The dual diagnosis of attention-deficit/hyperactivity disorder and substance abuse: case reports and literature review.
BACKGROUND
It is now recognized that attention-deficit/hyperactivity disorder (ADHD) may persist into adulthood. A number of studies have found an association between ADHD and substance abuse. This article describes three adult patients with both ADHD and substance abuse who were treated successfully with psychostimulants. A review of the relevant literature is included.


METHODS
The patients were drawn from a university-based referral center for adults with ADHD. Evaluations for ADHD and substance abuse were completed. Medical therapy and follow-up were completed by the first author.


RESULTS
All of the patients responded to psychostimulants and have remained abstinent from alcohol and other drugs for the past 2 to 3 years.


CONCLUSIONS
This case series and review of the literature suggest that specific treatment for ADHD with psychostimulants is feasible in patients who also have substance abuse. Future studies should evaluate the prevalence of this "dual diagnosis" and the efficacy of differing management strategies.
Schubiner
H
H
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Mich, USA.
Tzelepis
A
A
Isaacson
J H
JH
Warbasse
L H
LH
Zacharek
M
M
Musial
J
J
D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry); D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D013695:Temperance
D008774:Methylphenidate