Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study.
BACKGROUND
Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample.


METHODS
Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25.


RESULTS
In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups.


CONCLUSIONS
Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels.
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D000293:Adolescent D000328:Adult D000428:Alcohol Drinking D001289:Attention Deficit Disorder with Hyperactivity D002170:Canada D002648:Child D000073865:Cigarette Smoking D005260:Female D006801:Humans D008137:Longitudinal Studies D008297:Male D000074609:Marijuana Use D019966:Substance-Related Disorders D014481:United States D055815:Young Adult
adolescence ADHD Attention deficit disorder drug abuse