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Defiance, Not Hyperactivity, Linked to Drug Dependence

Defiance, Not Hyperactivity, Linked to Drug DependenceA new population-based, multi-year study suggests that children who exhibit oppositional behavior are more likely to become addicted to nicotine, cannabis and cocaine.

Researchers from the University of Montreal say that inattention symptoms are associated with a specific additional risk of nicotine addiction. But contrary to some earlier findings, hyperactivity in itself does not seem to be associated with any specific risk of substance abuse or dependence.

The conclusion stems from a 15-year study published in Molecular Psychiatry.

Investigators studied the behavior of 1,803 children between 6 and 12 years of age as they were evaluated annually by their mothers and teachers.

Over half the participants were females. The study revealed that by the age of 21, 13.4 percent were either abusing or addicted to alcohol, 9.1 percent to cannabis, and 2.0 percent to cocaine. Tobacco addiction was a problem for 30.7 percent of the participants.

Previous research had suggested a link between attention deficit hyperactivity disorder (ADHD) in childhood and substance abuse in adulthood.

However, University of Montreal researchers observed that very few studies have been undertaken into the particular and respective roles of behavioral symptoms such as opposition that are often associated with ADHD.

Furthermore, at least as many girls as boys were sampled in order to assess the potential impact of gender on the findings.

“By taking into account the unique effect of inattention and hyperactivity, which had seldom been considered separately before, we came to realize that the link between ADHD symptoms in childhood and substance abuse in adulthood was overestimated and hyperactivity in itself did not seem, in this study, to predispose for future substance abuse,” observed Jean-Baptiste Pingault, Ph.D.

“We have rather observed strong oppositional behaviors to be associated with cannabis and cocaine abuse. In ADHD symptoms, only inattention is closely correlated with nicotine addiction,” he continued.

As for the impact of gender on findings, the study reveals opposition and inattention play a largely identical role in girls and boys. However, within the context of the study, it was established that boys consumed more cannabis and alcohol, while girls smoked more cigarettes.

Researchers discovered the strongest behavioral predictor of substance abuse lies in frequent oppositional behavior in childhood, which can be recognized through traits such as irritability, being quick to “fly off the handle,” disobedience, refusal to share materials with others to carry out a task, blaming others and being inconsiderate of others.

In fact, in strongly oppositional children, the risk of tobacco abuse, once other factors were taken into account, was 1.4 times higher than in children who exhibited little oppositional behavior.

The risk is 2.1 times higher for cannabis abuse and 2.9 times higher for cocaine abuse. It should be noted that the mothers’ evaluations provided further essential information in relation to the teachers’ evaluations.

In fact, some children who were declared highly oppositional by their mothers, but not at all by their teachers, also ran a higher risk of substance abuse and addiction.

Another important relationship established by the study was the link between inattention and smoking.

Very inattentive children had a 1.7-fold increased risk of becoming addicted to tobacco. The degree of inattention even reveals the intensity of future nicotine addiction. The link supported the hypothesis that inattentive people would use tobacco as a “treatment” to help them concentrate.

“If other studies can establish a chemical relation of cause and effect between ADHD symptoms and smoking, we could suppose that treating inattention symptoms would make it easier to quit smoking.

“Until this is demonstrated, our study’s findings nonetheless suggest that the prevention or treatment of inattention and opposition symptoms in children could reduce the risk of smoking and drug abuse in adulthood,” Pingault said.

Source: University of Montreal

Young girl smoking photo by shutterstock.

Defiance, Not Hyperactivity, Linked to Drug Dependence

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Defiance, Not Hyperactivity, Linked to Drug Dependence. Psych Central. Retrieved on September 28, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 2 Aug 2012)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.