ADHD as a risk factor for early onset and heightened adult problem severity of illicit substance use: An accelerated gateway model

Abstract

The primary aims of the present study were to assess ADHD history as a risk factor for earlier initiation and current use of licit and illicit substances among a sample of drug using adults. It was hypothesized that ADHD history would accelerate the Gateway Theory of drug use. Participants included 941 drug-using African American and Caucasian individuals in Baltimore, Maryland. The sample consisted of 124 (13.2%) participants who reported a history of ADHD and 817 (86.8%) who reported no history of ADHD. The accelerated gateway hypothesis was supported, as a history of self-reported ADHD was significantly associated with younger ages of initiation for alcohol, cigarettes, marijuana, and cocaine use. Participants with a history of ADHD were also more likely to engage in recent HIV-risk behavior, such as injection drug use and needle sharing. This study provides compelling data in support of an accelerated gateway model for substance use related to ADHD history and increased problem severity in adulthood. Targeted substance use prevention and intervention may be beneficial for those with ADHD.

Attention deficit hyperactivity disorder and drug addiction rehabilitation patients

“…Corroborating this finding, Dunne et al 16 found a lower age at first use of cocaine among patients with ADHD in a study of 941 substance users, and Carroll et al 17 reported a similar finding in a study of 298 patients undergoing treatment for cocaine dependence.…”

“…A larger sample or a sample consisting of patients with a higher degree of dependence might produce results similar to those reported in other studies. 16,18 In the ADHD patients in therapeutic communities, a lower age at first use of cannabis in patients with ADHD appears to lead to heavier use of cannabis as well as cocaine. These correlations are specific to the ADHD group, once they were not identified in the group without ADHD or in the overall group.…”

Point Prevalence of Co-Occurring Behavioral Health Conditions and Associated Chronic Disease Burden Among Adolescents

“…18 Furthermore, studies have found high rates of SUDs among adolescents with ADHD. [19][20][21] Mood disorders have also been found to be significantly associated with SUDs, including alcohol, marijuana, tobacco, and polysubstance use. 22,23 Despite the high prevalence of BHCs among adolescents, many go unidentified and untreated.…”

Preschool hyperactivity is associated with long‐term economic burden: evidence from a longitudinal health economic analysis of costs incurred across childhood, adolescence and young adulthood

“…ADHD has a substantial negative impact on daily functioning and achievement in multiple domains (Polderman, Boomsma, Bartels, Verhulst, & Huizink, 2010). In the long term, ADHD is linked to reduced academic performance (Holmberg & Bolte, 2014), more limited employment prospects (Fletcher, 2014), increased risk of criminality (Dalsgaard, Mortensen, Frydenberg, & Thomsen, 2013), substance use (Dunne, Hearn, Rose, & Latimer, 2014), risky sexual behaviour (Sarver, McCart, Sheidow, & Letourneau, 2014) and relationship difficulties (Moya, Stringaris, Asherson, Sandberg, & Taylor, 2014). ADHD in childhood increases the risk of low socio‐economic status (SES) in adult life (Galera et al., 2012).…”