title: Comorbid attention deficit hyperactivity disorder and substance use disorder complexity and chronicity in treatment-seeking adults.
abstract: OBJECTIVE
  Attention deficit hyperactivity disorder (ADHD) is a known risk factor for substance use disorder (SUD); however, the potential additive contribution of comorbid ADHD to drug-specific dependence in SUD populations is largely unknown. The current study aimed to assess this association between ADHD symptoms and drug-specific SUD complexity and chronicity.
  
  
  METHODS
  A cross-sectional survey was administered to a convenience sample of 489 adults receiving SUD treatment at 16 Australian drug and alcohol treatment centres between September 2010 and August 2011. Participants were screened for adult ADHD symptoms using the Adult ADHD Self-Report Scale. Associations between ADHD screening status and drug-specific SUD complexity and chronicity were assessed using multivariate logistic and modified Poisson regression analysis, controlling for a range of potential confounders.
  
  
  RESULTS
  Overall, 215 (44%) patients screened positive for concurrent adult ADHD and SUD. After Simes' correction, a significant positive association was observed between ADHD screening status and current amphetamine SUD (odds ratio (OR) = 1.85; 95% confidence interval (CI): 1.19-2.36). Patients who screened positive for ADHD were significantly more likely to report SUD history for heavy alcohol use (OR = 2.05; 95% CI: 1.21-3.45) and amphetamine (OR = 1.96; 95% CI: 1.26-3.06) as well as significantly increased risk of moderate (3-4 years) duration for benzodiazepine and amphetamine SUDs and long (≥5 years) duration for alcohol, opiates other than heroin or methadone, and amphetamine SUDs.
  
  
  CONCLUSIONS
  The findings provide evidence that there is increased drug dependence complexity and chronicity in treatment-seeking SUD patients who screen positively for ADHD, specifically for amphetamine, alcohol, opiates other than heroin or methadone, and benzodiazepines.
authors: National Drug Research Institute, Curtin University, Perth, Australia.|Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Australia.|Melbourne School of Population and Global Health, University of Melbourne, Parkville, Parkville, Australia.
authors: Jesse Tyler
authors: http://orcid.org/0000-0001-5702-372X
authors: JT
authors: Young
authors: National Drug Research Institute, Curtin University, Perth, Australia.
authors: Susan
authors: S
authors: Carruthers
authors: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
authors: Sharlene
authors: S
authors: Kaye
authors: National Drug Research Institute, Curtin University, Perth, Australia.
authors: Steve
authors: S
authors: Allsop
authors: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
authors: Joanne
authors: J
authors: Gilsenan
authors: Melbourne School of Population and Global Health, University of Melbourne, Parkville, Parkville, Australia.|National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
authors: Louisa
authors: L
authors: Degenhardt
authors: Trimbos-Instituut, ICASA Foundation, Utrecht, The Netherlands.|Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Geurt
authors: G
authors: van de Glind
authors: Amsterdam Institute for Addiction Research, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Wim
authors: W
authors: van den Brink
authors: Centre for Health Services Research, School of Population Health, The University of Western Australia, Perth, Australia.
authors: David
authors: D
authors: Preen
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology; D016012:Poisson Distribution; D011569:Psychiatric Status Rating Scales; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: ADHD; ASRS; comorbidity; dependence; substance use disorder