246667 Psychostimulant Treatment and Substance Use Among Adolescents with ADHD

Monday, October 31, 2011

Brandon Nichter, BA , Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
Tilda Farhat, PhD, MPH , Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
Ronald Iannotti, PhD , Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
Bruce G. Simons-Morton, EdD, MPH , Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
BACKROUND: Attention-deficit/Hyperactivity Disorder (ADHD) is among the most common conditions in the general population, and adolescents with ADHD are at increased risk for subsequent development of substance use disorders. Psychostimulants are a common and highly effective treatment for ADHD symptomology. However, prescription stimulant use for adolescents remains highly controversial due to inconsistent evidence about its potential contribution to substance use. Recent evidence suggests that youth with ADHD who do not receive pharmacological treatment may be at heightened risk for substance use. Most of these associations are derived from clinically referred samples of youth, and to date, no nationally representative studies have investigated this issue.

The objectives of this study are to: (1) evaluate the associations between ADHD, prescription stimulant use, and substance use; and (2) examine differences in these associations by type of substance and gender. METHODS: In the 2010 Next Generation Health Study, a nationally-representative sample of 10th-grade students (N=2,511) provided self-reported substance use, chronic health conditions, and medication use. EXPECTED RESULTS: 5% of the total sample reported a clinical diagnosis of ADHD (n=124); of these, 34% reported taking stimulants to treat their condition. We hypothesize that adolescents not receiving stimulant treatment would have higher rates of tobacco, alcohol and illicit drug use as compared to those receiving stimulant treatments. DISCUSSION: Given the rise in the prescription of stimulants for the management of ADHD over the past two decades, additional evidence of the association between stimulants and substance use can guide clinicians, parents, and adolescents when making therapeutic decisions.

Learning Areas:
Clinical medicine applied in public health
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe the prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) and prescription stimulant use in a nationally representative sample of U.S. adolescents. 2. Examine the prevalence of substance use among adolescents with ADHD, by gender. 3. Identify the association between substance use and prescription stimulants among youth with ADHD, by gender and type of substance.

Keywords: Adult and Child Mental Health, Substance Abuse Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For the past two years, I have served as a research fellow at various research institutions such as the National Institute of Mental Health, National Institute of Child Health & Human Development, and the University of Chile, School of Public Health. My research in these institutions has focused on adolescent substance use and psychopathology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Predictors and Outcomes of Alcohol, Tobacco, and Other Drug Use Among Youth
See more of: Alcohol, Tobacco, and Other Drugs