The relationship between ADHD and substance use disorder: Evidence based treatment and clinical implications

First published: 10/05/2019 | Last updated: May 20th, 2019

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders in childhood, characterized by an early onset of three core symptoms of inattention, hyperactivity and impulsivity. ADHD often results in lifelong impairments in psychiatric, cognitive, social, and educational domains and sometimes also in delinquency. Depending on the severity of the symptoms, the use of pharmacological agents including stimulants is often an important part of a treatment program for ADHD. The evidence for the positive effects of methylphenidate for ADHD on core symptoms is overwhelming.

Follow-up studies have shown that individuals with ADHD have an increased risk for cigarette smoking, alcohol and substance use disorder (SUD) in adolescence and adulthood. In correspondence with this studies of adults with a known alcohol abuse or use of illicit substances have very high prevalence rates of undiagnosed ADHD.

Using stimulant treatment in individuals already at risk of developing substance use problems has always been a concern, among both parents and professionals. An increasing amount of studies shows that stimulant treatment does not increase the risk of SUD and that it stimulant treatment for ADHD may in fact reduce the risk of developing SUD.

The evidence behind this association and the clinical implications will be presented in this lecture.

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Dr Søren Dalsgaard