Stimulant Therapy for Adolescent ADHD Not Associated With Subsequent Non-medical Stimulant Use
Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance use disorder. Prescription stimulant medications are highly effective for treating ADHD, but there is concern that adolescents with ADHD who are treated with stimulants may escalate to non-medical stimulant use over time. This US-based, prospective, multi-cohort study investigated the association between young adults who have received stimulant ADHD therapy, and future non-medical use of prescription stimulants and/or cocaine use from ages 18 to 24, compared with ADHD controls (participants with ADHD who received non-stimulant therapy) and population controls.
- Multi-cohort panels of 11,905 US 12th graders were surveyed at the time of baseline data collection and biennially thereafter for six years.
- At baseline, 10 percent of participants reported lifetime receipt of stimulant medication for ADHD; 3 percent reported lifetime receipt of non-stimulant therapy for ADHD; and 87 percent reported receipt of neither.
- There was no significant difference in prevalence or incidence of past-year non-medical use of prescription stimulants and cocaine use between all groups.
Comments: Negotiating ADHD treatment options can be complex, particularly when weighing the risk of potentially addictive stimulant therapy against the risk(s) associated with untreated ADHD (including predisposition to substance use disorder). This study did not demonstrate increased incidence or prevalence of non-medical use of prescription stimulants and/or cocaine use in young adults with a history of prescription stimulant therapy for ADHD in adolescence. This finding (and a similar retrospective evidence base) may lend reassurance to prescribers, patients, and caregivers when electing to utilize prescription stimulants as clinically indicated for ADHD.
Emily Nields, DO
Reference: McCabe VV, Veliz PT, Wilens TE, et al. Adolescents’ use of medications for attention-deficit/hyperactivity disorder and subsequent risk of nonmedical stimulant use. J Adolesc Health. 2024;75(1):188–191.