title: A naturalistic study of the effects of pharmacotherapy on substance use disorders among ADHD adults.
abstract: BACKGROUND
  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).
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Our results are consistent across substances and ADHD diagnoses, and support the hypothesis that pharmacotherapy does not cause subsequent SUDs.
authors.affiliation: Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 13210, USA. faraones@upstate.edu
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
authors.forename: Joel
authors.initials: J
authors.lastname: Adamson
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology
chemical_list: D000697:Central Nervous System Stimulants; D013287:Illicit Drugs