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A new study finds taking medications for ADHD as a child doesn’t increase risk of substance misuse in adulthood. ferrantraite/Getty Images
  • Stimulants like adderall have long been a treatment for Attention Deficit Hyperactivity Disorder (ADHD).
  • New research suggests that youth who use these stimulants as prescribed are not at a higher risk of addiction simply due to their use.
  • ADHD medications are still stimulants and have risks for side effects.

New research published in JAMA Psychiatryhas found that youth who are prescribed stimulants to treat their ADHD are not more likely to become addicted to drugs later in life.

Dr. Brooke Molina (PhD), a professor of psychology, psychiatry, and pediatrics at the University of Pittsburgh, was one of the authors of this recent study. She says that ideally her team’s findings will help support clinicians, parents, and patients.

“I think, for providers, and for parents, it’s helpful information for them to have at the ready when they’re considering whether or not to prescribe a child stimulant medication for ADHD, hopefully, will help alleviate some concerns about whether or not the medication is going to increase the risk for substance use beyond the risk they already have, because they have ADHD,” Molina said.

The study involved 579 children with ADHD who were part of longitudinal research that began to identify participants in the mid 1990’s. After setting the initial baseline, and after participants were provided treatment that included a variety of methods depending on their grouping over 14 months, they were then assessed at eight stages, ranging from two to sixteen years after their initial involvement. The method used included multiple questionnaires and interviews.

“This study found no evidence that stimulant treatment was associated with increased or decreased risk for later frequent use of alcohol, marijuana, cigarette smoking, or other substances used for adolescents and young adults with childhood ADHD,” the study authors wrote.

Dr. Michael Reardon (MD), a child neurologist with Pediatrix Specialty Care of Austin, says that, in practice, practitioners are keenly aware of addictions when it comes to young people with ADHD.

“The very long-standing viewpoint from the standpoint of like psychiatry, mental health, child neurology is that having ADHD increases the risk of experimenting with tobacco, alcohol, drugs; increases the risk of getting into problematic substance use; and that having ADHD that’s not treated or not well managed, increases the risk of substance use problems,” Reardon said. “Whereas, ADHD that’s being treated and managed well lowers that risk.”

Just because the prescription of these medications in childhood may not increase substance abuse risk does not mean these drugs themselves are inherently harmless. Dr. Eric C. Alcera (MD), a double board-certified child and adult psychiatrist for Hackensack Meridian Health, says that the public needs to be aware of the risks these drugs can carry if not used appropriately.

“They are controlled medications that create significant side effects. Some of it can result in death, if taken inappropriately, so they’re not medications that should be taken lightly. even though your friends or someone else is taking it and it helps them, it may not necessarily be the best medication for you and you really need to consult with a specialist,” Alcera said.

In fact, a lot of public discussions about stimulants medications used to treat ADHD are about how they can be misused by people looking to get a brain-based boost, like university students. Molina says that the study supports health care providers being cautious about prescribing the medications so that they are not misused by people without ADHD.

“Our findings are saying, if we have a child that we’re thinking about prescribing stimulant medication for, we are showing no evidence of increased risk for substance use disorder later from that medication,” Molina said. “However, if you have a teenager or young adult coming into the office, let’s increase the monitoring and careful management a bit, pay a little extra attention to whether or not these medications are being used as directed and not being shared, sold, or traded to other people for cognitive enhancement or recreational use.”

If a stimulant is prescribed, Alcera says that it’s important to keep an eye on how your body is reacting and not to jump to conclusions about the drug’s effectiveness too quickly.

“Start low and go slow. You’re introducing your brain to a new medication, so you don’t want to rush it, right … The one thing about stimulants is that they do work pretty quickly, but sometimes it takes time to adjust the dose.”

Reardon says that one advantage of how quickly these medications take effect is that they can just as quickly be processed through the body.

“So, if you don’t like how the medicine makes you feel, you don’t like the response that you’re having to the medication, you can stop taking it and you’re back to your baseline,” Reardon said.

With these findings, and amidst a growing amount of literature surrounding ADHD, Molina says that a condition like this requires consistently checking in with not just medications, but treatment approaches like cognitive behavioral therapy.