Adolescents with ADHD also were more likely to experiment with nicotine and illegal substances at earlier ages than those without ADHD, according to an analysis of 27 long-term studies that followed 4,100 ADHD and 6,800 non-ADHD children into young adulthood - in some cases for 10 years or more.
The study, by psychologists at the University of California-Los Angeles and the University of South Carolina-Columbia, was funded by the National Institute of Alcohol Abuse and Alcoholism. It was published online in the journal Clinical Psychology Review and will appear in the journal’s print edition this summer.
ADHD usually makes an appearance around age 8 or 9 as the learning environment in elementary school becomes more structured and academic expectations are more significant, says lead researcher Steve Lee, an assistant professor of clinical psychology at UCLA. It affects 5 percent to 7 percent of school-age children, he says; symptoms include persistent difficulty focusing and strong signs of hyperactive and impulsive behavior that interferes with learning and social activities.
That may seem like a description of many school-age children, and in fact these symptoms are common, Lee says. But for a clinical diagnosis of ADHD, he says, the behaviors must be developmentally extreme compared with other children, and must negatively affect a child’s social and academic functioning.
His analysis suggests that kids with ADHD are three times more likely to develop nicotine dependence, 1.5 times more likely to use marijuana, and twice as likely to use cocaine, compared with kids without ADHD.
An ADHD diagnosis both increased a child’s odds of ever having used nicotine or illicit drugs and predicted the likelihood of developing substance abuse problems in adolescence and adulthood, Lee says. That was true for boys and girls of all ages and races.
Still, for children with ADHD, substance abuse is not inevitable, says Brooke Molina, associate professor of psychology and psychiatry at the University of Pittsburgh. “This risk is roughly the same as the risk of alcoholism for a child of an alcoholic,” she says.
But why young people with ADHD are more likely to abuse substances is the million-dollar question.
Drugs may provide a temporary relief from the distress caused by the anxiety, social dysfunction, stress and conflict that can result from ADHD, Lee says.
He recommends parents stay aware of changes in a child’s social relationships, unexpected changes in mood, and notable declines in academic performance, as well as the signs and symptoms of substance use.
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