Attention Deficit Hyperactivity Disorder and Obsessive-Compulsive Disorder among Former Heroin Addicts Currently in Methadone Maintenance Treatment

Abstract

Background: The aim of this study was to evaluate the prevalence of childhood and adulthood attention deficit hyperactivity disorder (ADHD) and clinical obsessive-compulsive disorder (OCD) among adult patients in methadone maintenance treatment (MMT) and to characterize possible risk factors. Sampling andMethods: A random sample of 154 current MMT patients was studied for childhood ADHD (Wender Utah Rating Scale), current clinical OCD (Yale-Brown Obsessive Compulsive Scale), lifetime trauma history and modified Addiction Severity Index for demographics, as well as any lifetime DSM-IV-TR psychiatric diagnosis. Results: Fifty-one patients (33.1%) had childhood ADHD, and more of this group currently had clinical OCD compared to patients who did not have childhood ADHD (55.3 vs. 30.1%). The two groups did not differ with regard to gender and age of admission to MMT. Logistic regression found that the childhood ADHD group had a higher risk of having OCD [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.6–8.8], more severe nicotine smoking (OR 1.4, 95% CI 1.1–1.7) and fewer years of education (OR 0.8, 95% CI 0.6–1) and were more likely to have a DSM-IV-TR axis II disorder (OR 4.3, 95% CI 1.4–13.4) and a history of falls (OR 4.3, 95% CI 1.4–12.9). Conclusions: Although ADHD is more prevalent among males in the general population, the rates in our MMT population were similar in each gender. One third of our sample had suffered from ADHD during childhood, which may have led them to self-medicate with drugs and thus to addiction. Childhood ADHD was associated with current OCD, and both conditions were highly prevalent among our MMT patients. The reason for a history of repeated falls warrants further study.

ADHD risk alleles associated with opiate addiction: study of addicted parents and their children

“…This emphasizes again the interaction between ADHD and drug dependence, as observed in many studies (17)(18)(19). The rate is higher in addicted males compared to addicted females, in line with the general higher prevalence of ADHD in males.…”

“…It is, however, well known that ADHD is a significant risk factor for drug abuse, and there is a high rate of ADHD among heroin-dependent persons (17)(18)(19), much higher than the 6-9% of ADHD in populations of normal children (20,21).…”

Differences in Methylphenidate Abuse Rates Among Methadone Maintenance Treatment Patients in Two Clinics

“…Our earlier study of ADHD among a random sample of 154 of our MMT patients (Peles, Schreiber, Sutzman, & Adelson, 2012) demonstrated that 33.1% of them had been diagnosed as having childhoodonset ADHD (a score N46), and they, too, were characterized as having few years of education. They also had more severe tobacco smoking, which is well known among ADHD population (McLernon & Kollins, 2008), and were more likely to have a DSM-IV-TR axis II disorder.…”

Comorbidity of attention deficit-hyperactivity disorder and substance use disorder

“…These two studies demonstrate an important effect of a childhood trauma history on ADHD and additional psychiatric symptoms. It has been reported that patients with opioid use disorder and ADHD patients under maintenance treatment show a high rate of obsessive-compulsive disorder (42). A study with outand inpatients in Turkey being treated for opioid use disorder found that a probable ADHD diagnosis is correlated with the severity of the psychopathology, especially in the obsessive-compulsive dimension, and that the severity of impulsivity (esp.…”