Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men

Abstract

We investigated whether adult attention-deficit/hyperactivity disorder (ADHD) predicts risky substance use and substance use disorders (SUDs), and its impact on the course of these problematic substance use patterns. Our sample included 4975 Swiss men (mean age 20 ± 1.2 years) who participated in the baseline and 15-month follow-up assessments of the Cohort Study on Substance Use Risk Factors. We examined: (1) the contribution of ADHD, as assessed at baseline, on the risky use of alcohol, nicotine and cannabis, and their corresponding use disorders (AUD, NUD, CUD) at follow-up; and (2) the association between ADHD and the course of outcomes (i.e., absence, initiation, maturing out, persistence) over 15 months. All analyses were adjusted for socio-demographics and co-morbidity. Men with ADHD were more likely to exhibit persistent risky alcohol and nicotine use, and to mature out of risky cannabis use. ADHD at baseline was positively linked to AUD and negatively to CUD at follow-up, but not to NUD. For all SUDs, ADHD had a positive association with use persistence and maturing out. Comparing these two trajectories revealed that early age of alcohol use initiation distinguished between persistence and maturing out of AUD, while the course of NUD and CUD was related to ADHD symptoms and SUD severity at baseline. Already in their early twenties, men with ADHD are especially likely to exhibit persistent problematic substance use patterns. Substance-specific prevention strategies, particularly implemented before early adulthood, may be crucial to reducing the development and persistence of pathological patterns in such individuals.

Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder

“…The observed higher ADHD symptom severity in comorbid individuals in this sample, especially impulsivity, might also resemble a predisposing factor for developing a comorbidity of AUD in ADHD. As proposed in other studies, ADHD individuals are more susceptible to developing AUD (Charach et al, 2011;Estévez-Lamorte et al, 2019;Estévez et al, 2015;Lee et al, 2011;Wilens & Morrison, 2011). Increased impulsivity (Pedersen et al, 2016;Roberts et al, 2014) and decreased inhibitory control (Smith et al, 2014) have been associated with the development of AUD.…”

“…The worldwide prevalence of adult ADHD is estimated to be 2.8% in the general population (Fayyad et al, 2017). ADHD increases the risk for heavy substance use or developing a substance use disorder (SUD), particularly alcohol use disorder (AUD; Charach, Yeung, Climans, & Lillie, 2011;Estévez-Lamorte et al, 2019;Estévez et al, 2015;Lee, Humphreys, Flory, Liu, & Glass, 2011;Vogel et al, 2016;Wilens & Morrison, 2011). Within the AUD population, prevalence of adult ADHD ranges from 7.7% to 21.1%, with a rate of 20.5% in a German sample (Daigre et al, 2015;Luderer et al, 2018;Reyes et al, 2016;Roncero et al, 2019).…”

“…Within the AUD population, prevalence of adult ADHD ranges from 7.7% to 21.1%, with a rate of 20.5% in a German sample (Daigre et al, 2015;Luderer et al, 2018;Reyes et al, 2016;Roncero et al, 2019). The increased prevalence of ADHD in adults with AUD seems to be greatly attributable to ADHD individuals being more susceptible to early alcohol use, a persisting risky drinking behavior and is predictive of the maintenance of AUD in later life (Charach et al, 2011;Estévez-Lamorte et al, 2019;Estévez et al, 2015;Lee et al, 2011;Wilens & Morrison, 2011). The cooccurrence of these disorders might be due to shared genetics (Capusan, Bendtsen, Marteinsdottir, Kuja-Halkola, & Larsson, 2015;Edwards & Kendler, 2012) or neuropsychological factors such as increased impulsivity (Pedersen et al, 2016;Roberts, Peters, Adams, Lynam, & Milich, 2014) or decreased inhibitory control (Smith, Mattick, Jamadar, & Iredale, 2014).…”

Screened Attention Deficit/Hyperactivity Disorder as a Predictor of Substance Use Initiation and Escalation in Early Adulthood and the Role of Self-Reported Conduct Disorder and Sensation Seeking: A 5-Year Longitudinal Study with Young Adult Swiss Men

“…Molina et al [12] observed an escalation of alcohol, tobacco, cannabis, and illicit drug use throughout adolescence until the age of 21, and a decline in alcohol, tobacco, and cannabis use thereafter. Another study by Estévez-Lamorte et al [50], using the same sample as Vogel et al [30], found that a subsample of the ADHD S+ group showed maturation out of alcohol, nicotine, and CUDs and risky cannabis use. Breyer et al [16] and Levy et al [19] did not observe any change in SUD prevalence rates over time.…”

ADHS bei erwachsenen Patienten mit Substanzkonsumstörungen

“…Viele Betroffene leiden auch an einer gestörten Affektregulation. Die Erkrankung ist mit einem erhöhten Risiko für verschiedenste psychische Störungen verbunden, insbesondere eine Substanzkonsumstörung (SKS; [8,29]).…”