No Increased Risk of Substance Abuse After Stimulant Treatment for Childhood ADHD

Background: It is felt that childhood attention deficit hyperactivity disorder (ADHD) carries an increased risk for developing substance abuse disorder as an adult. There are theoretical differences regarding the effect of stimulant medications, a first-line treatment for ADHD, on such a risk. On one hand, the benefits of such medications to decrease impulsivity, a characteristic prominent in models of addiction, should decrease substance use. On the other hand, perhaps early exposure to stimulants might cause neurobiological and behavioral sensitization to other drugs and increase the risk of substance use. Objective: To assess the association of use of stimulant medication in treating ADHD with future substance use. Methods: The database for the study was the Multimodal Treatment Study of ADHD, a multisite study at 6 U.S. sites and 1 Canadian site, which began as a 14-month randomized clinical trial of medication and behavior therapy before transitioning to a longitudinal observati more...