title: Stimulant ADHD medication and risk for substance abuse.
abstract: BACKGROUND
  There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse.
  
  
  METHODS
  Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits.
  
  
  RESULTS
  ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse.
  
  
  CONCLUSIONS
  We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients.
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Chang
authors.forename: Paul
authors.initials: P
authors.lastname: Lichtenstein
authors.forename: Linda
authors.initials: L
authors.lastname: Halldner
authors.forename: Brian
authors.initials: B
authors.lastname: D'Onofrio
authors.forename: Eva
authors.initials: E
authors.lastname: Serlachius
authors.forename: Seena
authors.initials: S
authors.lastname: Fazel
authors.forename: Niklas
authors.initials: N
authors.lastname: Långström
authors.forename: Henrik
authors.initials: H
authors.lastname: Larsson
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000209:etiology* / Q000523:psychology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants
keywords: ADHD; pharmacology; substance abuse