Pharmacotherapy of attention-deficit/hyperactivity disorder reduces risk for substance use disorder.
OBJECTIVE
To assess the risk for substance use disorders (SUD) associated with previous exposure to psychotropic medication in a longitudinal study of boys with attention-deficit/hyperactivity disorder (ADHD).


METHODS
The cumulative incidence of SUD throughout adolescence was compared in 56 medicated subjects with ADHD, 19 nonmedicated subjects with ADHD, and 137 non-ADHD control subjects.


RESULTS
Unmedicated subjects with ADHD were at a significantly increased risk for any SUD at follow-up compared with non-ADHD control subjects (adjusted OR: 6.3 [1.8-21.6]). Subjects with ADHD medicated at baseline were at a significantly reduced risk for a SUD at follow-up relative to untreated subjects with ADHD (adjusted OR: 0.15 [0.04-0.6]). For each SUD subtype studied, the direction of the effect of exposure to pharmacotherapy was similar to that seen for the any SUD category.


CONCLUSIONS
Consistent with findings in untreated ADHD in adults, untreated ADHD was a significant risk factor for SUD in adolescence. In contrast, pharmacotherapy was associated with an 85% reduction in risk for SUD in ADHD youth.
Biederman
J
J
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston, MA 02114, USA. biederman@helix.mgh.harvard.edu
Wilens
T
T
Mick
E
E
Spencer
T
T
Faraone
S V
SV
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy*; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology*
D000697:Central Nervous System Stimulants