Substance Use Among Adolescents with Attention-Deficit/Hyperactivity Disorder: Reasons for Use, Knowledge of Risks, and Provider Messaging/Education.
Elizabeth Harstad, Lauren E Wisk, Rosemary Ziemnik and 4 others
PMID 28661957WHAT IT FOUND
Most adolescents with ADHD did not know alcohol could worsen symptoms or interfere with medication, and few received ADHD-specific alcohol messages from providers.
Screening was common, but tailored risk education was not.
Key findings
01Most participants answered incorrectly when asked whether alcohol could make ADHD symptoms worse (62.5%) and whether it could interfere with medications (62.5%).
02Among past-year marijuana users, 61% said they used it because they thought it would improve ADHD symptoms or help medication side effects, and 56% said they chose it instead of alcohol because they thought alcohol was worse for their ADHD.
03Most participants reported being asked about alcohol by a provider (74%), but only 9.4% were told alcohol could make ADHD symptoms worse, 14.6% were told it could interfere with medications, and 69.8% reported receiving none of four specific messages.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample was relatively small and homogeneous, with all participants recruited from one developmental subspecialty clinic. Findings may not generalise to adolescents seen by primary care physicians or to those in other geographic areas. The study may have been underpowered to detect some differences by demographics. Participants were already receiving subspecialty ADHD care, so their knowledge and substance use may differ from other ADHD populations. Current level of ADHD symptoms was not reported, so substance use by symptom severity could not be examined. Co-morbid conditions were not collected, and the short mental health screen may not have captured existing mental health problems. Alcohol and marijuana use rates were lower than the MTA study, possibly because of age differences and past-year versus lifetime recall. Provider screening and messages were reported by adolescents rather than observed or reported by providers, so recall may be incomplete.
Declared interests
The authors reported no conflicts of interest to disclose.
The easy way to misread this
Do not read this as evidence that provider screening or education reduces substance use, or that marijuana helps ADHD. The study was cross-sectional self-report and did not test an intervention. It found many adolescents believed marijuana could help ADHD symptoms, while most did not know alcohol risks.