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ADHD medication does not increase substance abuse risk

ADHD medication treatment was not associated with increased risk for substance-related problems in adolescence or adulthood, according to study results.

“Prospective studies show that the risk of substance use disorders is a persisting concern in ADHD at least in part because the two disorders share genetic influences. Substance use disorders contribute substantially to elevated mortality rates among patients with ADHD,” Patrick D. Quinn, PhD, of Indiana University, Bloomington, and colleagues wrote.

To determine concurrent and long-term associations between ADHD medication treatment and substance-related problems, researchers analyzed commercial health care claims from 2005 to 2014 for 2,993,887 adolescents and adults with ADHD. The cohort was 47.2% female.

Adjusted within-individual comparisons indicated males were 35% less likely to experience concurrent substance-related problems when receiving ADHD medication (OR = 0.65; 95% CI, 0.64-0.67), and females were 31% less likely (OR = 0.69; 95% CI, 0.67-0.71).

Two years after medication periods, males were 19% less likely to experience substance-related problems (OR = 0.81; 95% CI, 0.78-0.85) and females were 14% less likely (OR = 0.86; 95% CI, 0.82-0.91).

Sensitivity analyses supported most associations but appeared less consistent for long-term findings among females.

“Given mixed results from clinical trials, our results should not be interpreted as supporting the use of ADHD medication in the treatment of substance-related problems,” the researchers wrote. “More broadly, our results cannot speak to the possibility of diversion or misuse of stimulants outside of treatment. However, they do join a growing evidence base of protective associations for patients receiving medication therapy. It may be useful to consider these associations in conjunction with other potential benefits and harms (eg, growth delay) when making treatment decisions.” – by Amanda Oldt

Disclosure: Quinn reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ relevant financial disclosures.