ADHD Meds May Not Up Drug Abuse Risk in Adulthood

Analysis shows no greater threat of addiction to alcohol, cocaine, marijuana, nicotine or other drugs

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, May 29 (HealthDay News) -- Children taking stimulants to treat attention-deficit/hyperactivity disorder (ADHD) don't face a greater risk of becoming drug addicts in adulthood, researchers report.

Whether or not these medications (such as Ritalin or Adderall) increase the odds of children becoming addicted later to alcohol, cocaine, marijuana, nicotine or other drugs has been debated for years, with studies coming to conflicting conclusions.

"Previously, there was evidence for both increased risk and decreased risk for substance problems related to stimulant medication in the treatment of ADHD," said study author Kathryn Humphreys, a doctoral student in psychology at University of California, Los Angeles.

"The present study suggests that, on average, children who received stimulant medication treatment for ADHD are at no differential risk for these substance outcomes than their counterparts who did not receive medication treatment," she said.

Many parents face difficult decisions regarding the best course of treatment for their child's ADHD, Humphreys pointed out.

"Pediatricians and child psychiatrists also must weigh the potential costs and benefits of various treatment options. Our study provides an important update to clinicians," she noted.

"Particularly for those who are concerned that stimulant medication is a 'gateway' drug or increases the risk for later substance use, there is no evidence at the group level for this hypothesis," Humphreys stated.

One expert said that an earlier study had even found a protective effect from stimulants that reduced the risk of children with ADHD going on to abuse drugs.

"That was accepted as gospel, and pediatricians had taken comfort in that there was a secondary benefit to treating patients with stimulant medications," said Dr. Andrew Adesman, chief of developmental & behavioral pediatrics at the Steven & Alexandra Cohen Children's Medical Center of New York in New Hyde Park.

"This study is somewhat disappointing in the sense that these medications don't appear to have the protective effect that we thought that they do," he said.

Adesman noted that children with ADHD are at a higher risk to become dependent on drugs in adulthood. The good news, he said, is that the risk is not the result of stimulant medications, but most likely from the condition itself.

"These drugs may not be protective, but they are not a risk factor," he said. "There is nothing to suggest that medicines like Ritalin are 'gateway' drugs."

Another expert agreed.

"This is a finding that will reassure families that there is no worry later on of the risk of drug abuse," said Dr. Rani Gereige, a professor of pediatrics and director of medical education at Miami Children's Hospital. "This worry should not be an issue [for parents] in deciding whether or not to put their child on stimulant medication."

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ADHD in Childhood May Raise Risk for Obesity in Adulthood

Study found boys with the disorder were twice as likely to have a higher body-mass index when they were men

By Dennis Thompson

HealthDay Reporter

MONDAY, May 20 (HealthDay News) -- Boys who are diagnosed with attention deficit-hyperactivity disorder (ADHD) are twice as likely to become obese adults as those who didn't have the disorder when they were young, a new 30-year study shows.

Researchers found that men with childhood ADHD tended to have a higher body-mass index (BMI) and obesity, even if they no longer had symptoms of the disorder. Socioeconomics made no difference; well-off or poor, they tended toward obesity.

"The bottom line is, boys who were hyperactive when followed up for more than 30 years turn out to be more likely to be obese than comparable kids from their same communities," said study co-author Dr. Francisco Xavier Castellanos, a professor of child and adolescent psychiatry in the Child Study Center at NYU Langone Medical Center in New York City.

"That really seems to be reflective of their early hyperactivity. It doesn't matter what their current diagnosis is so much, so we think these are longstanding issues that likely arose in early adolescence," he added.

A lack of impulse control and poor planning skills, symptoms often associated with ADHD, could lead to poor eating habits and food choices as well as the tendency to overeat, the study authors speculated.

"It fits with other studies, and suggests that the inability to control one's impulses, the tendency to be relatively reward-driven, may represent a risk of obesity over time," Castellanos said.

The study, published online May 20 and in the June print issue of Pediatrics, tracked 111 men diagnosed with childhood hyperactivity, touching base with them at ages 18, 25 and 41. By adulthood, 41 percent had become obese, compared with a non-hyperactive control group that had a 22 percent obesity rate.

The results are somewhat confounding, Castellanos said.

"The pattern of results to a certain extent was counterintuitive," he said. "We thought we would get the strongest effect in those men who manifested ADHD as adults, and that wasn't the case. That suggests that it's not something that is very tightly related to the current diagnosis, but the tendency to have the diagnosis."

The findings run counter to an earlier study that showed that hyperactive adult men had a greater tendency for obesity than men who left childhood ADHD behind, said Dr. Craig Surman, scientific coordinator for the Adult ADHD Research Program at Massachusetts General Hospital in Boston.

"So, the simple story here would be we don't know, because you have to replicate studies to know," he said. "The question now becomes why the findings are different."

Future research also needs to consider whether women with childhood ADHD are as likely as men with childhood ADHD to become obese, and whether controlling hyperactivity through the use of medication can have an impact, Surman said.

ADHD is more common in boys than girls, with 12 percent of U.S. boys aged 3 to 17 receiving the diagnosis, according to the U.S. Centers for Disease Control and Prevention.

The link between ADHD and obesity has become a topic of great interest as elevated rates of obesity have been reported in children with the disorder, Surman said. Obesity can lead to heart disease and diabetes later in life.

"It's very important to understand the ways ADHD affects life and self-care," Surman said. "We've known for some time that it's not just people's desks and houses that are messy. For some people, it's a lack of ability to control how to care for themselves as well."

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Is Childhood Intelligence Linked to Pain Problems in Adulthood?

Title: Is Childhood Intelligence Linked to Pain Problems in Adulthood?
Category: Health News
Created: 12/4/2012 6:37:00 PM
Last Editorial Review: 12/5/2012 12:00:00 AM

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