ARTICLES
Prospective Study of Adolescent Drug Use Among Community Samples of ADHD and Non-ADHD Participants

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ABSTRACT

Objective:

To describe the late adolescent drug use outcomes from a relatively large, community-identified sample of children with attention-deficit/hyperactivity disorder (ADHD) who have been assessed longitudinally from childhood through late adolescence.

Method:

Adolescent drug use outcomes were compared between ADHD-only (n = 27), ADHD-externalizing (mostly oppositional defiant disorder) (n = 82), and normal control (n = 91) groups.

Results:

The ADHD-externalizing group revealed significantly worse drug use outcomes (drug use frequency and substance use disorders) compared to the other two groups, and the ADHD-only group showed outcomes comparable to the community control group.

Conclusions:

ADHD without a comorbid externalizing disorder is not associated with an increased risk of drug abuse. ADHD with a comorbid externalizing disorder, primarily oppositional defiant disorder, is associated with an elevated risk of drug use, particularly with respect to marijuana and tobacco involvement.

Section snippets

Participants

The data reported here were collected as part of the Minnesota Competence Enhancement Project (MNCEP), a longitudinal study of ADHD that began in 1991. The project identified samples of disruptive and control (nondisruptive) children drawn from 22 suburban elementary schools using a multiple-gate screening procedure (August et al., 1995). A total of 7,231 students in grades 1 through 4 (and ranging in age from 7 to 11 years) were screened. Of these, 318 (ages 7-9) were identified as having

Attrition Analysis

Two sets of attrition analysis were conducted. First, we compared T1 ADHD and control cases who were “ineligible” for a T4 assessment because the family chose to discontinue with the study after the initial assessment and had no T2 and T3 data (ADHD, n = 37; control, n = 28) versus subjects who were “eligible” for a T4 assessment because a T2 and T3 evaluation had been collected and other exclusion criteria were not present (ADHD, n = 138; control, n = 99). Separate one-way ANOVAs (attrition

DISCUSSION

The present prospective longitudinal study found increased rates of drug use among a community-derived sample of children diagnosed with childhood ADHD and followed into the late adolescent years compared with a sample of community controls. These findings were true regardless of whether the drug use outcomes were assessed as categorical or continuous variables. However, increased rates were found only in children in whom ADHD was comorbid with another early-onset externalizing disorder

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    Support for this study came from National Institute on Drug Abuse grants DA12995 and K02 DA15347.

    Disclosure: Dr. August has financial ties to McNeil Consumer and Specialty Pharmaceuticals. Dr. Realmuto's financial relationships are with McNeil Consumer and Specialty Pharmaceuticals as well as with Shire Pharmaceuticals. The other authors have no financial relationships to disclose.

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