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NIDA. (2003, June 1). Studies Link Stimulant Treatment of ADHD in Childhood to Lower Risk of Later Substance Abuse. Retrieved from

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June 01, 2003

Children treated for attention-deficit/hyperactivity disorder (ADHD) with stimulant medications are less likely to develop substance abuse disorders later in life than are children with ADHD who are not given stimulants, according to NIDA-supported researchers. Dr. Timothy Wilens and his colleagues at the Massachusetts General Hospital and Harvard Medical School in Boston reviewed long-term studies in which stimulant-treated and untreated children with ADHD were evaluated later in life and concluded that stimulant therapy cuts in half the likelihood of subsequent substance abuse disorders.

The researchers examined six studies with a combined total of 647 children with ADHD who had been treated with stimulants and 360 who had not. On average, the studies followed up on the participants for 6 years (range 4 to 15 years) after treatment ended and they were more than 20 years old (range 15 to 22 years of age). Four of the six studies included treated and untreated participants with similar severity in their initial diagnoses. The studies found less incidence of any substance abuse disorder in participants treated with stimulants. One study in which the severity of initial diagnosis was not similar for treated and untreated groups found that participants who received stimulants were more likely to smoke and to abuse cocaine, but not more likely to abuse alcohol or marijuana. The other study in which diagnostic severity was not matched found that stimulant-treated participants were more likely to abuse alcohol or marijuana.

"Considering all six studies, there was an almost twofold decrease in the likelihood of substance abuse disorders risk for youths treated previously with stimulant medication," Dr. Wilens says.

The Harvard group's findings counter concerns voiced by some practitioners that exposure to stimulants might increase children's disposition to subsequently abuse drugs. "These findings should reassure clinicians and families by providing compelling evidence that pharmacotherapy with stimulants for ADHD does not lead to substance abuse disorders, but instead seems to have protective effects," says Dr. Wilens.


  • Wilens, T.E., et al. Does stimulant therapy of attention-deficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics111(1):179-185, 2003.