Boys Treated With Ritalin, Other Stimulants Less Likely to Abuse Drugs Later

[Drug Benefit Trends 11(9):12-BH, 1999. © 1999 Cliggott Publishing Co., Division of SCP/Cliggott Communications, Inc.]

Boys with attention-deficit hyperactivity disorder (ADHD) who are treated with stimulants such as ritalinare significantly less likely to abuse drugs and alcohol when they get older, according to a new study funded by the NIH. The study, which appears in the August 2nd issue of Pediatrics,compared three groups of boys -- those with ADHD who had been treated with stimulants, those with ADHD who had not been treated with stimulants, and those without ADHD -- and their susceptibility to substance abuse.

ADHD is usually treated with stimulants, such as methylphenidate (Ritalin) or dextroamphetamine dexedrine, Adderall), because these drugs reduce patients' behavioral and attentional problems. As a result, children with ADHD perform better in school and on the job and relate better to family and friends. Research indicates that between 3% and 5% of school-age children have ADHD and that the disorder is about four times more prevalent among boys than girls.

"While some clinicians have expressed concern about giving stimulants to children with ADHD because they fear it might increase the risk that these children will abuse stimulants and other drugs when they get older, this study shows exactly the opposite," says National Institute on Drug Abuse (NIDA) Director Alan I. Leshner. "Treating the underlying disorder, even if with stimulants, significantly reduces the probability they will use drugs later on."

In the study, researchers compared the incidence of substance use disorder in 56 boys with ADHD who had been treated with stimulants for an average of 4 years, in boys with ADHD who had not been treated with stimulants for an average of 4 years, in 19 boys with ADHD who had not been treated with stimulants, and in 137 boys without ADHD. All boys were at least 15 years old when they were evaluated for substance use disorders involving alcohol, marijuana, hallucinogens, stimulants, or cocaine. In a substance use disorder, a person continues to use a mood- or behavior-altering substance despite the fact that this substance causes significant problems in the person's life.

Results of the study showed that 75% of the nonmedicated boys with ADHD had at least one substance use disorder, compared to 25% of medicated boys with ADHD and 18% of the boys who did not have ADHD. The researchers calculated that treating ADHD with medication (stimulants were used in more than 90% of cases) was associated with an 84% reduction in risk of developing a substance use disorder. The researchers will continue to monitor this entire group of boys in a follow-up study funded by the NIDA.