Conflict of interest statement: No conflicts declared.
Stimulant ADHD medication and risk for substance abuse
Version of Record online: 25 OCT 2013
© 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
Journal of Child Psychology and Psychiatry
Volume 55, Issue 8, pages 878–885, August 2014
How to Cite
Chang, Z., Lichtenstein, P., Halldner, L., D'Onofrio, B., Serlachius, E., Fazel, S., Långström, N. and Larsson, H. (2014), Stimulant ADHD medication and risk for substance abuse. Journal of Child Psychology and Psychiatry, 55: 878–885. doi: 10.1111/jcpp.12164
- Issue online: 7 JUL 2014
- Version of Record online: 25 OCT 2013
- Manuscript Accepted: 23 SEP 2013
- Manuscript Revised: 21 AUG 2013
- Manuscript Received: 21 JUN 2013
- Swedish Research Council
- Swedish Council for Working Life and Social Research
- Swedish Prison and Probation Services
- National Institute of Child Health and Human Development. Grant Number: HD061817
- Wellcome Trust. Grant Number: 095806
- ADHD ;
- substance abuse
There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse.
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.
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.
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.