@article {267, title = {ADHD Medication and Substance-Related Problems}, journal = {American Journal of Psychiatry}, volume = {174}, year = {2017}, pages = {877-885}, abstract = {

Objective: substance use disorders are major contributors to excess mortality among individuals with attention deficit hyperactivity disorder (ADHD), yet associations between pharmacological ADHD treatment and substance-related problems remain unclear. This study investigated concurrent and long-term associations between ADHD medication treatment and substance-related events.

Method: the authors analyzed 2005\–2014 commercial health care claims from 2,993,887 (47.2\% female) adolescent and adult ADHD patients. Within-individual analyses compared the risk of substance-related events (i.e., emergency department visits related to substance use disorders) during months in which patients received prescribed stimulant medication or atomoxetine relative to the risk during months in which they did not.

Results: in adjusted within-individual comparisons, relative to periods in which patients did not receive ADHD medication, male patients had 35\% lower odds of concurrent substance-related events when receiving medication (odds ratio=0.65, 95\% CI=0.64\–0.67), and female patients had 31\% lower odds of concurrent substance-related events (odds ratio=0.69, 95\% CI=0.67\–0.71). Moreover, male patients had 19\% lower odds of substance-related events 2 years after medication periods (odds ratio=0.81, 95\% CI=0.78\–0.85), and female patients had 14\% lower odds of substance-related events 2 years after medication periods (odds ratio=0.86, 95\% CI= 0.82\–0.91). Sensitivity analyses supported most findings but were less consistent for long-term associations among women.

Conclusions: these results provide evidence that receiving ADHD medication is unlikely to be associated with greater risk of substance-related problems in adolescence or adulthood. Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.

}, doi = {10.1176/appi.ajp.2017.16060686}, url = {https://doi.org/10.1176/appi.ajp.2017.16060686}, author = {Quinn, Patrick D. and Chang, Zheng and Hur, Kwan and Gibbons, Robert D. and Benjamin B Lahey and Rickert, Martin E. and Sj{\"o}lander, Arvid and Lichtenstein, Paul and Henrik Larsson and D{\textquoteright}Onofrio, Brian M.} } @article {253, title = {Childhood attention-deficit/hyperactivity disorder symptoms and the development of adolescent alcohol problems: A prospective, population-based study of Swedish twins}, journal = {American Journal of Medical Genetics Part B: Neuropsychiatric Genetics}, volume = {171}, year = {2016}, pages = {958-970}, abstract = {

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of problematic alcohol and other substance use in adolescence. This study used data from an ongoing, prospective, population-based twin study of Swedish children and adolescents to evaluate the extent to which the association between ADHD symptoms and alcohol problems reflects a unique source of genetic or environmental risk related to ADHD versus a broader predisposition to youth externalizing behavior. We used all available data from same-sex monozygotic (MZ) and dizygotic (DZ) twins on ADHD symptoms in childhood (age 9/12; N\ =\ 15,549) and alcohol problems in late adolescence (age 18; N\ =\ 2,564). Consistent with prior longitudinal studies, the phenotypic association between hyperactive/impulsive ADHD symptoms and alcohol problems was small in magnitude, whereas the association for inattentive symptoms was even weaker. Additive genetic influences explained 99.8\% of the association between hyperactive/impulsive symptoms and alcohol problems. Furthermore, we found that the genetic risk specifically associated with hyperactive/impulsive symptoms was attenuated when estimated in the context of externalizing behavior liability during childhood, of which ADHD symptoms were specific expressions. In sensitivity analyses exploring hyperactivity in mid-adolescence, we found a similar pattern of genetic associations. These results are consistent with previous findings of genetically driven overlap in the etiology of ADHD and problematic alcohol use. At least some of this co-occurrence may result from a general predisposition to externalizing behaviors in youth. \© 2015 Wiley Periodicals, Inc.

}, keywords = {ADHD, behavioral genetics, externalizing, neurodevelopmental problems, substance misuse}, doi = {10.1002/ajmg.b.32412}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.b.32412}, author = {Quinn, Patrick D. and Erik Pettersson and Lundstr{\"o}m, Sebastian and Anckars{\"a}ter, Henrik and L{\r a}ngstr{\"o}m, Niklas and Gumpert, Clara Hellner and Henrik Larsson and Lichtenstein, Paul and D{\textquoteright}Onofrio, Brian M.} }