Early ADHD Medication Use: No Substance Abuse Link
Author: University of Michigan
Published: 2016/06/09 - Updated: 2025/12/28
Publication Details: Peer-Reviewed, Research, Study, Analysis
Category Topic: Pharmaceuticals - Related Publications
Page Content: Synopsis - Introduction - Main - Insights, Updates
Synopsis: This research examines medication patterns and substance abuse risk among American high school seniors, drawing on data from over 40,000 participants across ten cohorts between 2005 and 2014. Conducted by University of Michigan researchers and published in the Journal of the American Academy of Child & Adolescent Psychiatry, the study found that youth who began stimulant medication for ADHD early and maintained longer treatment showed no increased risk of substance abuse compared to teens without ADHD - a finding that addresses persistent concerns among parents and healthcare providers. However, the research identified a critical concern: teens who started stimulant medications late, during middle or high school, did show elevated substance use risk, suggesting that timing of treatment initiation matters significantly. The findings also revealed that males were more likely to use stimulant therapy while showing no gender differences in nonstimulant medication use - Disabled World (DW).
Introduction
Youth who take Ritalin, Adderall or other stimulant medications for attention deficit hyperactivity disorder (ADHD) over an extended period of time early in life are no more at risk for substance abuse in later adolescence than teens without ADHD, according to a University of Michigan study.
Main Content
The findings also show that teens who start using stimulant medications for attention deficit hyperactivity disorder for a short time later in adolescence - during middle or high school - are at high risk of substance use..
The U-M research is believed to be the first national study to compare early-use and longer-duration stimulant medication therapy with nonstimulant therapy for ADHD.
A large sample size of high school seniors also meant researchers could separate doctor-prescribed ADHD medication use by gender. The results show no gender differences in the overall associations between stimulant medication therapy for ADHD and risk of substance use, said Sean Esteban McCabe, a research professor at the U-M Institute for Research on Women and Gender.
More than 40,000 individuals from 10 cohorts nationwide between 2005 to 2014, answered questions about ADHD medication use and recent substance use as part of the Monitoring the Future study.
Among the Findings
- Nearly one in eight high school seniors in the U.S. have used stimulant or nonstimulant medication therapy for ADHD.
- Males are more likely to use stimulant medication therapy for ADHD, while no gender differences were found for nonstimulant medication therapy.
Given that higher substance-use behaviors are associated with later initiation of stimulant medications for ADHD during adolescence, the researchers recommend monitoring this later initiation subgroup carefully for pre-existing risk factors or the onset of substance use behaviors.
About the Study
McCabe collaborated with Kara Dickinson, former intern at the U-M Institute for Research on Women and Gender; Brady West, research associate professor at the U-M Institute for Social Research; and Dr. Timothy Wilens of Massachusetts General Hospital and Harvard University.
The findings appear in the current issue of the Journal of the American Academy of Child & Adolescent Psychiatry.
The National Institute on Drug Abuse and National Institutes of Health supported research grants for the study.
Insights, Analysis, and Developments
Editorial Note: The significance of this study lies not merely in what it debunks - the long-standing worry that early ADHD medication leads to substance abuse - but in what it reveals about the heterogeneity of at-risk populations. The distinction between early, sustained treatment and late initiation suggests that substance abuse risk among adolescents may reflect pre-existing vulnerabilities or co-occurring conditions rather than medication itself. For individuals with ADHD and their families navigating treatment decisions, the findings offer reassurance about early intervention while simultaneously flagging the need for more intensive monitoring and assessment when treatment begins later in adolescence - Disabled World (DW).Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by University of Michigan and published on 2016/06/09, this content may have been edited for style, clarity, or brevity.