Comorbid Attention Deficit/Hyperactivity Disorder and Substance Use Disorder: Treatment Considerations
Abstract
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is predominantly a diagnosis of childhood and adolescence but has also been recognized in adults. It is associated with high rates of comorbid psychiatric conditions, particularly substance use disorders (SUD). METHODS: A review of the literature was conducted with a focus on ADHD, SUD, their comorbidity, and treatment considerations. RESULTS: Literature suggests that the use of methylphenidate (MPH) in children does not increase SUD later in life, and may in fact reduce substance use and abuse in adolescence and adulthood. Concurrent treatment of ADHD-SUD, which may be supported theoretically, has yielded inconsistent data on clinical trials. While MPH use in adults with ADHDSUD may be effective in alleviating ADHD symptoms, the benefits on SUD are not clear and remain controversial. Studies suggest that adults with comorbid ADHD-SUD do not misuse or divert their medication, but MPH does not consistently improve substance use. However, data are lacking for substances other than cocaine and stimulants other than MPH. While the risk of stimulant abuse should not be ignored, it may be minimized by selecting medications that are not readily crushed and solubilized for parenteral administration, or by utilizing non-stimulant medications and/or psychotherapy. CONCLUSION: While there are a lack of evidence-based guidelines for the concurrent treatment of ADHD and SUD, evidence to date suggests that stimulant medications should not necessarily be avoided for patients with comorbid ADHDSUD and that concurrent treatment may be a successful approach to improve ADHD outcomes without worsening SUD symptoms.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
Effective treatment of ADHD has been shown to improve comorbid disorders including SUD, bipolar disorder, depression, and anxiety disorders.
“Effective treatment of ADHD has been shown to improve comorbid disorders including SUD [69,95,132], bipolar disorder [17], depression [69], and anxiety disorders [114,133].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [95]
Cites
Still being checked.
Cited by
Sorted by citations
Adult ADHD and comorbid disorders: clinical implications of a dimensional approach
Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1463-3 · Cited by 732 · see citing works
Self-citationUpdated 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
Ersche, K. D., Williams, G. B., Robbins, T. W., & Bullmore, E. T. (2013) · Current Opinion in Neurobiology · doi:10.1016/j.conb.2013.02.017 · Cited by 205 · see citing works
Crunelle, C., van den Brink, W., Moggi, F., Konstenius, M., Franck, J., Levin, F., van de Glind, G., Demetrovics, Z., Coetzee, C., Luderer, M., et al. (2018) · European Addiction Research · doi:10.1159/000487767 · Cited by 151 · see citing works
Mao, A. R., & Findling, R. L. (2014) · Postgraduate Medicine · doi:10.3810/pgm.2014.09.2799 · Cited by 68 · see citing works
ADHD and Bipolar Disorder in Adulthood: Clinical and Treatment Implications
Salvi, V., Ribuoli, E., Servasi, M., Orsolini, L., & Volpe, U. (2021) · Medicina · doi:10.3390/medicina57050466 · Cited by 67 · see citing works
Pharmacological Treatment of ADHD in Addicted Patients: What Does the Literature Tell Us?
Carpentier, P., & Levin, F. (2017) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000122 · Cited by 46 · see citing works
Brooks, S. J., Löchner, C., SHOPTAW, S. J., & Stein, D. J. (2017) · Progress in brain research · doi:10.1016/bs.pbr.2017.08.002 · Cited by 69 · see citing works
Dalbudak, E., Evren, C., Aldemir, S., Taymur, İ., Evren, B., & Topcu, M. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.04.035 · Cited by 53 · see citing works
Attention-deficit/hyperactivity disorder in postsecondary students
Murkett, K., Smart, W., & Nugent, K. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s64136 · Cited by 45 · see citing works
Oliva, F., Mangiapane, C., Nibbio, G., Berchialla, P., Colombi, N., & Vigna-Taglianti, F. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.11.021 · Cited by 36 · see citing works
Gao, Z., Winhusen, T. M., Gorenflo, M. P., Ghitza, U. E., Davis, P. B., Kaelber, D. C., & Xu, R. (2023) · Addiction · doi:10.1111/add.16168 · Cited by 40 · see citing works
Katzman, M. A., & Sternat, T. (2014) · CNS Drugs · doi:10.1007/s40263-014-0175-1 · Cited by 40 · see citing works
Perugi, G., Pallucchini, A., Rizzato, S., de Rossi, P., Sani, G., Maremmani, A. G. I., Pinzone, V., & Maremmani, I. (2018) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2018.1551878 · Cited by 34 · see citing works
Muld, B. B., Jokinen, J., Bölte, S., & Hirvikoski, T. (2014) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2014.11.005 · Cited by 32 · see citing works
Decreased serum levels of adiponectin in adult attention deficit hyperactivity disorder
Mavroconstanti, T., Halmøy, A., & Haavik, J. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.01.025 · Cited by 29 · see citing works
Manni, C., Cipollone, G., Pallucchini, A., Maremmani, A. G. I., Perugi, G., & Maremmani, I. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16203911 · Cited by 29 · see citing works
Spera, V., Pallucchini, A., Maiello, M., Carli, M., Maremmani, A. G. I., Perugi, G., & Maremmani, I. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17103509 · Cited by 27 · see citing works
Nidey, N., Momany, A. M., Strathearn, L., Carter, K. D., Wehby, G. L., Bao, W., Xu, G., Scheiber, F. A., Tabb, K. M., Froehlich, T. E., et al. (2021) · Annals of Epidemiology · doi:10.1016/j.annepidem.2021.06.005 · Cited by 23 · see citing works
Young, S., Abbasian, C., Al‐Attar, Z., Branney, P., Colley, B., Cortese, S., Cubbin, S., Deeley, Q., Gudjonsson, G. H., Hill, P., et al. (2023) · World Journal of Psychiatry · doi:10.5498/wjp.v13.i3.84 · Cited by 25 · see citing works
Liebrenz, M., Frei, A., Fisher, C., Gamma, A., Buadze, A., & Eich, D. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-141 · Cited by 22 · see citing works
Exploring the Role of Caffeine Use in Adult-ADHD Symptom Severity of US Army Soldiers
Cipollone, G., Gehrman, P., Manni, C., Pallucchini, A., Maremmani, A. G. I., Palagini, L., Perugi, G., & Maremmani, I. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9113788 · Cited by 22 · see citing works
Muld, B. B., Jokinen, J., Bölte, S., & Hirvikoski, T. (2016) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-016-0195-4 · Cited by 21 · see citing works
Evren, C., Dalbudak, E., Evren, B., Can, Y., & Umut, G. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.06.002 · Cited by 17 · see citing works
Liebrenz, M., Gamma, A., Ivanov, I., Buadze, A., & Eich, D. (2015) · F1000Research · doi:10.12688/f1000research.6780.1 · Cited by 20 · see citing works
Able, S., Haynes, V., & Hong, J.-Y. (2014) · Pragmatic and Observational Research · doi:10.2147/por.s64348 · Cited by 14 · see citing works
Kocyigit, S., Güzel, H. Ş., Açıkel, S. B., & Çetinkaya, M. (2021) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00494-2 · Cited by 16 · see citing works
Capuzzi, E., Capellazzi, M., Caldiroli, A., Cova, F., Auxilia, A. M., Rubelli, P., Tagliabue, I., Zanvit, F. G., Peschi, G., Buoli, M., et al. (2022) · Healthcare · doi:10.3390/healthcare10020180 · Cited by 14 · see citing works
Gao, Z., Winhusen, T. M., Gorenflo, M. P., Ghitza, U. E., Nunes, E. V., Saxon, A. J., Korthuis, P. T., Brady, K. T., Luo, S. X., Davis, P. B., et al. (2023) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2023.110958 · Cited by 13 · see citing works
Lukkes, J. L., Freund, N., Thompson, B. S., Meda, S., & Andersen, S. L. (2016) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2016.06.003 · Cited by 11 · see citing works
Toward a Theory of Childhood Learning Disorders, Hyperactivity, and Aggression
Mawson, A. R. (2012) · ISRN Psychiatry · doi:10.5402/2012/589792 · Cited by 10 · see citing works
Battini, V., Cirnigliaro, G., Giacovelli, L., Boscacci, M., Manzo, S. M., Mosini, G., Guarnieri, G., Gringeri, M., Benatti, B., Clementi, E., et al. (2023) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2023.2211261 · Cited by 9 · see citing works
Roncero, C., Abad, A. C., Padilla-Mata, A., Ros‐Cucurull, E., Barral, C., Casas, M., & Grau‐López, L. (2016) · Current Neuropharmacology · doi:10.2174/1570159x14666160324144912 · Cited by 9 · see citing works
Brancati, G. E., Rosa, U. D., Dominicis, F. D., Petrucci, A., Nannini, A., Medda, P., Schiavi, E., & Perugi, G. (2023) · Brain Sciences · doi:10.3390/brainsci13091251 · Cited by 9 · see citing works
Liebrenz, M., Fisher, C. E., Nellen, R., Frei, A. L., Biechl, A. C., Hiestand, N., Huber, A., Buadze, A., & Eich, D. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0911-9 · Cited by 9 · see citing works
Liebrenz, M., Gamma, A., Ivanov, I., Buadze, A., & Eich, D. (2016) · F1000Research · doi:10.12688/f1000research.6780.2 · Cited by 9 · see citing works
Methylphenidate as a treatment option for substance use disorder: a transdiagnostic perspective
van Ruitenbeek, P., Franzen, L., Mason, N. L., Stiers, P. L. J., & Ramaekers, J. G. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1208120 · Cited by 8 · see citing works
van Kernebeek, M. V., Vorspan, F., Crunelle, C., van den Brink, W., Dom, G., Moggi, F., Konstenius, M., Franck, J., Levin, F., van de Glind, G., et al. (2022) · Annales de Toxicologie Analytique · doi:10.1016/j.toxac.2022.02.001 · Cited by 4 · see citing works
Dutta, C. N., Christov‐Moore, L., Ombao, H., & Douglas, P. K. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.938501 · Cited by 7 · see citing works
Brancati, G. E., Dominicis, F. D., Petrucci, A., Pallucchini, A., Carli, M., Medda, P., Schiavi, E., Rossi, P. D., Vicari, S., & Perugi, G. (2023) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2023.2168750 · Cited by 5 · see citing works
Atomoxetine for the Treatment of ADHD in Incarcerated Adolescents.
Jillani, S., Patel, P., Trestman, R. L., & Kamath, J. (2016) · PubMed · Cited by 5 · see citing works
Diagnosis and Management of Comorbid ADHD in Patients with Substance Use Disorders
Busch, B. (2024) · Springer eBooks · doi:10.1007/978-3-031-72219-6_50 · Cited by 1 · see citing works
Lu, N., Wang, M., Zheng, Z., Zhang, F., Huang, W., Pan, H., Zhong, Y. J., Du, X., Zhang, G., Li, C., et al. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116662 · Cited by 2 · see citing works
Tierney, J., Morrissey, A., Adamis, D., Wrigley, M., & Robinson, K. (2026) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02955-8 · Cited by 2 · see citing works
Das, J., Biswal, J., & Mohanty, R. (2025) · Al-Rafidain Journal of Medical Sciences · doi:10.54133/ajms.v8i2.1737 · Cited by 1 · see citing works
Adult ADHD in Substance-Related and Addictive Disorders
Pallanti, S., & Salerno, L. (2020) · Springer eBooks · doi:10.1007/978-3-030-39051-8_16 · Cited by 1 · see citing works
Psycho- und Pharmakotherapie bei ADHS und Substanzmissbrauch
Stieglitz, R., & Fallahpour, M. H. (2014) · DNP - Der Neurologe und Psychiater · doi:10.1007/s15202-014-0939-y
ADHS im Erwachsenenalter und komorbide Suchterkrankungen
Adorjan, K., Karch, S., Martin, G., Plörer, D., Winter, C., Hantschk, I., Koller, G., Erbas, B., & Pogarell, O. M. (2019) · MMW - Fortschritte der Medizin · doi:10.1007/s15006-019-0740-0
Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung im Erwachsenenalter
Sobanski, E., Alm, B., & Thome, J. (2017) · Springer eBooks · doi:10.1007/978-3-662-49295-6_85
Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung im Erwachsenenalter
Sobanski, E., Alm, B., & Thome, J. (2015) · Springer eBooks · doi:10.1007/978-3-642-45028-0_85-1
Evidenzbasierte Psychotherapie bei Patienten mit Substanzabhängigkeit und psychischer Komorbidität
Kensche, M., Bromand, Z., & Kienast, T. (2014) · PSYCH up2date · doi:10.1055/s-0033-1360008
Li, S. M., Wang, D., & Zhu, Y. (2022) · International Conference on Biotechnology, Life Science and Medical Engineering (BLSME) · doi:10.23977/blsme.2022066
Adult ADHD and internet addiction among undergraduate medical college students
Afshan, N., Bodepudi, S., Benerji, T., Kodali, M., & Parvathaneni, K. M. (2023) · IP Indian Journal of Neurosciences · doi:10.18231/j.ijn.2023.006
Brancati, G. E., Marcenaro, M., Costagli, E., Magnesa, A., Medda, P., Schiavi, E., & Perugi, G. (2026) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000630
- Authors
- J. Klassen, L., S. Bilkey, T., A. Katzman, M., & Chokka, P.
- ORCID
- Chokka, Pratap
- Venue
- Current Drug Abuse Reviewse
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2012-10-01
- Volume
- 5
- Issue
- 3
- Pages
- 190-198
- ISSN
- 1874-4737 (ISSN-L)
- OpenAlex
- W2159901703
- Cited by
- 54
- References
- 0
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 8 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 10 · 2013: 1 · 2012: 1
- FWCI
- 3.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Drug Abuse Reviews (publishedVersion)
- PubMed (publishedVersion)
- 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, substance use disorders, comorbidities, methylphenidate, stimulant abuse, adult ADHD, cocaine use, medication misuse, non-stimulant medication, concurrent treatment, psychotherapy
- MeSH terms
- Adolescent, Adult, Age Factors, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Humans, Methylphenidate, Diagnosis, Dual (Psychiatry), 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