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Review
. 2011 Apr;31(3):328-41.
doi: 10.1016/j.cpr.2011.01.006. Epub 2011 Jan 20.

Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review

Steve S Lee  1 , Kathryn L Humphreys, Kate Flory, Rebecca Liu, Kerrie Glass
Affiliations
Review

Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review

Steve S Lee et al. Clin Psychol Rev. 2011 Apr.

Abstract

Given the clinical and public health significance of substance disorders and the need to identify their early risk factors, we examined the association of childhood attention-deficit/hyperactivity disorder (ADHD) with substance use (nicotine, alcohol, marijuana) and abuse/dependence outcomes (nicotine, alcohol, marijuana, cocaine, other). To strengthen a potential causal inference, we meta-analyzed longitudinal studies that prospectively followed children with and without ADHD into adolescence or adulthood. Children with ADHD were significantly more likely to have ever used nicotine and other substances, but not alcohol. Children with ADHD were also more likely to develop disorders of abuse/dependence for nicotine, alcohol, marijuana, cocaine, and other substances (i.e., unspecified). Sex, age, race, publication year, sample source, and version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to diagnose ADHD did not significantly moderate the associations with substance outcomes that yielded heterogeneous effect sizes. These findings suggest that children with ADHD are significantly more likely to develop substance use disorders than children without ADHD and that this increased risk is robust to demographic and methodological differences that varied across the studies. Finally, few studies addressed ADHD and comorbid disruptive behavior disorders (DBD), thus preventing a formal meta-analytic review. However, we qualitatively summarize the results of these studies and conclude that comorbid DBD complicates inferences about the specificity of ADHD effects on substance use outcomes.

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Figures

Figure 1
Figure 1. Lifetime nicotine use predicted from childhood ADHD
Figure 2
Figure 2. Nicotine dependence predicted from childhood ADHD
Figure 3
Figure 3. Lifetime alcohol use predicted from childhood ADHD
Figure 4
Figure 4. Alcohol abuse or dependence predicted from childhood ADHD
Figure 5
Figure 5. Lifetime marijuana use predicted from childhood ADHD
Figure 6
Figure 6. Marijuana abuse or dependence predicted from childhood ADHD (excluding Gignac et al. (2005)
Figure 7
Figure 7. Cocaine abuse or dependence predicted from childhood ADHD
Figure 8
Figure 8. Non-specific substance abuse or dependence predicted from childhood ADHD
See this image and copyright information in PMC

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