Children with attention-deficit hyperactivity disorder (ADHD) are far more likely than their peers to engage in serious substance abuse as teens and adults.
But do ADHD meds contribute to the risk?
In the most comprehensive research ever on this topic, UCLA psychologists found that children with ADHD who take medications such as Ritalin and Adderall are at no greater risk of using alcohol, marijuana, nicotine or cocaine later in life than kids with ADHD who don’t take these medications.
The researchers looked at 15 long-term studies, including data from three studies not yet published. The studies followed more than 2,500 children with ADHD from childhood into their teen and young adult years.
“We found the children were neither more likely nor less likely to develop alcohol and substance-use disorders as a result of being treated with stimulant medication,” said Kathryn Humphreys, a doctoral candidate in UCLA’s Department of Psychology and lead author of the study. “We found no association between the use of medication such as Ritalin and future abuse of alcohol, nicotine, marijuana and cocaine.”
The children had a mean age of 8 years old when the research began and 20 at the most recent follow-up assessments. They came from a broad geographical range, including California, New York, Michigan, Pennsylvania, Massachusetts, Germany and Canada.
“For parents whose major concern about Ritalin and Adderall is about the future risk for substance abuse, this study may be helpful to them,” Humphreys said.
“We found that on average, their child is at no more or less at risk for later substance dependence. This does not apply to every child but does apply on average. However, later substance use is usually not the only factor parents think about when they are choosing treatment for their child’s ADHD.”
The researchers report that children with ADHD are two to three times more likely than children without the disorder to develop serious substance-abuse problems in adolescence and adulthood, including the use of nicotine, alcohol, marijuana, cocaine and other drugs.
This new study does not oppose those results but finds that, on average, children who take stimulant medication for ADHD are not at additional risk for future substance abuse.
Ritalin is associated with certain side effects, such as suppressing appetite, disrupting sleep and changes in weight, said Steve S. Lee, a UCLA associate professor of psychology and senior author of the study.
“The majority of children with ADHD—at least two-thirds—show significant problems academically, in social relationships, and with anxiety and depression when you follow them into adolescence,” Lee said.
“For any particular child, parents should consult with the prescribing physician about potential side effects and long-term risks,” said Lee.
“Saying that all parents need not be concerned about the use of stimulant medication for their children is an overstatement; parents should have the conversation with the physician. As with other medications, there are potential side effects, and the patient should be carefully evaluated to, for example, determine the proper dosage.”
As the study participants get older, researchers will be able to study the rate at which they graduate from college, get married, have children and/or get divorced and to assess how well they function, Humphreys said.
As children with ADHD enter adolescence and adulthood, they typically fall into one of three groups of similar size, Lee said: one-third will have significant problems in school and socially; one-third will have moderate impairment; and one-third will exhibit only mild impairment.
The research is published in the journal JAMA Psychiatry, a psychiatry research journal published by the American Medical Association.
Source: JAMA Psychiatry