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    Ochoa-Mangado, E. Madoz-Gúrpide, A. Villacieros-Durbán, I. Llama-Sierra, P. and Sancho-Acero, J.L. 2010. Trastorno por déficit de atención e hiperactividad (TDAH) y consumo de sustancias: datos preliminares de seguimiento en una población de sujetos jóvenes. Trastornos Adictivos, Vol. 12, Issue. 2, p. 79.

    2010. The Science of ADHD.

    Bukstein, Oscar 2009. Substance use disorders and attention-deficit/hyperactivity disorder: A review of recent developments. Current Attention Disorders Reports, Vol. 1, Issue. 1, p. 12.

    Faraone, S. V. Kunwar, A. Adamson, J. and Biederman, J. 2009. Personality traits among ADHD adults: implications of late-onset and subthreshold diagnoses. Psychological Medicine, Vol. 39, Issue. 04, p. 685.

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    Kollins, Scott H. 2008. A qualitative review of issues arising in the use of psycho­stimulant medications in patients with ADHD and co‑morbid substance use disorders. Current Medical Research and Opinion, Vol. 24, Issue. 5, p. 1345.

    GOODMAN, DAVID W. 2007. The Consequences of Attention-Deficit/Hyperactivity Disorder in Adults. Journal of Psychiatric Practice, Vol. 13, Issue. 5, p. 318.


A naturalistic study of the effects of pharmacotherapy on substance use disorders among ADHD adults

  • DOI:
  • Published online: 01 March 2007

Studies of adults with attention deficit hyperactivity disorder (ADHD) show an elevated prevalence of substance use disorders (SUDs) and the substance abuse literature shows that ADHD is elevated in substance users. Some researchers postulate that stimulant treatment of ADHD increases the risk for SUD in ADHD patients but follow-up studies suggest treatment protects patients from subsequent SUDs. This report uses retrospective data to assess the impact of prior ADHD pharmacotherapy on SUDs in 206 ADHD adults (n=79 late-onset ADHD, n=127 full ADHD) grouped by lifetime history of ADHD treatment (no treatment, past treatment, current and past treatment).


Structured Clinical Interview for DSM-IV (SCID) data were used to establish abuse and dependence, and Drug Use Screening Inventory (DUSI) responses were used to establish prevalence of use, preference for cigarettes, alcohol and drugs of abuse, complications from use, and motivation for use (get high, change mood, sleep better).


No differences were found in the prevalence of cigarette smoking, alcohol or drug abuse or dependence, as well as no significant differences in 1-month prevalence of any use or use more than 20 times. No differences were found in complications of drug or alcohol use across groups. Subjects with current treatment rated getting high as a motivating factor significantly more frequently than subjects in the past treatment group; this result lost significance when we included ADHD diagnostic category.


Our results are consistent across substances and ADHD diagnoses, and support the hypothesis that pharmacotherapy does not cause subsequent SUDs.

Corresponding author
*Address for correspondence: Stephen V. Faraone, Ph.D., Department of Psychiatry, Neuroscience, and Physiology, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY 13210, USA. (Email:
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P. N. Augustyniak , S. Kourrich , S. M. Rezazadeh , J. Stewart & A. Arvanitogiannis (2006). Differential behavioral and neurochemical effects of cocaine after early exposure to methylphenidate in an animal model of attention deficit hyperactivity disorder. Behavioural Brain Research 167, 379382.

R. A. Barkley , M. Fischer , L. Smallish & K. Fletcher (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology 111, 279289.

R. A. Barkley , M. Fischer , L. Smallish & K. Fletcher (2003). Does the treatment of ADHD with stimulant medication contribute to illicit drug use/abuse? A 13 year prospective study. Pediatrics 111, 97109.

J. Biederman , T. Wilens , E. Mick , T. Spencer & S. V. Faraone (1999). Pharmacotherapy of attention-deficit/hyperactivity disorder reduces risk for substance use disorder. Pediatrics 104, e20.

K. Carroll & B. Rounsaville (1993). History and significance of childhood attention deficit disorder in treatment-seeking cocaine abusers. Comprehensive Psychiatry 34, 7582.

S. V. Faraone , J. Biederman , T. J. Spencer , E. Mick , K. Murray , C. Petty , J. J. Adamson & M. C. Monuteaux (2006 b). Diagnosing adult attention deficit hyperactivity disorder: are late onset and subthreshold diagnoses valid? American Journal of Psychiatry 163, 17201729.

S. K. Katusic , W. J. Barbaresi , R. C. Colligan , A. L. Weaver , C. L. Leibson & S. J. Jacobsen (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. Journal of Child and Adolescent Psychopharmacology 15, 764776.

N. M. Lambert & C. S. Hartsough (1998). Prospective study of tobacco smoking and substance dependencies among samples of ADHD and non-ADHD participants. Journal of Learning Disabilities 31, 533544.

J. F. Leckman , D. Sholomskas , D. Thompson , A. Belanger & M. M. Weissman (1982). Best estimate of lifetime psychiatric diagnosis: a methodological study. Archives of General Psychiatry 39, 879883.

F. R. Levin , S. Evans & H. D. Kleber (1998). Prevalence of adult attention-deficit hyperactivity disorder among cocaine abusers seeking treatment. Drug and Alcohol Dependence 52, 1525.

S. Mannuzza , R. G. Klein , A. Bessler , P. Malloy & M. LaPadula (1993). Adult outcome of hyperactive boys: educational achievement, occupational rank and psychiatric status. Archives of General Psychiatry 50, 565576.

C. E. Paternite , J. Loney , H. Salisbury & M. A. Whaley (1999). Childhood inattention-overactivity, aggression, and stimulant medication history as predictors of young adult outcomes. Journal of Child and Adolescent Psychopharmacology 9, 169184.

T. Sagvolden , V. A. Russell , H. Aase , E. B. Johansen & M. Farshbaf (2005). Rodent models of attention-deficit/hyperactivity disorder. Biological Psychiatry 57, 12391247.

H. Schubiner , A. Tzelepis , S. Milberger , N. Lockhart , M. Kruger , B. J. Kelley & E. P. Schoener (2000). Prevalence of attention-deficit/hyperactivity disorder and conduct disorder among substance abusers. Journal of Clinical Psychiatry 61, 244251.

J. L. Shifren , G. D. Braunstein , J. A. Simon , P. R. Casson , J. E. Buster , G. P. Redmond , R. E. Burki , E. S. Ginsburg , R. C. Rosen , S. R. Leiblum , K. E. Caramelli & N. A. Mazer (2000). Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. New England Journal of Medicine 343, 682688.

R. E. Tarter & L. Kirisci (1997). The Drug Use Screening Inventory for adults: psychometric structure and discriminative sensitivity. American Journal of Drug and Alcohol Abuse 23, 207219.

G. Weiss , L. Hechtman , T. Milroy & T. Perlman (1985). Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children. Journal of the American Academy of Child and Adolescent Psychiatry 24, 211220.

T. Wilens (2004). Attention-deficit/hyperactivity disorder and the substance use disorders: the nature of the relationship, subtypes at risk and treatment issues. Psychiatric Clinics of North America 27, 283301.

T. Wilens , J. Biederman , A. M. Abrantes & T. J. Spencer (1997). Clinical characteristics of psychiatrically referred adolescent outpatients with substance use disorder. Journal of the American Academy of Child and Adolescent Psychiatry 36, 941947.

T. Wilens , S. V. Faraone , J. Biederman & S. Gunawardene (2003). Does stimulant therapy of attention deficit hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics 111, 179185.

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