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Review: stimulant pharmacotherapy for children with ADHD is associated with a reduced risk of later substance abuse disorder

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 Question In children with attention deficit hyperactivity disorder (ADHD), what is the relation between stimulant pharmacotherapy and later substance use disorder (SUD)?

Data sources

Studies were identified by searching PubMed with the terms ADHD, pharmacotherapy, stimulants, and SUD and by seeking data from presentations at national and international scientific meetings.

Study selection

Prospective and retrospective studies were included if they evaluated children, adolescents, and adults who had received stimulant pharmacotherapy in childhood and if they reported on SUD outcome (overall rates of any non-nicotine drug and alcohol use disorder) in adolescence or adulthood.

Data extraction

Data were extracted on baseline severity of ADHD, patient age at follow up, length of follow up, use of stimulants, and incidence of alcohol use disorder and drug use disorder. Odds ratios for developing SUD were pooled in a meta-analysis using the random effects model.

Main results

6 studies from the US and …

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  • Source of funding: not stated.

  • For correspondence: Dr T E Wilens, Massachusetts General Hospital, Boston, MA, USA. wilens{at}