Substance Abuse Rates Higher In Teenagers With ADHD: Large Study

Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: ADHD;  Pediatrics / Children's Health
Article Date: 13 Feb 2013 - 1:00 PST Current ratings for:
Substance Abuse Rates Higher In Teenagers With ADHD: Large Study

A new study published online in the Journal of the American Academy of Child and Adolescent Psychiatry revealed a significantly higher prevalence of substance abuse and cigarette use by adolescents with attention deficit hyperactivity disorder (ADHD) histories than in those without ADHD. Researchers from the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic of UPMC as well as six other health centers across the United States also found that, contrary to previous findings, current medications for ADHD do not counter the risk for substance abuse and substance use disorder (SUD) among teenagers.

This study is the first to examine teenage substance abuse and treatment for ADHD in a large multi-site sample. It also is the first to recognize that increased use of cigarettes in teenagers with ADHD histories commonly occurs with use of other substances such as alcohol and marijuana.

"This study underscores the significance of the substance abuse risk for both boys and girls with childhood ADHD," said Brooke Molina, Ph.D., professor of psychiatry and psychology at the University of Pittsburgh School of Medicine and lead author of the report. "These findings also are the strongest test to date of the association between medication for ADHD and teenage substance abuse."

Researchers studied nearly 600 children over an eight-year period from childhood through adolescence to test the hypothesis that children with ADHD have increased risk of substance use and abuse or dependence in adolescence. Molina and colleagues also examined substance abuse patterns, the effects of ADHD medications over time, and the relationship between medication and substance use.

The findings showed: When the adolescents were an average of 15 years old, 35 percent of those with ADHD histories reported using one or more substances, as compared to only 20 percent of teens without ADHD histories. Ten percent of the ADHD group met criteria for a substance abuse or dependence disorder, which means they experienced significant problems from their substance use, as compared to only 3 percent of the non-ADHD group. When the adolescents were an average of 17 years old, marijuana was particularly problematic with 13 percent versus 7 percent of the ADHD and non-ADHD groups, respectively, having marijuana abuse or dependence. Daily cigarette smoking was very high at 17 percent of the ADHD group, a significantly higher rate than national estimates for this age. The smoking rate of non-ADHD teens was only 8 percent. Alcohol use was high in both groups, highlighting its common occurrence for teenagers in general. Substance abuse rates were not different for children who were still being treated with ADHD medication compared to children who were not. The authors noted the important finding that substance abuse rates were the same in teenagers still taking medication and in those no longer on medication, even after considering multiple factors that might cause teenage medication use. They noted that these results suggest a need to identify alternative approaches to substance abuse prevention and treatment for boys and girls with ADHD.

"We are working hard to understand the reasons why children with ADHD have increased risk of drug abuse. Our hypotheses, partly supported by our research and that of others, is that impulsive decision making, poor school performance, and difficulty making healthy friendships all contribute," added Molina.

"Some of this is biologically driven because we know that ADHD runs in families. However, similar to managing high blood pressure or obesity, there are non-medical things we can do to decrease the risk of a bad outcome. As researchers and practitioners, we need to do a better job of helping parents and schools address these risk factors that are so common for children with ADHD."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our alcohol / addiction / illegal drugs section for the latest news on this subject. Collaborators on this study include Stephen P. Hinshaw, Ph.D., of the University of California, Berkeley; Eugene Arnold, M.D., of Ohio State University; James M. Swanson, Ph.D., of the University of California, Irvine; William E. Pelham, Ph.D., Florida International University; Lily Hechtman, M.D., of McGill University; and others.
This research was supported by cooperative agreement grants and contracts from the National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse.
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U.S. Cancer Rates Continue to Fall

THURSDAY, March 31 (HealthDay News) -- The rate of new cancers in the United States has dropped by almost 1 percent a year and the rate of death from cancer has fallen 1.6 percent a year, a new report shows.

These declines, seen between 2003 and 2007, continue a trend that began in the 1990s, the researchers added.

Importantly, this is the first time a drop in the rate of deaths from lung cancer among women has been seen, coming a decade after lung cancer death rates started declining in men, they noted.

"The drop in lung cancer rates among women is due to women quitting smoking," said report co-author Lynn Ries, a health statistician at the U.S. National Cancer Institute. "Women started smoking a lot later than men, so the peak in the mortality rate occurred a lot later," she added.

The report is the work of researchers at the North American Association of Central Cancer Registries, the U.S. National Cancer Institute, the U.S. Centers for Disease Control and Prevention and the American Cancer Society. It is published in the March 31 online edition of the Journal of the National Cancer Institute.

Although cancer rates are declining in adults, there has been a rise in cancers diagnosed in children. Most of these involve increases in the incidence of leukemias. However, the rate of death from cancer among children is declining, Ries noted.

Ries noted that the reasons for the increase in childhood cancers isn't clear.

Among men, the overall cancer rate has remained about the same. In fact, cancer rates in men would have also shown a decline, except for a small rise in the rate of prostate cancer, according to the report.

One section of the report focuses specifically on both brain and nervous system cancers and benign tumors. According to the report, benign brain tumors are twice as common as cancerous ones, Ries said.

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Prostate Cancer Screening Doesn't Cut Death Rates: Study

Prostate Cancer Screening Doesn't Cut Death Rates: Study

And researchers add that widescale testing is linked to overdiagnosis, overtreatment

By Amanda Gardner
HealthDay Reporter

THURSDAY, March 31 (HealthDay News) -- A 20-year study from Sweden suggests that screening for prostate cancer does not substantially reduce the risk of death from the disease.

On the other hand, a good many men might receive false-positive results and overtreatment, adding an element of risk to widescale screening, the researchers report in the March 31 online issue of the BMJ.

"In the light of our findings, I would say that the benefit from screening is not sufficient to support mass screening," said study author Dr. Gabriel Sandblom, an associate professor at the Karolinska Institute in Stockholm.

"However," added Sandblom, "the study was initiated more than 20 years ago, when PSA [prostate specific antigen testing] was not available and the treatment of localized prostate cancer was not as effective as it is today. I would thus not categorically advise against PSA testing based on an individual decision from a man who feels concern about prostate cancer."

This advice is not out of line with recently updated guidelines on prostate cancer screening from the U.S. government. The recommendations, issued in 2008, take a dim view of prostate cancer screenings at any age for healthy men and flatly recommend against them entirely for men over 75.

The American Cancer Society has also recently revisited the issue of prostate cancer screening.

"A little over a year ago, the American Cancer Society revised its guidelines, which reinforced the message that men need to be informed that there are known benefits, but also limits, to PSA screenings," said Dr. Durado Brooks, director of prostate and colon cancer at the American Cancer Society. "The American Cancer Society does not encourage nor discourage prostate cancer screenings."

This new study does carry with it several significant weaknesses, Brooks added. In particular, because of the timing and design of the study, most men really only received one and, at most, two PSA tests.

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