Does Early Exposure to Stimulants Lead to Substance Use Disorders Later on?

2015 ◽  
Vol 17 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Jonathan E. Prousky

Attention deficit/hyperactivity disorder (ADHD) denotes childhood problems of hyperactivity, inattention, and impulsivity, leading to impairments in daily functioning, scholastic performance, and relationships with peers. Although the rationale for stimulant medication is to reduce the morbidity associated with having ADHD, critics have argued that methylphenidate and other prescribed stimulant drugs (PSDs) are overly prescribed and inherently dangerous. Researchers have also raised concerns that PSDs might prime the central nervous system, thus rendering individuals more susceptible to substance use disorders (SUDs) later in life. There is also a strong comorbidity between ADHD and SUDs in adulthood. If many adults with SUDs were prescribed stimulants for ADHD as children or during adolescence, this could suggest that taking these drugs during these critical developmental periods increase the risks for SUDs later on. Research articles (i.e., both animal and human data) were reviewed to ascertain if any associations exist between PSDs and brain and behavioral changes. Review articles, meta-analyses, clinical trials, and clinical data were examined to assess associations between PSDs during childhood and adolescence and the development of SUDs in adolescence and adulthood. Contentious evidence does suggest that PSDs are not likely responsible for substance use and SUDs in adolescence, although it remains equivocal if PSDs offer any protection against substance use and abuse in adolescence. Although PSDs do reduce symptoms of ADHD that may interfere with learning in childhood, the evidence raises the possibility that these drugs might be responsible for substance use and SUDS in some adults.

2016 ◽  
Vol 33 (S1) ◽  
pp. S54-S54
Author(s):  
J.A. Ramos-Quiroga

Attention-deficit/hyperactivity disorder (ADHD) is a complex, and multifactorial and chronic neurodevelopmental disorder. Comorbid psychiatric disorders are highly prevalent in individuals with a diagnosis of ADHD. There is a solid overlap between ADHD and substance use disorders (SUD). Prevalence of SUD is high among patients with ADHD, so that SUD are approximately double as common among individuals with ADHD than in general population, and individuals with SUD have much higher rates than expected of a comorbid ADHD. Studies shown that treatment during childhood of attention-deficit/hyperactivity disorder with stimulant medication neither protects nor increases the risk of later substance use disorders. Nevertheless, recent studies found that patients with ADHD and SUD can reduce ADHD symptoms and SUD with stimulants and cognitive-behavioral therapy. Treatment of ADHD in patients with SUD requires a comprehensive diagnostic assessment. It is recommendable to stabilize the addiction prior to treating the ADHD. In this talk, the recent literature for the treatment of adults with co-occurring ADHD and SUD will be reviewed.Disclosure of interestThe author has not supplied his declaration of competing interest.


CNS Spectrums ◽  
2009 ◽  
Vol 14 (S6) ◽  
pp. 10-12 ◽  
Author(s):  
Oscar Bukstein

In examining the challenges in treating comorbid attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD), there are a number of issues regarding misinformation and misconception that exist for clinicians. Like other ADHD comorbidities, there is a lack of screening, particularly among adult clinical populations who have the psychiatric comorbidity or, for patients with SUDs, there is the issue of prioritization, which condition to treat first, and determining the place of medication management—particularly stimulant medication—paramount in treatment planning.


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