Substance Use Among Adolescents with Attention-Deficit/Hyperactivity Disorder: Reasons for Use, Knowledge of Risks, and Provider Messaging/Education

Abstract

Objective Adolescents with ADHD are at increased risk for alcohol and marijuana use. This study’s objective is to describe adolescents’ ADHD-specific reasons for marijuana use, knowledge of ADHD-specific alcohol risks, and reported subspecialty provider messaging/education regarding alcohol use among adolescents with ADHD. Methods Youths with ADHD ages 12–18 years completed a survey about alcohol and marijuana use, ADHD-specific reasons for marijuana use, knowledge of ADHD-specific alcohol risks, and reported provider messaging/education regarding alcohol use. We assessed knowledge towards substance use using descriptive statistics. We used chi-square and t-tests to determine if knowledge or provider messaging/education differed by sociodemographic characteristics. Results Of the 96 participants, 61.5% were male, average age was 15.7 years; 31.3% reported past year alcohol use and 20.8% reported past year marijuana use. The majority (65.2%) said “no/don’t know” to both “Can alcohol make ADHD symptoms worse?” and “Can alcohol interfere or get in the way of the medications you take?”. Older participants were more likely to correctly answer the medication question “yes”. Despite most (74%) participants reporting that their provider asked about alcohol use, few youth reported that their providers gave specific messages/education that alcohol could make ADHD symptoms worse (9.4%) or interfere with ADHD medications (14.6%); older participants and past-year alcohol users were more likely to have received these alcohol specific messages. Conclusion Many youth with ADHD are unaware of the risks of alcohol use in relation to ADHD and providers are not consistently discussing these risks in the context of clinical ADHD care.

Neurodevelopmental Effects of Cannabis Use in Adolescents and Emerging Adults with ADHD: A Systematic Review

“…53 Similarly, adolescents with ADHD who use cannabis have often reported thinking that it would lead to improvement in their ADHD symptoms. 54 These observations are in line with globally increasing trends in adolescent cannabis use in the face of decreased use of other illicit substances. 55 Together with other factors, such as tetrahydrocannabinol (THC) potency roughly tripling from 1995 to 2014, 56 it is increasingly critical to establish the links between ADHD and cannabis use and their shared impact on neurodevelopmental outcomes.…”

“…By contrast, high school seniors do not perceive cannabis to be particularly risky, with only 26.7% reporting use as harmful 53 . Similarly, adolescents with ADHD who use cannabis have often reported thinking that it would lead to improvement in their ADHD symptoms 54 . These observations are in line with globally increasing trends in adolescent cannabis use in the face of decreased use of other illicit substances 55 .…”

Pediatric Subspecialist Alcohol Screening Rates and Concerns About Alcohol and Cannabis Use Among Their Adolescent Patients

“…We have previously reported that youth who report having been asked about whether they use alcohol were more likely to have also received advice or counseling regarding alcohol [10], thus failure to screen in subspecialty care may represent a missed opportunity. Accurate information from a healthcare provider may take particular importance as parents of children with chronic medical conditions may not be aware of the unique vulnerabilities of their children [17].…”