International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder

Özgen, Heval; Spijkerman, Renske; Noack, Moritz; Holtmann, Martin; Schellekens, Arnt; Glind, Geurt van de; Banaschewski, Tobias; Barta, Csaba; Begeman, Alex; Casas, Miguel; Crunelle, Cleo L.; Daigre, Constanza; Dalsgaard, Søren; Demetrovics, Zsolt; Boer, Jacomine den; Dom, Geert; Eapen, Valsamma; Faraone, Stephen V.; Franck, Johan; González, Rafael A.; Grau-López, Lara; Groenman, Annabeth P.; Hemphälä, Malin; Icick, Romain; Johnson, Brian; Kaess, Michael; Kapitány-Fövény, Máté; Kasinathan, John; Kaye, Sharlene; Kiefer, Falk; Konstenius, Maija; Levin, Frances R.; Luderer, Mathias; Martinotti, Giovanni; Matthys, Frieda; Mészáros, Gergely; Moggi, Franz; Munasur-Naidoo, Ashmita P; Post, Marianne; Rabinovitz, Sharon; Ramos-Quiroga, Josep Antoni; Sala, Regina; Shafi, Abu; Slobodin, Ortal; Thomasius, Rainer; Truter, Ilse; Kernebeek, Michiel W van; Vélez-Pastrana, María C.; Vollstädt‐Klein, Sabine; Vorspan, Florence; Young, Jesse T; Yule, Amy; Brink, Wim van den; Hendriks, Vincent M.

doi:10.1159/000508385

Cited by 33 publications

(26 citation statements)

References 55 publications

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“…In the short run, it could also show some antidepressant properties, thus explaining the data observed at the HAM-D. The detection of methylphenidate among the prescription drugs reported in our sample may indicate some level of comorbidity between adult ADHD and SUD, as recently reported (51).…”

Section: Discussionsupporting

confidence: 85%

Prescription Drug Misuse in “Clubbers” and Disco Goers in Ibiza

et al. 2020

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Background: Prescription drug misuse and its related risks are considered a worldwide public health issue. Current trends show that the extent of such phenomenon may not be limited to subjects with psychiatric disorders, as it also spreads to dance party and nightclub attendees, who often consume prescription drugs in combination with alcohol and psychoactive substances. This study aims to report the sociodemographic data and the psychiatric and clinical features of a sample of clubbers reporting prescription drugs use.Methods: Patients admitted to the psychiatry ward of the Can Misses Hospital in Ibiza were recruited for the study during a span of four consecutive years (2015–2018). The inclusion criteria were age 18–75 years old and the intake of psychoactive substances or more than five alcohol units during the previous 24 h. Substance use habits, psychopathological features, and use of unprescribed pharmaceuticals were investigated. Urine samples were collected and analyzed using gas chromatography/mass spectrometry.Results: A total of 110 subjects with psychoactive substance intoxication were recruited for the study. Among these, 37 (40%) disclosed the use of prescription drugs without medical supervision. The most common compounds were benzodiazepines (66%), antiepileptic drugs (8%), antidepressants (6%), opioids (6%), antipsychotics (6%), stimulants (6%), and non-steroidal anti-inflammatory drugs (NSAIDs, 2%). Prescription drug misuse was negatively associated with the use of psychodysleptics (two-tailed Fisher's exact test p = 0.018, ρ = −0.262).Conclusions: The use of prescription drugs is also common among clubbers, usually characterized by low propensity to be prescribed benzodiazepines, antipsychotics, or antidepressants. Prescription drugs may be an alternative to classic and novel psychoactive compounds or may be used to tamper and self-medicate the effects determined by the use of substances. Party goers should be adequately informed about possible risks of co-intake of psychoactive substances and prescription drugs to prevent serious medical and psychiatric consequences.

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Section: Discussionsupporting

confidence: 85%

Prescription Drug Misuse in “Clubbers” and Disco Goers in Ibiza

et al. 2020

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“…Research has also shown that among adults with a SUD, 23% also meet the criteria for ADHD, and even impulsivity facets without the diagnosis of ADHD were related to a higher prevalence of alcohol disorders [25]. The results of our study support a recent modified Delphi study in which a multidisciplinary group of 55 experts from 17 countries agree on the statement that routine screening for ADHD is recommended in substance abuse treatment [26].…”

Section: Discussionsupporting

confidence: 82%

The co-occurrence of mental disorders among Dutch adolescents admitted for acute alcohol intoxication

et al. 2020

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Adolescents with substance use disorders are often diagnosed with co-occurring mental disorders. However, it is unknown if adolescent hospital admission for acute alcohol intoxication is also associated with co-occurring mental disorders. Therefore, the primary aim of this study is to estimate the prevalence of co-occurring mental disorders among Dutch adolescents admitted for acute alcohol intoxication. Secondly, this study aims to explore the cross-sectional relationship between the co-occurrence of mental disorders and patient characteristics, such as sex, age and blood alcohol concentration at admittance. Data were retrospectively collected from 726 adolescents admitted for acute alcohol intoxication. Overall, 245 (34%) of the 726 adolescents treated for acute alcohol intoxication were diagnosed with a co-occurring mental health disorder, such as attention-deficit hyperactivity disorder (13%) or autism spectrum disorder (2.1%). Attention-deficit hyperactivity disorder in particular seems to be more prevalent in the study population than in the general Dutch adolescent population. Conclusion: This study demonstrates that among adolescents admitted for acute alcohol intoxication, the prevalence of co-occurring mental disorders is a common and a relevant issue for treatment and prevention strategies. What is Known:• Alcohol consumption among adolescents has been associated with negative psychosocial effect.• Among adolescents admitted for acute alcohol intoxication, risk factors for psychological dysfunction appear to be inadequately assessed, documented and followed up. What is New:• The current study reports on the prevalence of co-occurring mental disorders among a substantial sample of adolescents admitted for acute alcohol intoxication.• Understanding the prevalence of co-occurring mental disorders is clinically relevant for the outpatient follow-up of adolescents admitted for acute alcohol intoxication.

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“…Treatment of adolescents with comorbid ADHD and SUD is still in its infancy, however, pharmacotherapy with higher than standard doses if needed should be explored within the context of a beneficial psychosocial environment and without unnecessary exposure of these adolescents to unpleasant complementary treatment [90]. In addition, we need more research investigating the efficacy of psychosocial and complementary inventions both in ADHD-only patients and in patients with comorbid ADHD and SUD.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review

Özgen

Spijkerman

Noack

et al. 2021

JCM

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Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for the development of substance abuse and substance use disorders (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment, and is associated with poor treatment outcomes. In this study, we provide a systematic review of controlled studies on the effectiveness of pharmacological, psychosocial, and complementary treatments of ADHD in adolescents with and without comorbid SUD. In addition, we review the longitudinal association between pharmacotherapy for childhood ADHD and the development of SUD in adolescence and early adulthood. We conducted a systematic review of the research literature published since 2000 using Medline, PsycINFO, and the Cochrane Database of Systematic Reviews databases to select randomized clinical trials, observational studies, and meta-analyses. The quality of the evidence from each study was rated using the SIGN grading system. Based on the limited evidence available, strong clinical recommendations are not justified, but provisionally, we conclude that stimulant treatment in children with ADHD may prevent the development of SUD in adolescence or young adulthood, that high-dose stimulant treatment could be an effective treatment for adolescents with ADHD and SUD comorbidity, that cognitive behavior therapy might have a small beneficial effect in these patients, and that alternative treatments are probably not effective. More studies are needed to draw definitive conclusions that will allow for strong clinical recommendations.

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International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder

Abstract: Heval Özgen, Renske Spijkerman, Wim van den Brink and Vincent Hendriks contributed equally to this paper.

Cited by 33 publications

References 55 publications

Prescription Drug Misuse in “Clubbers” and Disco Goers in Ibiza

Prescription Drug Misuse in “Clubbers” and Disco Goers in Ibiza

The co-occurrence of mental disorders among Dutch adolescents admitted for acute alcohol intoxication

Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review

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