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      Childhood ADHD and Risk for Substance Dependence in Adulthood: A Longitudinal, Population-Based Study

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          Abstract

          Background

          Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to be at significantly greater risk for the development of substance use disorders (SUD) compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction), may also play a role.

          Objective

          This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood.

          Method

          Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR) and 95% CIs estimated from logistic regression models adjusted for age and gender.

          Results

          A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively). ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49–138.88) and drug (adjusted OR 3.48, 95% CI 1.38–8.79) dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence.

          Conclusions

          Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and alcohol dependence appears to be more complex.

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          Most cited references23

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          In vivo evidence for post-adolescent brain maturation in frontal and striatal regions.

          E Sowell, P Thompson, C Holmes … (1999)
          Article 0 comments Cited 255 times – based on 0 reviews     Review now
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            History of the Rochester Epidemiology Project: half a century of medical records linkage in a US population.

            Walter A Rocca, Barbara P. Yawn, Jennifer St. Sauver … (2012)
            The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
            Article 0 comments Cited 242 times – based on 0 reviews     Review now
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              Age at drinking onset and alcohol dependence: age at onset, duration, and severity.

              Ralph W Hingson, Timothy Heeren, Michael Winter (2006)
              To examine whether starting to drink at an early age is associated with developing alcohol dependence at a younger age and chronic relapsing dependence, controlling for respondent demographics, smoking and illicit drug use, childhood antisocial behavior and depression, and family alcoholism history. Cross-sectional survey. Nationwide face-to-face survey with a multistage probability sample. A total of 43,093 adults were surveyed in 2001-2002. Based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, lifetime alcohol dependence, dependence within 10 years of starting drinking, multiple episodes, an alcohol dependence episode in the past year, episodes exceeding 1 year, and meeting 6 or 7 dependence criteria. Relative to respondents who began drinking at 21 years or older, those who began drinking before age 14 years were more likely to experience alcohol dependence ever and within 10 years of first drinking (adjusted hazard ratios and 95% confidence intervals [CIs], 1.78 [1.51-2.11] and 1.69 [1.38-2.07], respectively). They also more often experienced past-year dependence and multiple dependence episodes (adjusted odds ratios, 1.93 [95% CI, 1.40-2.64] and 3.09 [95% CI, 2.19-4.35], respectively). Among alcohol-dependent persons, the odds were 2.62 (95% CI, 1.79-3.84) for having at least 1 episode exceeding 1 year and 2.89 (95% CI, 1.97-4.23) for meeting 6 or 7 dependence diagnostic criteria. There is a need to screen and counsel adolescents about alcohol use and to implement policies and programs that delay alcohol consumption.
              Article 0 comments Cited 216 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Efthimios M. C. Skoulakis: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2014
                Publication date (Electronic): 27 August 2014
                Volume: 9
                Issue: 8
                Electronic Location Identifier: e105640
                Affiliations
                [1 ]Division of Developmental Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
                [2 ]Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, United States of America
                [3 ]Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, United States of America
                [4 ]Department of Pediatrics, Texas Children’s Hospital, Baylor College of Medicine, Houston, Texas, United States of America
                Alexander Fleming Biomedical Sciences Research Center, Greece
                Author notes

                Competing Interests: Pilot work for the prospective portion of this project was provided through an investigator-initiated research grant from McNeil Consumer and Specialty Pharmaceuticals. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: SL SK RC AW JK RV WB. Performed the experiments: SK RC RV WB. Analyzed the data: SL SK RC AW JK RV WB. Contributed to the writing of the manuscript: SL SK RC AW JK RV WB.

                Article
                Publisher ID: PONE-D-14-25644
                DOI: 10.1371/journal.pone.0105640
                PMC ID: 4146503
                PubMed ID: 25162629
                SO-VID: 6e1a475d-e050-4943-ba63-7e9108d56eeb
                Copyright statement: Copyright @ 2014
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 9 June 2014
                Date accepted : 22 July 2014
                Page count
                Pages: 9
                Funding
                Supported by Public Health Service research grants MH076111, HD29745, and AG034676. Pilot work for the prospective portion of the project was funded by an investigator-initiated grant from McNeil Consumer and Specialty Pharmaceuticals. The funders had no role in study design, data collection and analyses, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Developmental Neuroscience
                Subject: Neurodevelopmental Disorders
                Subject: Adhd
                Subject: Medicine and Health Sciences
                Subject: Epidemiology
                Subject: Natural History of Disease
                Subject: Mental Health and Psychiatry
                Subject: Substance-Related Disorders
                Subject: Pediatrics
                Subject: Child Development
                Custom metadata
                Data Availability The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files.

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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