Substance use through adolescence into early adulthood after childhood‐diagnosed ADHD: findings from the MTA longitudinal study

• Published in: Journal of child psychology and psychiatry 2018-06, Vol.59 (6), p.692-702
• Main Authors: Molina, Brooke S.G., Howard, Andrea L., Swanson, James M., Stehli, Annamarie, Mitchell, John T., Kennedy, Traci M., Epstein, Jeffery N., Arnold, L. Eugene, Hechtman, Lily, Vitiello, Benedetto, Hoza, Betsy
• Format: Article
• Language: English
• Subjects: ADHD; adolescence; Adolescent; Adolescents; Adult; Adults; Age; Alcohol; Alcohol Drinking - epidemiology; Alcohol use; Attention deficit disorder; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Hyperactivity Disorder; Canada - epidemiology; Child; Child & adolescent psychiatry; Child development; Childhood; Cigarette Smoking - epidemiology; Cigarettes; Drug abuse; Female; Humans; Life course; Longitudinal Studies; Male; Marijuana; Marijuana Use - epidemiology; Medical screening; Medical treatment; Questionnaires; Smoking; Substance abuse; Substance-Related Disorders - epidemiology; United States - epidemiology; Young Adult; Young adults
• ISSN: 0021-9630; 1469-7610
• DOI: 10.1111/jcpp.12855

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.