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ADHD Medication and Substance-Related Problems
Department of Psychological and Brain Sciences, Indiana University, Bloomington, United States.
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2017 (English)In: American Journal of Psychiatry, ISSN 0002-953X, E-ISSN 1535-7228, Vol. 174, no 9, p. 877-885Article in journal (Refereed) Published
Abstract [en]

Objective: Substance use disorders are major contributors to excess mortality among individuals with attention deficit hyperactivity disorder (ADHD), yet associations between pharmacological ADHD treatment and substance-related problems remain unclear. This study investigated concurrent and tong-term associations between ADHD medication treatment and substance-related events.

Method: The authors analyzed 2005-2014 commercial health care claims from 2,993,887 (47,2% female) adolescent and adult ADHD patients. Within-individual analyses compared the risk of substance-related events (i.e., emergency department visits related to substance use disorders) during months in which patients received prescribed stimulant medication or atomoxetine relative to the risk during months in which they did not.

Results: In adjusted within-individual comparisons, relative to periods in which patients did not receive ADHD medication, male patients had 35% lower odds of concurrent substance-related events when receiving medication (odds ratio=0.65, 95% CI=0.64-0.67), and female patients had 31% tower odds of concurrent substance-related events (odds ratio=0.69, 95% CI=0.67-0.71). Moreover, male patients had 19% lower odds of substance-related events 2 years after medication periods (odds ratio=0.81, 95% CI=0.78-0.85), and female patients had 14% tower odds of substance-related events 2 years after medication periods (odds ratio = 0.86, 95% CI= 0.82-0.91). Sensitivity analyses supported most findings but were less consistent for long-term associations among women.

Conclusions: These results provide evidence that receiving ADHD medication is unlikely to be associated with greater risk of substance-related problems in adolescence or adulthood. Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.

Place, publisher, year, edition, pages
American Psychiatric Association , 2017. Vol. 174, no 9, p. 877-885
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-61036DOI: 10.1176/appi.ajp.2017.16060686ISI: 000408892000013PubMedID: 28659039Scopus ID: 2-s2.0-85028692944OAI: oai:DiVA.org:oru-61036DiVA, id: diva2:1142287
Funder
Swedish Research Council, 2013-2280Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-2780
Note

Funding Agencies:

NIMH  R01MH102221 

NIDA  K99DA040727 

European Union  602768 

Indiana Clinical and Translational Sciences Institute - National Center for Advancing Translational Sciences  TL1TR001107 

Shire 

Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2017-10-23Bibliographically approved

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Larsson, Henrik

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