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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.
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Discussion
aDepartments of Psychiatry, Psychology, &
bPediatrics University of Pittsburgh Pittsburgh PA USA
cDepartments of Psychiatry, Psychology, & Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA
dDepartment of Psychology Carleton University Ottawa ON Canada
eDepartment of Psychology, Carleton University, Ottawa, ON, Canada
fDepartment of Pediatrics University of California Irvine CA USA
gDepartment of Pediatrics, University of California, Irvine, CA, USA
hDepartment of Psychiatry &
iBehavioral Sciences Duke University Medical Center Durham NC USA
jDepartment of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
kDepartment of Psychiatry University of Pittsburgh School of Medicine Pittsburgh PA USA
lDepartment of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
mDepartment of Pediatrics University of Cincinnati Cincinnati OH USA
nDepartment of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
oDepartment of Psychiatry and Behavioral Health Ohio State University Columbus OH USA
pDepartment of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
qDivision of Child Psychiatry McGill University and Montreal Children's Hospital Montreal QC Canada
rDivision of Child Psychiatry, McGill University and Montreal Children's Hospital, Montreal, QC, Canada
sDepartment of Public Health and Pediatric Sciences University of Turin Turin Italy
tDepartment of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
uDepartment of Psychological Science University of Vermont Burlington VT USA
vDepartment of Psychological Science, University of Vermont, Burlington, VT, USA
