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. 2014 Aug;55(8):878-85.
doi: 10.1111/jcpp.12164. Epub 2013 Oct 25.

Stimulant ADHD medication and risk for substance abuse

Zheng Chang  1 , Paul Lichtenstein, Linda Halldner, Brian D'Onofrio, Eva Serlachius, Seena Fazel, Niklas Långström, Henrik Larsson
Affiliations

Stimulant ADHD medication and risk for substance abuse

Zheng Chang et al. J Child Psychol Psychiatry. 2014 Aug.

Abstract

Background: There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse.

Methods: Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits.

Results: ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse.

Conclusions: We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients.

Keywords: ADHD; pharmacology; substance abuse.

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Conflict of interest statement

All the authors declare no conflicts of interest. Zheng Chang and Paul Lichtenstein had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses.

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