicide [13,52], teen pregnancy [53], substance abuse [54], children and adolescent accidental injuries [55–57], adult motor accidents [58,59], as well all-cause mortality [60].”
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Self-citationADHD Symptoms and Financial Distress
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“Moreover, a recent Swedish register-based total population study indicated a decrease in substance abuse with ADHD medication; the longer duration of ADHD medication, the lower the rate of substance abuse.(32) Coexistent disorders, adverse effects, and insufficient follow-up routines have been associated with poor adh…”
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Attention-Deficit/Hyperactivity Disorder Medications and Work Disability and Mental Health Outcomes
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“A meta-analysis with data from two of these studies (88, 89) showed that the risk of substance use outcomes was reduced; however, it did not attain statistical significance (91).”
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“Similarly, Chang et al. (2014) found a 13% reduction in SUD risk for every year of stimulant treatment (Chang et al. 2014).”
Approach to Evaluating and Managing Adult Attention-Deficit/Hyperactivity Disorder in Primary Care
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“Several treatment strategies for adults with ADHD have been shown to be associated with symptom improvement [7] and reduced rates of traffic accidents [19], substance abuse [20], suicidal behavior [12], and criminal convictions [21].”
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“It has been reported that medication treatment for children with ADHD can reduce the risk of criminality, comorbid psychiatric disorders, and substance abuse in adolescence and adulthood (6, 7).”
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Self-citationEffect of Pharmacological Treatment of Attention-Deficit/Hyperactivity Disorder on Criminality
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Special Education Financing and ADHD Medications: A Bitter Pill to Swallow
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Drug Treatments for ADHD Reduce Risk of Substance Use Disorders
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“Beyond narrowly defined cognitive effects of stimulants Besides the population-based findings from Sweden [13 ,14,36 ], others have also reported improvements in self-reported functioning in those undergoing treatment for ADHD [4,33–35], although the mediators of these effects remain unknown.”
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Development of the Korean Practice Parameter for Adult Attention-Deficit/Hyperactivity Disorder
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- Authors
- Chang, Z., Lichtenstein, P., Halldner, L., D'Onofrio, B., Serlachius, E., Fazel, S., Långström, N., & Larsson, H.
- Affiliations
- Karolinska Institutet (SE)
- Indiana University Bloomington (US)
- University of Oxford (GB)
- Corresponding author
- Chang, Zheng
- ORCID
- Venue
- Journal of Child Psychology and Psychiatry
- Publisher
- Wiley
- Published
- 2013-10-25
- Volume
- 55
- Issue
- 8
- Pages
- 878-885
- ISSN
- 0021-9630 (ISSN-L)
- 1469-7610
- PMC
- PMC4147667
- OpenAlex
- W2042929391
- Cited by
- 225
- References
- 40
- Citations by year
- 2026: 17 · 2025: 19 · 2024: 25 · 2023: 24 · 2022: 21 · 2021: 14 · 2020: 26 · 2019: 18 · 2018: 14 · 2017: 16 · 2016: 11 · 2015: 16 · 2014: 4
- FWCI
- 7.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Swedish Research Council
- Swedish Council for Working Life and Social Research
- Swedish Prison and Probation Services
- National Institute of Child Health and Human Development (HD061817)
- Wellcome Trust (095806)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neuroethics, Human Enhancement, Biomedical Innovations
- Keywords
- attention deficit hyperactivity disorder, stimulant medication, substance abuse, crime, hospital visits, duration of drug use, children, stimulant abuse, drug diversion
- MeSH terms
- Adolescent, Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Middle Aged, Registries, Risk Factors, Sweden, Substance-Related Disorders, Young Adult
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