Stimulant Use Among Teens with ADHD Lowers Risk of Later Misuse: Study
Prescribed stimulant therapy for ADHD in adolescence lowers the risk of later stimulant misuse and does not raise the likelihood of prescription drug misuse more broadly, according to a new study.
July 22, 2024
Teens who take prescription stimulants to manage their diagnosed ADHD face no elevated risk for later prescription drug misuse (PDM), according to a study published in Psychiatry Services.1
Further, young adults with ADHD who took stimulants as teens are less likely to misuse stimulants compared with same-age peers who did not receive stimulant therapy. The strongest predictor of prescription stimulant misuse in young adulthood? Prescription drug misuse in adolescence.
The multi-cohort, U.S. national longitudinal study included 11,066 participants, ages 17 or 18, who completed questionnaires every two years until the age of 24. The questionnaires asked about the number of times participants used a prescription drug (benzodiazepine, opioid, or stimulant) without a doctor’s order.
Substance Use Disorder Rates Lower for Medicated Youth
This study marks the newest exploration in a body of research on the relationship between stimulant use and substance use in people with ADHD, conducted by a team that includes Timothy E. Wilens, M.D., Chief of Child and Adolescent Psychiatry, and Director of the Center for Addiction Medicine at the Massachusetts General Hospital.
“People with childhood ADHD are nearly twice as likely to develop a substance use disorder as are individuals who don’t have childhood ADHD,” 2 explained Wilens in the ADDitude article “Treating a Child with ADHD Medication Diminishes His Future Risk of Substance Abuse.” “However, the risk of substance abuse decreases substantially when patients are treated with stimulant medication – even though it is considered a controlled substance. ADHD patients treated with stimulants experience a 60% reduction in substance abuse disorders compared to those who were not treated.” 3
In fact, Wilens added, the longer the child is treated for ADHD, the more robust the protective effect: Research suggests a 10% reduction in risk for substance use disorders for every year of ADHD treatment.4
The fact that stimulants decrease the risk of later substance abuse for youth with ADHD comes as a surprise to many parents. A common misconception that makes caregivers hesitate to medicate children for ADHD is the worry that stimulants will pave the way for addiction later on.
“I was worried that medications whose names sound like illegal drugs could lead to addiction,” explained a reader in a response to ADDitude’s 2023 treatment survey. “I wish I had known that ADHD medication helps prevent addictions to dangerous substances for people with ADHD.”
“The fact that unmedicated kids are much more likely to develop addiction was an important factor for us to consider in our decision to medicate our six-year-old,” wrote another ADDitude reader. “We assumed it would be the opposite: introduce them to meds now and they’d be looking for meds later — but understanding how the meds work to support him, it makes so much sense.”
Sources
1 McCabe, Sean & Schulenberg, John & Wilens, Timothy & Schepis, Ty & Werner, Kennedy & McCabe, Vita & Veliz, Philip. (2024). Attention-Deficit Hyperactivity Disorder Stimulant Therapy and Prescription Drug Misuse During Transition to Young Adulthood. Psychiatric services (Washington, D.C.). 75. appips20230418. 10.1176/appi.ps.20230418.
2 Charach et al. “Childhood Attention-Deficit/Hyperactivity Disorder and Future Substance Use Disroders: Comparative Meta-Analyses.” Journal of the American Academy of Child & Adolescent Psychiatry. 2011; 50(1): 9-21. doi: 10.1016/j.jaac.2010.09.019
3 Chang Z et al. “Stimulant ADHD medication and risk for substance abuse.” J Child Psychol Psychiatry. 2014; 55(8):878-85. doi: 10.1111/jcpp.12164
4 McCabe SE, et al. “Age of Onset, Duration, and Type of Medication Therapy for Attention-Deficit/Hyperactivity Disorder (ADHD) and Substance Use During Adolescence: A Multi-Cohort National Study.” J Am Acad Child Adolesc Psychiatry. 2016; 55(6):479-486: doi: 10.1016/j.jaac.2016.03.011
