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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.
    James, Philip D. Smyth, Bobby P. and Apantaku-Olajide, Tunde 2013. Substance use and psychiatric disorders in Irish adolescents: a cross-sectional study of patients attending substance abuse treatment service. Mental Health and Substance Use, Vol. 6, Issue. 2, p. 124.
    Van Hout, M. C. and Foley, M. 2013. Attention-deficit hyperactivity disorder (ADHD) in adults attending addiction treatment in Ireland: preliminary international ADHD in substance-use disorders prevalence study (IASP) results. Irish Journal of Psychological Medicine, Vol. 30, Issue. 03, p. 171.
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Irish adolescents with ADHD and comorbid substance use disorder

  • Osamede Edokpolo (a1), Nnamdi Nkire (a2) and Bobby P Smyth (a3)
Abstract
Objectives:

To examine the literature for drug treatment of attention deficit hyperactivity disorder (ADHD) in adolescents with co-occurring substance use disorder (SUD), the challenges posed by this, and make recommendations taking into account current trend in Ireland.

Methods:

Articles published from 1992-2008 were identified using OVID-MEDLINE search using the search terms attention deficit hyperactivity disorder and substance use disorder. Studies cited include review articles, epidemiological studies, experimental researches, open and controlled trials of drugs in ADHD with comorbid SUD and clinical guidelines. No non-English language papers were included.

Results:

Thirty-six studies were examined. A number of the papers reported on the link between ADHD and SUD, that they frequently co-occur, and there is evidence that treating ADHD can reduce the risk of future SUD. Some of the studies reviewed demonstrated the safety and effectiveness of ADHD medication on the ADHD symptoms but less so on the SUD. Concerns around stimulant abuse and diversion are valid. Although there is no current evidence of frequent diversion of ADHD medications in Ireland, this practice is prevalent in the US. Consequently psychiatrists should remain vigilant to the possibility of such diversions and take measures to address them if identified.

Conclusions:

The available evidence suggests that medication is not hazardous in ADHD comorbid with SUD. Pharmacological treatment of ADHD, following consideration of potential risks and benefits, is justified in the presence of SUD. Both methylphenidate and atomoxetine can be used. Stabilisation of serious SUD before pharmacotherapy is preferable, and it is advisable to provide psychological treatment to address SUD in these patients.

Copyright
COPYRIGHT: © Cambridge University Press 2010
Corresponding author
*Correspondence E-mail: docede22@yahoo.com
References
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Irish Journal of Psychological Medicine
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