Although ADHD is associated with an increased risk of drug
use and misuse (including smoking) in adolescence and although some
methylphenidate is diverted from appropriate clinical usage into
illicit usage, there is little evidence that treatment with
psychostimulants increases the risk of drug misuse. Wilens
presented as yet unpublished data at the 48th Annual Meeting of the
American Academy of Child and Adolescent Psychiatry that
systematically reviewed the literature to evaluate the effect of
treatment with stimulant medications on the subsequent development
of substance misuse.
Six longitudinal studies were identified (follow-up in three
was during adolescence and in three during adulthood). In five out
of the six studies, pharmacotherapy of ADHD was associated with a
significant reduction in the risk for substance misuse in mid
adolescence and early adulthood. In the three adolescent studies
(total N=489; mean age 16 years), rates of substance misuse were
lower in treated groups (12%) than untreated groups (30%). These
data do not support the notion that treatment of ADHD leads to
increased risks of substance misuse. They do, however, support the
counter argument that treating ADHD decreases the risks of later
substance misuse.