{"title":"管理患有物质使用障碍(SUD)的成人并发注意力缺陷多动障碍(ADHD):成瘾专家需要知道的","authors":"Joe Johnson, Sarah Morris, Sanju George","doi":"10.1097/ADT.0000000000000237","DOIUrl":null,"url":null,"abstract":"Attention deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) often co-exist and the link between the 2 is bidirectional, with higher rates of ADHD symptoms found in the SUD population and higher rates of SUD found among the ADHD population. Some possible mechanisms which could explain the increased risk of developing a SUD in those who have ADHD include self-medication, both ADHD and SUD arising from dysregulation of 1 or more of the dopaminergic circuits, genetic factors as well exposure to parental SUD. Given the complex relationship between ADHD and SUD, those working in SUD services should be vigilant to ADHD as a possible comorbid diagnosis and refer to a specialist ADHD service for further assessment where appropriate. On the basis of a detailed clinical assessment, it has to be decided whether SUD or ADHD should be the priority for treatment or if they both ought to be; in either case, ADHD and SUD treatment services must work collaboratively. The recommended first line pharmacological treatment option for adolescents and adults with ADHD is a stimulant medication, with nonstimulants being reserved as a second or third line option. In the brief review paper, the authors further discuss the various medications for treatment of ADHD, the benefits and risks of treating ADHD in those with SUD, discuss the role of specialist ADHD treatment services, and illustrate these with the help of 2 anonymized case vignettes.","PeriodicalId":44600,"journal":{"name":"Addictive Disorders & Their Treatment","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Managing Comorbid Attention Deficit Hyperactivity Disorder (ADHD) in Adults With Substance Use Disorder (SUD): What the Addiction Specialist Needs to Know\",\"authors\":\"Joe Johnson, Sarah Morris, Sanju George\",\"doi\":\"10.1097/ADT.0000000000000237\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Attention deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) often co-exist and the link between the 2 is bidirectional, with higher rates of ADHD symptoms found in the SUD population and higher rates of SUD found among the ADHD population. Some possible mechanisms which could explain the increased risk of developing a SUD in those who have ADHD include self-medication, both ADHD and SUD arising from dysregulation of 1 or more of the dopaminergic circuits, genetic factors as well exposure to parental SUD. Given the complex relationship between ADHD and SUD, those working in SUD services should be vigilant to ADHD as a possible comorbid diagnosis and refer to a specialist ADHD service for further assessment where appropriate. On the basis of a detailed clinical assessment, it has to be decided whether SUD or ADHD should be the priority for treatment or if they both ought to be; in either case, ADHD and SUD treatment services must work collaboratively. The recommended first line pharmacological treatment option for adolescents and adults with ADHD is a stimulant medication, with nonstimulants being reserved as a second or third line option. In the brief review paper, the authors further discuss the various medications for treatment of ADHD, the benefits and risks of treating ADHD in those with SUD, discuss the role of specialist ADHD treatment services, and illustrate these with the help of 2 anonymized case vignettes.\",\"PeriodicalId\":44600,\"journal\":{\"name\":\"Addictive Disorders & Their Treatment\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2020-12-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Addictive Disorders & Their Treatment\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/ADT.0000000000000237\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addictive Disorders & Their Treatment","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/ADT.0000000000000237","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Managing Comorbid Attention Deficit Hyperactivity Disorder (ADHD) in Adults With Substance Use Disorder (SUD): What the Addiction Specialist Needs to Know
Attention deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) often co-exist and the link between the 2 is bidirectional, with higher rates of ADHD symptoms found in the SUD population and higher rates of SUD found among the ADHD population. Some possible mechanisms which could explain the increased risk of developing a SUD in those who have ADHD include self-medication, both ADHD and SUD arising from dysregulation of 1 or more of the dopaminergic circuits, genetic factors as well exposure to parental SUD. Given the complex relationship between ADHD and SUD, those working in SUD services should be vigilant to ADHD as a possible comorbid diagnosis and refer to a specialist ADHD service for further assessment where appropriate. On the basis of a detailed clinical assessment, it has to be decided whether SUD or ADHD should be the priority for treatment or if they both ought to be; in either case, ADHD and SUD treatment services must work collaboratively. The recommended first line pharmacological treatment option for adolescents and adults with ADHD is a stimulant medication, with nonstimulants being reserved as a second or third line option. In the brief review paper, the authors further discuss the various medications for treatment of ADHD, the benefits and risks of treating ADHD in those with SUD, discuss the role of specialist ADHD treatment services, and illustrate these with the help of 2 anonymized case vignettes.
期刊介绍:
Addictive Disorders & Their Treatment is a quarterly international journal devoted to practical clinical research and treatment issues related to the misuses of alcohol and licit and illicit drugs and the study and treatment of addictive disorders and their behaviors. The journal publishes broad-spectrum, patient-oriented coverage of all aspects of addiction, directed toward an audience of psychiatrists, clinical psychologists, psychopharmacologists, and primary care practitioners. Original articles help clinicians make more educated, effective decisions regarding optimal patient management and care. In-depth reviews examine current understanding, diagnosis, and treatment of addiction disorders.