Pharmacotherapy of attention-deficit/hyperactivity disorder reduces risk for substance use disorder.

The aim of this study (from Massachusetts General Hospital and Harvard School of Public Health) was to assess the risk for substance use disorders (SUD) associated with previous exposure to psychotropic medication in a longitudinal study of boys with attention-deficit/hyperactivity disorder (ADHD). The incidence of SUD throughout adolescence was compared in a sample of 56 medicated subjects with ADHD, 19 nonmedicated subjects with ADHD, and 137 non-ADHD control subjects. Nonmedicated subjects with ADHD were at a significantly increased risk for any SUD at follow-up compared with non-ADHD control subjects. Subjects with medicated ADHD were at a significantly reduced risk for a SUD at follow-up relative to nonmedicated subjects with ADHD. The take-home message was that untreated ADHD was a significant risk factor for SUD in adolescence, but pharmacotherapy was associated with a significantly reduced risk.