Attention-deficit hyperactivity disorder (ADHD) has been linked to many negative outcomes. Usually first diagnosed in childhood, ADHD is characterized by impulsivity and inability to focus on tasks. Until recently, it was believed that ADHD did not widely persist into adulthood. However, new research has shown that many individuals still struggle with the symptoms of ADHD through their adult lives. The impulsive and immediate gratification traits that are common in ADHD have also been shown to increase the risk for substance use disorders (SUDs). There has been much research dedicated to understanding this link. Additionally, people with ADHD are very likely to have other psychological issues, the most common of which are borderline personality disorder (BPD) and conduct disorder (CD). Both of these mental health problems also usually appear in childhood, and because of the similarity with ADHD, often go undiagnosed or misdiagnosed. Because of this, the majority of the research that has linked ADHD to SUD has failed to account for the influence of CD and BPD.
In order to get a clearer picture of how ADHD, CD, and BPD interact and affect the risk for SUD, Michelle Torok of the National Drug and Alcohol Research Centre at the University of New South Wales in Australia recently led a study involving 269 adult drug users. She assessed the participants and found that more than half of them had at least two of the mental health problems she screened for, and one-fourth of them had conduct disorder, BPD, and ADHD. Compared to the prevalence of these disorders co-occurring in the general population at rates of approximately 3%, these figures were startlingly higher.
After further examination, Torok discovered that contrary to previous research, ADHD was not the largest risk factor for SUD. Instead, when she controlled for both ADHD and BPD, Torok found that CD posed the biggest risk for future drug abuse in the participants. ADHD was actually found to be a minimal predictor of SUD. The study also revealed that the level of symptom severity of each mental health challenge was directly proportionate to level of illicit drug use. Even though her findings demonstrate that ADHD was not the most significant risk factor for drug use, she cautions clinicians and professionals to weigh these results carefully. She said, “Despite the weak predictive ability of ADHD, the significant comorbid associations between ADHD, CD, and BPD do attest to the fact that drug users with these disorders are an overall riskier subgroup of drug users.”
Torok, M., Darke, S., Kaye, S. (2012). Attention deficit hyperactivity disorder and severity of substance use: The role of comorbid psychopathology. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0027846
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