ADHD Medication and Crime Risk in Adolescents: Norway Study

Author: Elsevier
Published: 14 May 2024 - Updated: 4 Nov 2026
Publication Details: Peer-Reviewed | Observational Study

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This research, a peer reviewed study in the Journal of the American Academy of Child and Adolescent Psychiatry led by Dr. Tarjei Widding-Havneraas in Norway, examined whether medication for attention-deficit/hyperactivity disorder (ADHD) reduces crime among young people. Using national registry data on all 5,624 patients aged 10 to 18 who were diagnosed with ADHD in 2009 to 2011, and differences in how often clinics prescribed medication, the researchers found that treatment lowered violence and public-order charges over four years. It did not lower drug, traffic or property crimes. The study offers parents, clinicians and policymakers rare causal evidence on one of the most debated questions about ADHD treatment.*

At a Glance

1 - Patients with ADHD had a higher risk of all types of crime than the general population.
2 - The effect sizes mean many young people need to be treated to prevent one additional crime.
3 - In Norway, all ADHD treatment for children and adolescents takes place in the public healthcare system.
4 - Rates of medication treatment varied considerably between clinics, which shaped which patients were treated.

Topic Definition

Instrumental Variable Analysis: Instrumental variable analysis is a statistical method used to estimate cause and effect from observational data when a randomized trial is not possible. It relies on a third factor, the instrument, that strongly affects whether a person receives a treatment but has no direct effect on the outcome, such as a clinic's general prescribing preference, so that patients who differ only in that factor can be compared almost as if treatment had been assigned at random.

Overview

A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, found that pharmacological treatment of attention-deficit/hyperactivity disorder (ADHD) reduced violence and public-order related crimes. However, it did not reduce other types of crimes, among patients with ADHD in early to late adolescence considered to be in the gray zone (or on the margin) for such treatment.

This study uses variation in healthcare providers treatment preference as the basis for a quasi-experimental design that examines the effect of pharmacological treatment of ADHD on criminality among patients in the gray zone for treatment. Due to their healthcare providers' treatment preference, some patients may not receive pharmacological treatment.

This study found considerable variation in rates of pharmacological treatment of ADHD between clinics, which impacted patients' treatment. Pharmacological treatment of ADHD had a protective effect on violence- and public-order related charges, respectively, whereas there was no support for effects on other crimes (e.g., drugs, traffic, and property). Consistent with existing research this study also found that patients with ADHD had a higher risk of all types of crimes compared to the general population.

This is the first study to combine a quasi-experimental design with detailed population-wide registry data on types of crime and multiple years follow-up to assess effects of pharmacological treatment of ADHD on long-term criminal outcomes. Causal knowledge is challenging to establish since large-scale RCTs are ethically and practically unfeasible, while observational studies are limited by many potential confounding variables making treatment and control groups different. To address these issues, this study combines a quasi-experimental design with population-wide registry data on all patients aged 10 to 18 years who were diagnosed with ADHD in 2009-2011 (n=5,624), including their clinics, receipt of ADHD medication, and criminal charges with four years follow-up.

In these "instrumental variable" analyses, provider preference for pharmacological treatment acts as a source of randomization to treatment for patients in the gray zone for treatment where clinicians' treatment decisions vary most. The logic can be illustrated by two patients with ADHD who are otherwise similar apart from one patient being treated due to seeing a clinician with a high treatment preference, whereas the other is not treated due to seeing a clinician with a low treatment preference. This study was conducted in Norway, importantly characterized by all treatment of ADHD among children and adolescents taking place in the public healthcare system with virtually no private sector, and providers are assigned by patients' residence.

Pharmacological treatment of ADHD is commonly used in clinical practice, but the impact on crime remains debated. Some clinicians may hold a positive or "liberal" perspective, arguing that pharmacological treatment can reduce criminality by improving core symptoms of ADHD (inattention, hyperactivity, and impulsivity), whereas other clinicians advocate a negative or "restrictive" perspective based on concerns for medicalization, stigma and unnecessary side-effects.

While this study finds evidence of causal protective effects of pharmacological treatment on criminality, these effects importantly concern specific types of crime for a particular patient group, and the effect sizes imply that many need to be treated to prevent one additional crime. Nonetheless, this study contributes novel causal knowledge of treatment effects that may be relevant for clinicians and researchers in their overall assessment of the effects of pharmacological treatment of ADHD.

This study was first-authored by Dr Tarjei Widding-Havneraas and is a part of the ADHD Controversy Project led by Professor Arnstein Mykletun, which uses this and similar research designs to examine multiple outcomes including crime, education, comorbidities, injuries, and mortality.

Frequently Asked Questions

NOTE: Researched FAQs by Disabled World (DW)

What medications are used for ADHD?

The main options are stimulants such as methylphenidate and amphetamines, and non-stimulants such as atomoxetine and guanfacine. A doctor chooses based on age, symptoms and side effects.

Does ADHD medication cause addiction?

When taken as prescribed and monitored by a doctor, ADHD medication has not been shown to raise the risk of later substance misuse, though stimulants can be misused if shared or taken without a prescription.

Why are young people with ADHD at higher risk of legal trouble?

Impulsivity, difficulty with self-control, school problems and related conditions can increase the chance of risky or impulsive behavior that leads to contact with police.

Are there non-medication treatments for ADHD?

Yes. Behavioral therapy, parent training, classroom supports and skills coaching are recommended, often together with medication.

What does number needed to treat mean?

It is the number of patients who need a treatment for one extra person to benefit. A higher number means a smaller effect per person treated.

Can adults with ADHD benefit from treatment?

Yes. ADHD often continues into adulthood, and medication, therapy and workplace or study supports can help adults manage symptoms.

Do the results apply outside Norway?

Not necessarily. Health systems, prescribing habits and justice systems differ, so the findings may not transfer directly to other countries.

Should parents choose medication to prevent crime?

Treatment decisions should be based on a child's overall symptoms, wellbeing and family goals, made with a qualified clinician, rather than on crime risk alone.

Insights, Analysis, and Developments

Editorial Note: Whether ADHD medication changes life outcomes such as crime has divided clinicians for years, partly because randomized trials over many years are neither practical nor ethical. By using the fact that some clinics prescribe far more than others, this study comes closer to a fair comparison and finds a real but modest benefit limited to impulsive crimes such as violence and public disorder. For families, the results support medication as one useful part of care for some young people, alongside education, behavioral support and close follow-up, rather than as a cure for every risk linked to ADHD.*

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 issued as a press release by Elsevier and published on 14 May 2024. Last updated on 4 Nov 2026. This content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.