Stimulant Medications Targeting ADHD Not Linked to Increased Drug Use

Researchers at the University of Pittsburgh School of Medicine say children receiving a prescription stimulant to control the symptoms of attention deficit hyperactivity disorder (ADHD) do not have greater drug use or substance use disorder (SUD) as teens or young adults.

The study, published in JAMA Psychiatry, may provide parents and doctors some comfort who might be hesitant to give ADHD stimulant drugs out of concern that they would pave the way for later substance use.

"Stimulants are the first-line treatment recommended for most individuals with ADHD — the drug class is an evidence-based treatment with few side effects," says co-author Brooke Molina.

Molina continues that many individuals worry that stimulant pills might lead to dangerous substance usage because the Drug Enforcement Administration classifies them as Schedule 2 drugs with potential abuse.

Chronic inattention, hyperactivity, impulsivity, or a mix of the three, are the hallmarks of ADHD, a neurobehavioral disease that impairs daily functioning. ADHD is a chronic disorder that must be watched throughout a person's life, even though it can be controlled with medication and other therapy methods.

To determine whether there was any correlation between stimulant therapy and eventual drug use, Molina and her colleagues evaluated individuals with ADHD across 16 years from infancy through adolescence to early adulthood.

The Pitt research, one of the first to examine the link between early prescription stimulant use and later SUD, considered a wide range of demographic, clinical, and psychological variables that might influence a person's propensity for treatment and drug use.

Our study not only accounted for age but also used a statistical method that adjusted over time for the many characteristics that may distinguish treated from non-treated individuals.

- Traci Kennedy

She says these considerations enabled them to investigate the association between stimulants and drug usage more precisely.

The relationship between the use of prescription stimulants for ADHD and SUD has remained disputed despite efforts by other research to identify and characterize it. While other studies could not identify a link, specific research findings revealed a protective impact of prescription stimulant usage on the likelihood of developing SUD later.

Researchers from Pitt found no indication that stimulant medication in infancy offered protection against developing a SUD for teenagers or young adults with ADHD after accounting for age and other time-varying variables, including family income, behavior issues, and parental support.

Researchers could not discover a connection between early stimulant use and later increases in drug abuse. Age and stimulant therapy were correlated, making older individuals less likely to continue using the medicine. However, some research participants self-reported an increase over time in frequent drinking, marijuana usage, daily cigarette smoking, and using other drugs.

When these patterns were combined with meticulous statistical analysis, the findings did not show a relationship between extended stimulant use and a decreased or increased risk for SUD.

Molina concludes: "We hope the results of this study will help educate providers and patients. By understanding that stimulant medication initially prescribed in childhood is not linked to harmful levels of substance use, I anticipate that parents' and patients' fears will be alleviated."

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