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Childhood ADHD Increases Risk of Substance Abuse

Not only can attention deficit hyperactivity disorder (ADHD) affect a child’s learning ability and behavior, but it can also increase the risk of smoking and drug and alcohol abuse in early adulthood, according to a new study.

The researchers also found that children with ADHD and conduct disorder (a tendency for disruptive and violent behavior) have about three times the risk of developing substance abuse problems compared to those with ADHD alone.

Timothy Wilens, MD, of Massachusetts General Hospital’s Pediatric Psychopharmacology Unit and an associate professor of psychiatry at Harvard Medical School in Boston, said that ADHD significantly increases the risk of smoking cigarettes and abusing alcohol and drugs, and that parents should be mindful of this risk. He added that having both ADHD and conduct disorder increases the risk even more, so parents should talk to their children about substance abuse and be careful to keep alcohol, cigarettes, and prescription medications out of reach.

For the study, the researchers looked at data from two studies examining the prevalence of psychiatric and behavioral disorders that co-occur with ADHD in children. The participants, with an average age of 10, were followed for 10 years. Those participants with ADHD were found to be about 1.5 times more likely to develop substance abuse problems in their early 20s, compared to those without ADHD.

Those who still had ADHD at the end of the follow-up period were at the greatest risk for substance abuse problems, compared with those who no longer had an ADHD diagnosis after 10 years. In addition, those who had both ADHD and conduct disorder were about three times more likely to develop substance abuse problems, compared to those with ADHD alone.
The study found that the risk of developing substance abuse problems was not affected by gender, academic problems, mood disorders, learning disabilities, or family history of substance abuse.

Dr. Wilens said boys and girls with ADHD were at an equal risk of developing substance abuse problems, and because academic achievement and cognitive issues did not predict substance abuse, something else is causing this increased risk.
The study also found that medication treatment for ADHD did not affect the risk for substance abuse, but more studies are needed to draw firm conclusions.

Jon Shaw, MD, a professor of psychiatry of the University of Miami School of Medicine, said that the increased risk for substance abuse likely has to do with the nature of the disorder, as children with ADHD tend to be very impulsive and don’t learn well from experience. Many people with ADHD may also self-medicate with drugs like marijuana in an attempt to alleviate their restlessness. Dr. Shaw added that treating ADHD is essential, as the disorder can lead to academic problems.

Stephen Grcevich, MD, a child and adolescent psychiatrist at Family Center by the Falls in Chagrin Falls, Ohio, says that family members and clinicians should screen both children and adults with ADHD for signs of substance abuse, as early intervention can help prevent addiction.

Source: Web MD, Denise Mann, Childhood ADHD Linked to Later Risk of Drug Abuse, June 1, 2011

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