Pediatric ADHD, Psychiatric Disorders Medication Lowers Substance Misuse Risk

Treating psychiatric disorders in children and adolescents with psychotropic medication does not increase the risk of developing substance use, misuse, or substance use disorder and, in fact, appears to reduce the risk in individuals with pediatric attention-deficit/hyperactivity disorder (ADHD), major depressive disorder, and psychotic disorders. Researchers published their findings in the Journal of Child and Adolescent Psychopharmacology.

“We found that pharmacological treatments for psychiatric disorders during childhood appears to reduce the development of substance use disorder by about 30% to 35%, especially when treatment is initiated early and for longer durations, particularly with ADHD,” said study coauthor Amy Berger, research coordinator in the division of child and adolescent psychiatry at Massachusetts General Hospital in Boston. 

The investigation was systematic review of 26 studies examining pharmacological treatments for psychiatric disorders in nearly 6 million adolescents and young adults and the effect of such treatments on the development of substance use, substance misuse, and substance use disorder. Among them, 21 studies focused on ADHD, two studies focused on major depressive disorder, and three studies focused on psychotic disorders. 

The majority of the studies, 14 in all, found that pharmacologic treatment reduced later substance use disorder, while 10 studies reported no effect on the development of substance use disorder, researchers reported. Two studies indicated medication treatment enhanced rates of substance use disorder.

Related: Learning Not Impacted by Stimulant Medication in Pediatric ADHD

Studies in people with ADHD showed that earlier-onset and longer duration pharmacological treatment had the largest reduction in risk for later substance use disorder.

“The treatments that began before the age of nine, and were more ongoing, were the most effective at reducing substance use disorder, especially in ADHD,” said study leader Timothy Wilens, MD, chief of the division of child and adolescent psychiatry, codirector of the center for addiction medicine, and director of substance abuse services in pediatric psychopharmacology at Massachusetts General Hospital. “And we think that it is probably pertinent to other psychiatric disorders.”

References

Wilens TE, Woodward DW, Ko JD, Berger AF, Burke C, Yule AM. The impact of pharmacotherapy of childhood-onset psychiatric disorders on the development of substance use disorders. J Child Adolesc Psychopharmacol. 2022 May;32(4):200-214. doi: 10.1089/cap.2022.0016

Medication treatment of pediatric psychiatric disorders reduces the later onset of substance use problems. News release. Massachusetts General Hospital; May 19, 2022. Accessed July 29, 2022.