CoChat
Sign Up
Cited by 89Attention Deficit Hyperactivity DisorderSubstance Abuse Treatment and OutcomesPrenatal Substance Exposure Effects

Childhood ADHD and Risk for Substance Dependence in Adulthood: A Longitudinal, Population-Based Study

Open access
Levy, Sharon, Katusic, Slavica K., Colligan, Robert C., Weaver, Amy L., Killian, Jill M., Voigt, Robert G., Barbaresi, William J.·2014·PLoS ONE
DOI 10.1371/journal.pone.0105640PMC PMC4146503
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to be at significantly greater risk for the development of substance use disorders (SUD) compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction), may also play a role. OBJECTIVE: This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood. METHOD: Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR) and 95% CIs estimated from logistic regression models adjusted for age and gender. RESULTS: A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively). ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49-138.88) and drug (adjusted OR 3.48, 95% CI 1.38-8.79) dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence. CONCLUSIONS: Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and alcohol dependence appears to be more complex.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0105640

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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 finding that earlier initiation of treatment was associated with lower SUD odds was replicated in four other studies.

    “This finding was replicated in four other studies, suggesting that earlier initiation of treatment may lead to better outcomes for SUD (Wilens et al. 2008; Dalsgaard et al. 2014; Levy et al. 2014; McCabe et al. 2016).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Levy et al. 2014

    The Results section, “Impact of Stimulant Treatment in childhood on Substance Dependence in Adulthood,” explicitly reports no association between age of treatment initiation and risk for SUD. It instead finds a difference in combined adult alcohol-or-drug dependence by whether stimulant treatment continued after age 13, which is a different measure of treatment timing. (LLM, conf=0.90)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Earlier initiation of treatment may lead to better outcomes for SUD.

    “This finding was replicated in four other studies, suggesting that earlier initiation of treatment may lead to better outcomes for SUD (Wilens et al. 2008; Dalsgaard et al. 2014; Levy et al. 2014; McCabe et al. 2016).”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Levy et al. 2014

    The Results section on childhood stimulant treatment explicitly reports no association between age of treatment initiation and risk for SUD. Its comparison of treatment ending before versus after age 13 concerns when treatment ended, not when it began, so it does not establish the claimed benefit of earlier initiation. (LLM, conf=0.88)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Confounds were not accounted for in the analyses.

    “Confounds not accounted for in analyses”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Levy et al. (2014)

    The Statistical Methods section says the logistic regression analyses adjusted for age and gender; the outcomes were also stratified by adolescent-onset substance use disorder. The Discussion acknowledges that unmeasured factors might still confound the findings, but that is different from saying confounds were not accounted for in the analyses. (LLM, conf=0.91)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • No significant differences were found among treated versus untreated groups on rates of SUD.

    “No | significant differences among Tx versus groups on rates of SUD”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Levy et al. (2014)

    In Results, under “Impact of Stimulant Treatment in childhood on Substance Dependence in Adulthood” (page unavailable), the paper reports no significant difference in adult alcohol or drug dependence when each was analyzed separately. But that comparison is between earlier- and later-ending stimulant treatment, not treated versus untreated groups; the combined dependence outcome differed significantly between those treatment-timing groups (Table 5, p = 0.046). (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Higher risk for SUD was found in those treated after age 13 years.

    “Higher risk for SUD in those Tx after age 13 years”

    From The Impact of Pharmacotherapy of Childhood-Onset Psychiatric Disorders on the Development of Substance Use Disorders (2022) · cites this paper as Levy et al. (2014)

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

No citation lists for this paper

No citation lists for this paper yet — checked again daily.

References 45 · Cited by 89

Research works printed but not linked: 30

  1. [1]Katusic SK, Barbaresi WJ, Colligan RC, Weaver AL, Leibson CL, et al (2005) Psychostimulant treatment and risk for substance abuse among young adults with a history of attention-deficit/hyperactivity disorder: a population-based, birth cohort study. J Child Adolesc Psychopharmacol 15: 764– 776 Available: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16262593. 16262593
  2. [2]Upadhyaya HP, Rose K, Wang W, O’Rourke K, Sullivan B, et al (2005) Attention-deficit/hyperactivity disorder, medication treatment, and substance use patterns among adolescents and young adults. J Child Adolesc Psychopharmacol 15: 799– 809 Available: http://online.liebertpub.com.ezp-prod1.hul.harvard.edu/doi/abs/10.1089/cap.2005.15.799?journalCode=cap Accessed 2014 February 6 16262596 · DOI
  3. [5]American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.
  4. [6]Nestler EJ (2001) Molecular basis of long-term plasticity underlying addiction. Nat Rev Neurosci 2: 119– 128 Available: http://www.nature.com.ezp-prod1.hul.harvard.edu/nrn/journal/v2/n2/full/nrn0201_119a.html Accessed 2014 February 6.. 11252991
  5. [7]Volkow ND, Li T-K (2004) Drug addiction: the neurobiology of behaviour gone awry. Nat Rev Neurosci 5: 963– 970 Available: http://www.nature.com.ezp-prod1.hul.harvard.edu/nrn/journal/v5/n12/full/nrn1539.html Accessed 2014 February 6.. 15550951
  6. [8]Everitt BJ, Belin D, Economidou D, Pelloux Y, Dalley JW, et al (2008) Review. Neural mechanisms underlying the vulnerability to develop compulsive drug-seeking habits and addiction. Philos Trans R Soc Lond B Biol Sci 363: 3125– 3135 Available: http://rstb.royalsocietypublishing.org.ezp-prod1.hul.harvard.edu/content/363/1507/3125.short Accessed 2014 January 24.. 18640910 PMC2607322
  7. [10]Hingson RW, Heeren T, Winter MR (2006) Age at drinking onset and alcohol dependence: age at onset, duration, and severity. Arch Pediatr Adolesc Med 160: 739– 746 Available: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16818840. 16818840
  8. [11]Grant BF, Dawson DA (1998) Age of onset of drug use and its association with DSM-IV drug abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey. J Subst Abuse 10: 163– 173 Available: http://www.ncbi.nlm.nih.gov/pubmed/9854701 Accessed 2014 February 5.. 9854701
  9. [12]Taioli E, Wynder EL (1991) Effect of the Age at Which Smoking Begins on Frequency of Smoking in Adulthood – NEJM. N Engl J Med 325: 968– 969 Available: http://www.nejm.org.ezp-prod1.hul.harvard.edu/doi/full/10.1056/NEJM199109263251318 Accessed 2014 February 6 1881424 · DOI
  10. [14]Sowell ER, Thompson PM, Holmes CJ, Jernigan TL, Toga AW (1999) In vivo evidence for post-adolescent brain maturation in frontal and striatal regions. Nat Neurosci 2: 859– 861 Available: http://www.nature.com.ezp-prod1.hul.harvard.edu/neuro/journal/v2/n10/full/nn1099_859.html Accessed 2014 February 6.. 10491602
  11. [15]Deas D, Riggs P, Langenbucher J, Goldman M, Brown S (2000) Adolescents are not adults: developmental considerations in alcohol users. Alcohol Clin Exp Res 24: 232– 237. 10698377
  12. [16]Molina BSG, Pelham WE (2003) Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. J Abnorm Psychol 112: 497– 507 Available: http://www.ncbi.nlm.nih.gov/pubmed/12943028 Accessed 2014 February 6.. 12943028
  13. [18]Lee SS, Humphreys KL, Flory K, Liu R, Glass K (2011) Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clin Psychol Rev 31: 328– 341 Available: http://www.ncbi.nlm.nih.gov/pubmed/21382538. 21382538 PMC3180912
  14. [20]Rocca WA, Yawn BP, St Sauver JL, Grossardt BR, Melton LJ (2012) History of the Rochester Epidemiology Project: Half a Century of Medical Records Linkage in a US Population. Mayo Clin Proc 87: 1202– 1213 Available: http://www.ncbi.nlm.nih.gov/pubmed/23199802. 23199802 PMC3541925
  15. [21]Yoshimasu K, Barbaresi WJ, Colligan RC, Voigt RG, Killian JM, et al (2012) Childhood ADHD is strongly associated with a broad range of psychiatric disorders during adolescence: a population-based birth cohort study. J Child Psychol Psychiatry Allied Discip 53: 1036– 1043 Available: http://www.ncbi.nlm.nih.gov/pubmed/22647074. PMC3608464 22647074
  16. [22]Barbaresi WJ, Katusic SK, Colligan RC, Weaver AL, Leibson CL, et al (2006) Long-term stimulant medication treatment of attention-deficit/hyperactivity disorder: results from a population-based study. J Dev Behav Pediatr 27: 1– 10 Available: http://www.ncbi.nlm.nih.gov/pubmed/16511362 Accessed 2014 February 5.. 16511362
  17. [23]Sheehan D, Lecrubier Y, Harnett Sheehan K, Janavs J, Weiller E, et al (1997) The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry 12: 232– 241 doi: 10.1016/S0924-9338(97)83297-X · DOI · Paper page
  18. [24]Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, et al.. (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59 Suppl 2: 22–33;quiz 34–57. doi:10.1590/S1516-44462000000300003. 9881538 · DOI
  19. [25]Jasti S, Dudley WN, Goldwater E (2008) SAS Macros for Testing Statistical Mediation in Data With Binary Mediators or Outcomes. Nurs Res 57. Available: http://journals.lww.com/nursingresearchonline/Fulltext/2008/03000/SAS_Macros_for_Testing_Statistical_Mediation_in.8.aspx. 18347484
  20. [26]Booth JR, Burman DD, Meyer JR, Lei Z, Trommer BL, et al (2005) Larger deficits in brain networks for response inhibition than for visual selective attention in attention deficit hyperactivity disorder (ADHD). J Child Psychol Psychiatry 46: 94– 111 Available: http://www.ncbi.nlm.nih.gov/pubmed/15660647 Accessed 2014 February 5.. 15660647
  21. [27]Rubia K, Smith AB, Brammer MJ, Toone B, Taylor E (2005) Abnormal brain activation during inhibition and error detection in medication-naive adolescents with ADHD. Am J Psychiatry 162: 1067– 1075 Available: http://www.ncbi.nlm.nih.gov/pubmed/15930054 Accessed 2014 February 6.. 15930054
  22. [28]Vasic N, Plichta MM, Wolf RC, Fallgatter AJ, Sosic-Vasic Z, et al. (2012) Reduced Neural Error Signaling in Left Inferior Prefrontal Cortex in Young Adults With ADHD. J Atten Disord. Available: http://www.ncbi.nlm.nih.gov/pubmed/22660917. Accessed 2014 February 6. 22660917
  23. [31]Schachar R, Mota VL, Logan GD, Tannock R, Klim P (2000) Confirmation of an inhibitory control deficit in attention-deficit/hyperactivity disorder. J Abnorm Child Psychol 28: 227– 235 Available: http://www.ncbi.nlm.nih.gov/pubmed/10885681 Accessed 2014 February 6.. 10885681
  24. [32]Nigg JT, Stavro G, Ettenhofer M, Hambrick DZ, Miller T, et al (2005) Executive functions and ADHD in adults: evidence for selective effects on ADHD symptom domains. J Abnorm Psychol 114: 706– 717 Available: http://www.ncbi.nlm.nih.gov/pubmed/16351391 Accessed 2014 February 4.. 16351391
  25. [33]Ries RK, David FA, Miller SC, Saitz R, editors (2009) Principles of Addiction Medicine. Fourth. Philadelphia PA: Lippincott Williams & Wilkins.
  26. [34]Wilens TE (2004) Impact of ADHD and its treatment on substance abuse in adults. J Clin Psychiatry 65 Suppl 3 38– 45 Available: http://www.ncbi.nlm.nih.gov/pubmed/15046534 Accessed 2014 February 7.. 15046534
  27. [36]Wise BK, Cuffe SP, Fischer T (2001) Dual diagnosis and successful participation of adolescents in substance abuse treatment. J Subst Abuse Treat 21: 161– 165 Available: http://www.ncbi.nlm.nih.gov/pubmed/11728790 Accessed 2014 February 7.. 11728790
  28. [37]Grella CE, Hser YI, Joshi V, Rounds-Bryant J (2001) Drug treatment outcomes for adolescents with comorbid mental and substance use disorders. J Nerv Ment Dis 189: 384– 392 Available: http://www.ncbi.nlm.nih.gov/pubmed/11434639 Accessed 2014 February 7.. 11434639
  29. [38]Wilens TE, Biederman J, Mick E (1998) Does ADHD Affect the Course of Substance Abuse?: Findings From a Sample of Adults With and Without ADHD. Am J Addict 7: 156– 163 Available: http://doi.wiley.com/10.1111/j.1521-0391.1998.tb00330.x Accessed 2014 February 6 9598219 · DOI
  30. [39]Molina BS, Hinshaw SP, Eugene Arnold L, Swanson JM, Pelham WE, et al (2013) Adolescent substance use in the multimodal treatment study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication. J Am Acad Child Adolesc Psychiatry 52: 250– 263 Available: http://www.ncbi.nlm.nih.gov/pubmed/23452682. 23452682 PMC3589108

Authors
Levy, S., Katusic, S. K., Colligan, R. C., Weaver, A. L., Killian, J. M., Voigt, R. G., & Barbaresi, W. J.
Affiliations
  • Boston Children's Hospital (US)
  • Mayo Clinic (US)
  • Baylor College of Medicine (US)
Corresponding author
  • Katusic, Slavica K.
  • Barbaresi, William J.
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-08-27
Volume
9
Issue
8
Pages
e105640
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0105640
PMC
PMC4146503
OpenAlex
W2126266712
Cited by
89
References
45
Citations by year
2026: 10 · 2025: 6 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 9 · 2020: 14 · 2019: 4 · 2018: 5 · 2017: 9 · 2016: 10 · 2015: 9 · 2012: 1
FWCI
7.13
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institute on Aging (R01AG034676, AG-034676)
  • National Institute of Mental Health (MH076111, R01MH076111)
  • National Center for Research Resources (C06RR018898)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 29745, R01HD029745)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords
attention deficit hyperactivity disorder, substance use disorders, substance dependence, alcoholism, drug addiction, impulsivity, adolescence, adulthood, birth cohort, longitudinal follow-up
MeSH terms
Adolescent, Adult, Age Factors, Alcoholism, Attention Deficit Disorder with Hyperactivity, Female, Humans, Longitudinal Studies, Male, Prospective Studies, Surveys and Questionnaires, Logistic Models, Odds Ratio, Substance-Related Disorders

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.

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