Brooke S G Molina1, Andrea L Howard2, James M Swanson3, Annamarie Stehli3, John T Mitchell4, Traci M Kennedy5, Jeffery N Epstein6, L Eugene Arnold7, Lily Hechtman8, Benedetto Vitiello9, Betsy Hoza10. 1. Departments of Psychiatry, Psychology, & Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA. 2. Department of Psychology, Carleton University, Ottawa, ON, Canada. 3. Department of Pediatrics, University of California, Irvine, CA, USA. 4. Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. 5. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 6. Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA. 7. Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA. 8. Division of Child Psychiatry, McGill University and Montreal Children's Hospital, Montreal, QC, Canada. 9. Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy. 10. Department of Psychological Science, University of Vermont, Burlington, VT, USA.
Abstract
BACKGROUND: Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample. METHODS: Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25. RESULTS: In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups. CONCLUSIONS: Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.
BACKGROUND: Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample. METHODS: Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25. RESULTS: In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups. CONCLUSIONS: Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.
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