CoChat
Sign Up
Cited by 187Attention Deficit Hyperactivity DisorderSubstance Abuse Treatment and OutcomesOpioid Use Disorder Treatment

ADHD Medication and Substance-Related Problems

Open access
Quinn, Patrick D., Chang, Zheng, Hur, Kwan, Gibbons, Robert D., Lahey, Benjamin B., Rickert, Martin E., Sjölander, Arvid, Lichtenstein, Paul +2 more·2017·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2017.16060686PMC PMC5581231
Open this paper in CoChat — free accountOpen PDF

Abstract

Large within-individual claims study of ADHD medication and substance-related events.

Integrity signals

Registry

Crossref · 10.1176/appi.ajp.2017.16060686

Cites

0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

15 of 24 cited sources checked · 11 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    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).”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [18] source
      Experimental — accuracy not yet measured
    • cites [19] source
      Experimental — accuracy not yet measured
    • cites [20] source

      The Discussion (Duration of stimulant medication therapy; page unavailable) reports lower subsequent substance-use rates with early, sustained ADHD stimulant treatment. The claim omits that qualification: the Results and Discussion describe higher substance-use rates among adolescents who began stimulant treatment later or received it for a shorter period, relative to the early, sustained-treatment group. The study supports an association for a particular treatment pattern, not medication treatment generally. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    The Multimodal Treatment Study follow-up and a meta-analysis found no link between medication and substance use or problems.

    “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).”
    Quote in the paperNot a substantial claim2 of 2 sources checked
  • Interpretationcitation

    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).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [19] source

      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 measured
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.
  • Premisereasoning

    Investigators have adopted observational designs using large health-record datasets and within-person comparisons between medicated and un-medicated periods, with each patient serving as their own control.

    “Consequently, researchers have turned to observational approaches that combine large-scale health-record data with designs that make within-individual comparisons across medicated and un-medicated periods, treating each patient as their own control (26, 27).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [26] source
    • cites [27] source
  • Premisecitation

    Observational study conclusions are limited by possible confounding from differences between pharmacologically treated and untreated patients, known as confounding by indication.

    “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).”
    Quote in the paperSubstantial claim1 of 1 sources checked
  • Classified as probably not a substantial claim. 10
  • May combine two claims. 18

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    SSRIs served as a negative control exposure in the tenth sensitivity analysis to assess specificity.

    “Finally, in order to evaluate the specificity of the association to ADHD medication, the tenth used selective serotonin reuptake inhibitors (SSRIs) as a negative control medication exposure (27, 30).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [27] source
    • cites [30] source

  • May combine two claims.

    Premisecitation

    Stimulants reduce ADHD symptoms over the short term and are considered first-line treatment for children, adolescents, and adults.

    “Stimulant medications are effective in reducing ADHD symptoms in the short-term and are recognized as the first-line treatment option for school-aged children, adolescents, and adults (10–12).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [10] source
    • cites [11] source

      The Medication discussion (INTRODUCTION; page unavailable) says stimulants are highly effective at reducing core ADHD symptoms in most children, and another passage says their effects are seen immediately. The guideline discusses medication treatment for school-aged children and adolescents, but it does not establish stimulants as first-line treatment for adults; that population is outside its scope. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [12] source

  • May combine two claims.

    Premisecitation

    Research following individuals over time indicates that substance use disorder risk remains a concern in ADHD, partly due to shared genetic influences between the two conditions.

    “Prospective studies show that risk of substance use disorders is a persisting concern in ADHD (4, 5), at least in part because the two disorders share genetic influences (6–8).”
    Quote in the paperNot a substantial claim2 of 5 sources checked
    • cites [4] source
    • cites [5] source
    • cites [6] source
    • cites [7] source
    • cites [8] source

  • May combine two claims.

    Premisecitation

    Randomized trial conclusions are limited by sample sizes and treatment lengths too short to detect rare but serious substance-related events, by generalizability questions, and by ethical concerns about withholding effective treatment.

    “Conclusions from randomized clinical trials have been constrained by sample sizes and treatment durations that may be insufficient to detect rare-yet-serious substance-related events, questions regarding generalizability, and ethical concerns about withholding efficacious treatments (24, 25).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [24] source
    • cites [25] source

      The Introduction and Discussion (pages not provided) support the generalizability concern: adults in ADHD trials may not represent adults with ADHD in the community. The paper describes a six-week trial and exclusions for substance abuse, but does not say that trial size or duration prevents detection of rare serious substance-related events, or discuss ethical concerns about withholding effective treatment. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Premisecitation

    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.”
    Quote in the paperSubstantial claim1 of 1 sources checked

  • May combine two claims.

    Premisecitation

    That 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.”
    Quote in the paperSubstantial claim1 of 1 sources checked

  • May combine two claims.

    Findingown data

    The within-individual associations between ADHD medication and substance-related events remained in the same direction in all age groups and were statistically significant in adjusted models.

    “Although their point estimates varied, the within-individual associations remained in the same direction in all age groups (and were statistically significant in adjusted models).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • May combine two claims.

    Findingown data

    Adjusted long-term associations pointed in the same direction across all age groups for both sexes, though not all were statistically significant.

    “Additionally, the adjusted associations remained in the same direction in all age groups in both sexes, although they were not all statistically significant, likely in part because of decreased power.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • May combine two claims.

    Findingown data

    Among patients with prior substance use disorder diagnoses, the concurrent within-individual associations were somewhat attenuated but remained statistically significant, except in the unadjusted model for male patients.

    “Among patients with prior substance use disorder diagnoses, the concurrent associations were somewhat attenuated but remained statistically significant, except in the unadjusted model for male patients (Table 2).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • May combine two claims.

    Findingown data

    When time since last event was not adjusted for, long-term associations remained among men but were weaker among women.

    “Long-term associations without adjustment for time since last event persisted among men but were attenuated among women (Table S3).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • May combine two claims.

    Findingown data

    In models restricted to first substance-related events, medication was associated within individuals with 55% lower odds of events among male patients and 43% lower odds among female patients.

    “Notably, in models of first substance-related events only, medication was associated within-individuals with 55% and 43% lower odds of events among male and female patients, respectively, suggesting that results from the repeated events analyses may be conservative estimates of ADHD medication associations.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • May combine two claims.

    Findingown data

    Among female patients, long-term associations were weaker (4-7% reductions, not significant) for those without other medications or with incident ADHD diagnoses, while those without psychotherapy showed a 17% reduction in later substance-related event odds.

    “In contrast, female patients displayed attenuated long-term associations (4–7% reductions, which were not statistically significant) among those without other medications or with incident ADHD diagnoses, but they displayed a 17% reduction in the odds of later substance-related events among those without psychotherapy.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • May combine two claims.

    Findingown data

    Comparable associations were found when medication gaps were defined more conservatively, when only stimulant medication was included, and when inpatient and ambulance claims were added to the substance-related event definition.

    “Defining medication gaps more conservatively, including stimulant medication only, and including inpatient and ambulance claims as substance-related events all produced comparable associations.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • May combine two claims.

    Findingown data

    Concurrent within-individual associations significantly differed by sex, while long-term associations did not (p = .06).

    “We report associations separately for male and female patients because concurrent within-individual associations significantly differed by sex (long-term associations did not, p = .06).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Both concurrent and lagged medication status were predictors, so the lagged association would not be confounded by concurrent medication.

    “We included concurrent and lagged medication status as predictors, ensuring that the lagged association was independent of concurrent medication.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    More than 99.9% of ADHD patients could be matched to controls.

    “We used conditional logistic regression to compare the risk of at least one substance-related event from 2005 onward among ADHD patients with that among non-diagnosed, non-medicated controls matched 1:1 on sex, calendar year and age of first enrollment in MarketScan, and length of enrollment in months (PROC LOGISTIC; more than 99.9% of patients could be matched).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Even where reduced risk was not supported, little evidence indicated that medication raised the risk of substance-related events, including among patients with prior substance use disorders.

    “Even when the results failed to support reductions in risk, we found almost no evidence that medication increased risk of substance-related events, even among those with pre-existing substance use disorders.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Some individuals may appear more than once if they changed employers covered by MarketScan.

    “It is also possible, given the size of the databases, that individuals who switched MarketScan-covered employers were included as multiple enrollee observations.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    For female patients, concurrent associations were supported by many sensitivity analyses, but long-term reduced-risk associations were not consistently supported.

    “Among female patients, many sensitivity analyses supported a concurrent association, but some failed to support a long-term association with reduced risk.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationown data

    Because long-term associations were weaker in female than male patients, it is possible that ADHD medication offers less long-term benefit to women.

    “The finding that long-term associations were less clear among female relative to male patients may suggest that ADHD medication is associated with less long-term benefit among women.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Whether the findings apply to patients lacking commercial health insurance is unknown.

    “Fourth, we do not know whether our results would generalize to patients without commercial health insurance.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Conditional logistic regression compared ADHD patients with non-diagnosed, non-medicated controls matched one-to-one by sex, calendar year, age at first enrollment, and enrollment duration.

    “We used conditional logistic regression to compare the risk of at least one substance-related event from 2005 onward among ADHD patients with that among non-diagnosed, non-medicated controls matched 1:1 on sex, calendar year and age of first enrollment in MarketScan, and length of enrollment in months (PROC LOGISTIC; more than 99.9% of patients could be matched).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Claims data limitations constrain the conclusions, such as undiagnosed conditions, medications not captured in records, and filled prescriptions that were not consumed.

    “Finally, our conclusions are constrained by the limitations of claims data, including undiagnosed conditions, medications taken outside of recorded prescriptions, and, notably, prescriptions filled but not taken.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Only time since the last event was controlled for, since minor age or calendar-year shifts were judged unlikely to affect within-person event risk.

    “Because the relatively small changes in years of age or calendar year that occurred during follow-up were unlikely to impact within-individual risk of substance-related events, we controlled for time since last event only.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Medication was linked to lower concurrent risk of substance-related events and, at least for men, lower long-term risk of future events.

    “Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Because MarketScan records are de-identified, the analysis was exempt from IRB review.

    “As confirmed with the University of Chicago IRB, the analysis of MarketScan data is exempt because records are de-identified.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The findings do not address possible diversion or misuse of stimulants outside treatment.

    “More broadly, our results cannot speak to the possibility of diversion or misuse of stimulants outside of treatment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    For male patients, associations were present concurrently, over the long term, at most ages, and in most sensitivity analyses.

    “Among male patients, these associations held concurrently, in the long term, across most ages, and across multiple sensitivity analyses.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.
    • Rests on an assumption: Filled prescriptions for ADHD medication correspond to actual medication use.
    • Rests on an assumption: ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.
28 of 28

  • The paper relies on this without support.

    Emergency-department claims with a non-tobacco substance use disorder diagnosis correspond to actual substance-related events.

    “In order to exclude recurring treatment visits and ensure that claim dates corresponded with actual substance-related events, we counted follow-up months as having an event if they had at least one emergency-department claim with any non-tobacco substance use disorder diagnosis (primary or otherwise).”

  • The paper relies on this without support.

    Filled prescriptions for ADHD medication correspond to actual medication use.

    “Finally, our conclusions are constrained by the limitations of claims data, including undiagnosed conditions, medications taken outside of recorded prescriptions, and, notably, prescriptions filled but not taken.”

  • The paper relies on this without support.

    ADHD diagnosis codes or stimulant/atomoxetine prescriptions accurately identify ADHD patients.

    “We identified 2 993 887 (47.2% female; Table 1) ADHD patients, defined as enrollees who received either (a) an ADHD diagnosis (ICD-9 codes 314.xx) or (b) stimulant or atomoxetine ADHD medication treatment.”

  • The paper relies on this without support.

    Substance-related problems in childhood are rare.

    “However, because substance-related problems in childhood are rare, we analyzed only those enrollment periods in which patients were at least 13 years old.”
4 of 4

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?

  • Quinn et al. (2017) found that ADHD medication-mostly stimulants-was associated with a 14 to 19% reduction in the odds of an SUD-related emergency department visit two years later, with the largest reduction among adolescents.

    “Quinn et al. (2017) conducted within-individual analyses of registered health care data from nearly three million individuals with ADHD and found that ADHD medication—mostly stimulants—was associated with a 14 to 19% reduction in the odds of an SUD-related emergency department visit two years later, with the largest reduction among adolescents [61].”

    From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [61]

    The Results section on long-term associations reports 19% lower odds of a substance-related event two years after a medicated period for male patients and 14% lower odds for female patients in adjusted within-individual models. The Method section defines these events as substance-use-disorder-related emergency-department visits, and the ADHD Medication section says most medicated patients received stimulants only. The long-term sensitivity analyses say associations were in the same direction across age groups, but our copy does not establish that the largest reduction was among adolescents. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • In a large claims database of almost 3 million individuals with ADHD, Quinn et al. (2017) found that individuals treated for ADHD were approximately 50% less likely to develop new onset SUD compared to untreated individuals.

    “In a large claims database of almost 3 million individuals with ADHD, Quinn et al. (2017) found that individuals treated for ADHD were * 50% less likely to develop a new onset of SUD compared to individuals who did not receive treatment.”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Quinn et al. 2017

    The Method (Sample) identifies nearly 3 million ADHD patients, and the Results (Concurrent Associations; page unavailable) report 55% and 43% lower odds of a first substance-related event for male and female patients during medicated periods. But those events were emergency-department claims with a substance use disorder diagnosis, not necessarily new-onset disorders; the comparison was primarily between medicated and unmedicated periods within individuals, not treated versus untreated individuals. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • Quinn et al. (2017) found an approximately 30% reduced likelihood to manifest SUD during active times of receiving versus not receiving medication treatment.

    “This group also showed an * 30% reduced likelihood to manifest SUD during active times of receiving versus not receiving medication treatment (Quinn et al. 2017).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Quinn et al. 2017

    The Results section reports 35% lower odds for men and 31% lower odds for women during medicated versus unmedicated months, supporting the approximate 30% figure. But the Methods define the outcome as emergency-department claims with a substance use disorder diagnosis, not the likelihood of developing SUD generally. The Discussion also cautions that filled prescriptions do not establish that medication was taken. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Studies in samples followed over time showed that enhanced protection against the development of SUD was lost over time, presumably linked to adherence.

    “Wealso noted that studies in samples followed over time showed enhanced protection against the development of SUD lost over time, presumably linked to adherence (Biederman et al. 2008; Quinn et al. 2017).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Quinn et al. 2017

    The Discussion (page not provided) says the weaker long-term than concurrent associations suggest that some risk reduction may dissipate with time. But the Results report reduced odds of substance-related events two years later, so protection was not shown to be lost entirely; the cited passages also do not link the change to adherence. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Data from within-group designs support that unmedicated treatment periods were related to an almost 30% increase in the likelihood to develop SUD compared to medicated times.

    “Data from within-group designs support that unmedicated treatment periods were related to an almost 30% increase in the likelihood to develop SUD compared to medicated times (Goldstein et al. 2013; Quinn et al. 2017).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Quinn et al. 2017

    The Results section’s within-individual comparisons support an association between unmedicated months and more substance-related events. But the reported 31%–35% lower odds during medicated months correspond to roughly 45%–54% higher odds during unmedicated months when the comparison is reversed, not almost 30%. The Methods define the outcome as emergency-department claims with a substance use disorder diagnosis, not the development of a new disorder. Page numbers are not provided in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Cites

The publisher hasn’t deposited this paper’s reference list.

Cited by

Sorted by citations

Related

Authors
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.
Affiliations
  • Örebro University (SE)
  • From the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2017-09-01
Volume
174
Issue
9
Pages
877-885
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2017.16060686
PMC
PMC5581231
OpenAlex
W2728417648
Semantic Scholar
fd3b878f14538e0045cfdb6b43d45f4a3fb5b821
Cited by
187
References
0
Citations by year
2026: 16 · 2025: 17 · 2024: 27 · 2023: 20 · 2022: 23 · 2021: 20 · 2020: 23 · 2019: 20 · 2018: 15 · 2017: 6
FWCI
14.35
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Eli Lilly and Company
  • European Commission (602768)
  • National Institutes of Health (UL1TR001108, TL1TR001107)
  • National Institute of Mental Health (R01MH102221)
  • National Institute on Drug Abuse (K99DA040727)
  • National Center for Advancing Translational Sciences
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, ADHD medication, stimulants, atomoxetine, substance use disorders, emergency department visits, sex differences, long-term drug effects, adolescents, adults
MeSH terms
Atomoxetine Hydrochloride, Adolescent, Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Female, Humans, Male, Sex Factors, United States, Comorbidity, Substance-Related Disorders, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review