ADHD, Substance Use Disorders, and Psychostimulant Treatment: Current Literature and Treatment Guidelines
Abstract
Objective: This review explores the relationship between ADHD and substance use disorder (SUD), factors that determine the abuse potential of psychostimulants, and strategies for identifying and treating at-risk ADHD patients. Method: This study uses a Medline review of literature. Results: Psychostimulants, such as methylphenidate and amphetamines, are effective first-line pharmacotherapy for ADHD and when used appropriately in individuals with ADHD do not appear to be frequently abused by patients. Diversion and misuse of prescription stimulants are growing concerns, especially among young adults and college students. Short-acting psychostimulant formulations may have higher potential for abuse, misuse, and diversion, but more data are needed to substantiate this observation. Nonstimulant treatments for ADHD may be considered for patients at particularly high risk for substance use, misuse, or diversion of stimulants. Conclusion: In treating patients with ADHD and comorbid substance use, psychostimulants may be a useful pharmacologic alternative. However, the risks of such treatment with high-risk populations must be considered alongside potential benefits. (J. of Att. Dis. 2008; 12(2) 115-125)
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There is extremely limited evidence in the literature of psychostimulant abuse among ADHD patients.
“Despite this potential, there is extremely limited evidence in the literature of psychostimulant abuse among ADHD patients [145,146].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [146]
Atomoxetine has no abuse potential.
“Atomoxetine has an effect size of around 0.4 in adults [32,293], a duration of action of 24 hours, and no abuse potential [294].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [294]
Findings from preclinical research have suggested that animals exposed to stimulants become sensitized: subsequent administration results in more robust behavioural responses, and/or they become more likely to self-administer drugs of abuse later in development.
“Findings from preclinical research have suggested that animals exposed to stimulants become “sensitized”: subsequent administration results in more robust behavioural responses, and/or they become more likely to self-administer drugs of abuse later in development [72, 73].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [72]
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References 81 · Cited by 136
- Authors
- Kollins, S. H.
- Affiliations
- Duke Medical Center (US)
- Corresponding author
- Kollins, Scott H.
- ORCID
- Kollins, Scott H.
- Venue
- Journal of Attention Disorders
- Publisher
- SAGE Publications
- Published
- 2007-10-12
- Volume
- 12
- Issue
- 2
- Pages
- 115-125
- ISSN
- 1087-0547 (ISSN-L)
- 1557-1246
- OpenAlex
- W2110334034
- Cited by
- 136
- References
- 81
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 8 · 2022: 2 · 2021: 5 · 2020: 6 · 2019: 2 · 2018: 2 · 2017: 10 · 2016: 7 · 2015: 3 · 2014: 11 · 2013: 11 · 2012: 23
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Attention Disorders (publishedVersion)
- PubMed (publishedVersion)
- 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, substance use disorders, psychostimulants, methylphenidate, amphetamine, stimulant abuse, prescription drug diversion, comorbidities, at-risk patients
- MeSH terms
- Amphetamine, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Marijuana Abuse, Child, Humans, Methylphenidate, Practice Guidelines as Topic, Substance-Related Disorders, Cocaine-Related Disorders
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