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No Evidence That Stimulants for Childhood ADHD Lead to Later Substance Use
Receiving prescription stimulant treatment in childhood for attention-deficit/hyperactivity disorder (ADHD) does not increase or decrease substance use later in life. Longitudinal analysis results from the cohort study were published in JAMA Psychiatry.
"Parents and providers can be reassured that we found no evidence of increased risk of substance use or substance use disorder when children are prescribed stimulant medications for ADHD," said Professor Brooke Molina, PhD, director, Youth and Family Research Program, University of Pittsburg, when commenting on the study to MedPage Today.
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Researchers assessed the association of stimulant treatment for ADHD with subsequent substance use using the Multimodal Treatment Study of ADHD (MTA), which enabled the testing of this association “while addressing methodologic complexities (principally, multiple dynamic confounding variables.” The cohort included 547 children aged 7 to 9 with “rigorously diagnosed” ADHD who were assessed according to demographic, clinical, and treatment variables until a mean age of 25 years old. This included confidential self-reporting on a standardized substance use questionnaire.
Utilizing a causal analytic method, the authors found no evidence demonstrating that current (B range -0.62 to 0.34), previous stimulant treatment (B range -0.06 to 0.70), or their interaction with other substances (B range -0.49 to 0.86) were associated with substance use during adulthood. Marginal structural models that adjusted for dynamic cofounding by demographic, clinical, and familial factors, also showed that more years of treatment with stimulants (B range -0.003 to 0.04) or continuous, uninterrupted stimulant treatment (B range -0.25 to -0.03) were not associated with substance use as adults.
"We know, from multiple studies, including several others from the MTA, that ADHD is a risk factor for substance use disorders," Molina told MedPage Today. “[But] our confidence is now increased that prescribing stimulants in childhood does not contribute to this problem.”
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