Psychiatric Comorbidity and Addiction Severity Differences in Patients With ADHD Seeking Treatment for Cannabis or Cocaine Use Disorders

Abstract

Objective: The objective of this study was to compare psychiatric comorbidity and consumption-related variables in ADHD patients seeking treatment for cocaine, cannabis, or both. Method: Assessment was conducted using European Addiction Severity Index (EuropASI), Conners’ Adult ADHD Diagnostic Interview (CAADID), Structured Clinical Interview for DSM Disorders (SCID), Adult Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Barratt Impulsiveness Scale-11 (BIS-11), and FIDI, with statistical analyses of analysis of variance (ANOVA), Student’s t test, chi-square test, and multinomial regression model. Results: In total, 1,538 patients with substance use disorder (SUD) were evaluated for ADHD; 239 (15.5%) had ADHD, with cannabis 41, cannabis/cocaine 36, and cocaine 74. Men represented 80%, with mean age of 32.9 ± 10 years. Significant variables were—in bivariate analysis—more years of cannabis use in cannabis group and younger age for cocaine use disorder in cannabis/cocaine group, and—in multivariate analysis—lifetime anxiety disorder and younger age at onset of any SUD in cannabis group and working affected scale in cannabis and polysubstance use in cannabis/cocaine group. Conclusion: Groups with cannabis use had higher severity. ADHD features were similar in all groups. The assessment of ADHD and comorbid disorders is important.

Genetic overlap and causality between substance use disorder and attention‐deficit and hyperactivity disorder

“…We also found evidence of genetic correlations between all traits considered in the study, namely ADHD, smoking initiation, age of smoking initiation, cigarettes per day, smoking cessation, alcohol or cocaine dependence and lifetime cannabis use. These results are in agreement with extensive literature showing poorer smoking outcomes and higher rates of polysubstance use and comorbidity between ADHD and SUD (Capusan et al, 2019; Hayley et al, 2017; Martínez‐Luna et al, 2019; van Emmerik‐van Oortmerssen et al, 2014) and add additional evidence for a common genetic background among these phenotypes (Du Rietz et al, 2018; Wimberley et al, 2019, Wilens, 2007; Vink et al, 2014; Chang et al, 2019).…”

Adult Attention-Deficit/Hyperactivity Disorder and Quality of Life in High-Dose Benzodiazepine and Related Z-Drug Users

“…Second, information on childhood ADHD was not systematically assessed, because of the absence of informants and the underdiagnosis of this condition [13]. A retrospective screening questionnaire for childhood ADHD, for example, the Wender Utah Rating Scale could assess potential childhood ADHD in adult patients without information from third parties and overcome this limitation in future studies [48][49][50]. Third, DDDE and poly-drug use were based on patients' self-report and not confirmed by urine or serum toxicology.…”

Exploring the Link Between Attention-Deficit Hyperactivity Disorder and Cannabis Use Disorders: A Review

“…Comorbidity between ADHD and SUDs is associated with increased cannabis use. Numerous studies have shown that individuals with ADHD and SUDs have an earlier onset of substance use and cannabis use [ 11 , 24 , 55 , 56 ]. Early cannabis use (ie, during adolescence) is linked to the disruption of functional circuit maturation-refinement [ 14 , 56 ].…”

“…Numerous studies have shown that individuals with ADHD and SUDs have an earlier onset of substance use and cannabis use [ 11 , 24 , 55 , 56 ]. Early cannabis use (ie, during adolescence) is linked to the disruption of functional circuit maturation-refinement [ 14 , 56 ]. Research indicates that 33.19–38.10% of adolescents with CUDs have a comorbid ADHD diagnosis.…”

“…Clinicians failing to assess cannabis use or patients failing to admit to such use can lead to possible erroneous (false-positive) ADHD diagnoses. Some research suggests that the high comorbidity between ADHD and CUDs may result from the latter inducing neurocognitive changes that mimic ADHD symptoms [ 56 ]. However, other findings argue that cannabis-induced cognitive changes alone cannot explain the relationship between ADHD and CUDs due to their commonalities, such as ECS dysfunction [ 59 ].…”