ADHD and SUD

Brooke Molina, MD

I conduct research on the connection between ADHD and substance abuse. My research started about 20 years ago when researchers began to be interested in a possible link between these two problems. As we started to dig into it, we discovered that indeed there is a connection but what remains somewhat complicated is the extent to which there is a connection. So, just how much are these children at risk for which substances; alcohol, marijuana, cigarettes. When they are at risk, why? I'll be talking about that.

I am asked if this applies to adults, and absolutely, it applies to adults. Much of our research has actually been following these children into adult to understand how long this risk lasts. Some folks have the apparent risk at different stages in their lives. Depending on how you study the question, it shows up differently at different ages. That's the developmental component to my research.

As a result of part of our research, some people were surprised that we found that the most common treatment for ADHD, stimulant medication, did not have a clear and strong signal for preventing substance abuse. Some studies are showing that it helps. Some studies are not showing anything. The good news is that it doesn't appear to be visibly be harming children or to be escalating their risk for abuse. In other words, we're not seeing that stimulant medications spur on the use of drugs or alcohol, and that’s good news.

An important question arises when one considers the risk for substance misuse in teenagers vs. adults. Our research has focused quite a bit on the developmental issues here because substance abuse changes as people age. It starts when teenagers are young but it doesn't rapidly jump to an addiction or substance abuse. If you try to measure it that way, you might miss it.  Substance abuse looks a little different depending on the age of interest. We are working hard to understand what that looks like at the different ages and what are the different factors that lead to this risk at the different ages? We think that might have important implications for prevention and for treatment.