Childhood attention deficit hyperactivity disorder and the development of substance use disorders: valid concern or exaggeration?

Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder associated with many behavioral problems in adolescence and adulthood. In particular, researchers have identified comorbid substance use disorders in many adolescents and young adults who were diagnosed with ADHD as children. Conflicting reports exist regarding the developmental risk for substance use problems and disorders in these individuals. This paper reviews the recent literature evaluating the relationship between childhood ADHD and substance use. Research suggests that in the absence of conduct disorder, ADHD carries only a moderate risk for subsequent substance use. Degree of risk appears to be related to specific drugs of abuse and particular ADHD symptoms. Additionally, whether stimulant treatment of ADHD symptoms predisposes children to later substance use is an important concern. Currently, little evidence exists to support this notion and most research suggests that stimulant treatment serves as a protective factor for substance use. ADHD is an important precursor to subsequent disorders in children and further research is necessary to diminish the risk for substance use in this population.