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Severe Attention Disorder Linked with Drug Abuse

Jasbird Jasbird#dead-mail-box# at myrealbox.com
Mon Aug 18 02:46:13 EST 2003


Contact: Pam Willenz
pwillenz at apa.org
American Psychological Association 

Severity of ADHD in children increases risk of drug use in adolescence
Inattention symptoms appears to be culprit of early drug use and
multiple substance use

WASHINGTON -- Children diagnosed with attention-deficit/hyperactivity
disorder (ADHD) are more at risk for using illicit drugs, having
problems with alcohol, smoking cigarettes, and using marijuana in
their adolescence than children without ADHD, say researchers who
report their findings on childhood predictors of later substance use
in the August issue of the Journal of Abnormal Psychology, published
by the American Psychological Association (APA). Furthermore,
childhood ADHD is linked to earlier first use of cigarettes, earlier
progression to daily smoking and earlier use of illicit drugs. 
According to the study, those children with the most severe attention
problems in childhood were most at risk for alcohol and marijuana
problems and cigarette smoking by their teens. Those children with
ADHD with other behavior problems, such as defying parents and
fighting, were also at risk for illicit drug use, but severity of
attention problems was a better predictor for drinking, tobacco, and
marijuana outcomes. This could be, say the researchers, because
problems with paying attention in childhood have an immediate effect
on school learning and social relationships, which may set the stage
for other problems later on that include drug use and abuse. 

Psychologists Brooke S. G. Molina, Ph.D., and William E. Pelham, Jr.,
Ph.D. compared drug use between 142 teenagers (13-18 years of age)
diagnosed with ADHD in childhood with 100 children (same ages) without
ADHD, using measures of ADHD and antisocial behavior reported by the
teachers and parents. Because the children with ADHD had been
diagnosed and followed from childhood, the researchers were able to
evaluate whether the severity of symptoms in the ADHD group predicted
elevated drug use in adolescence. 

The presence of ADHD in childhood was found to increase the risk for
elevated use and abuse of alcohol and heavier drugs and the earlier
use of tobacco and other drugs by the teenage years, said the authors.
Furthermore, said Dr. Molina, "childhood ADHD symptoms, particularly
the inattention dimension of ADHD, predicted later substance use to a
greater degree than childhood antisocial behaviors." This suggests
that the severity of ADHD is a leading factor for the early emergence
of substance use behavior, said Molina. Thus, it was not surprising
that those children who still had ADHD in adolescence (about 72% of
them) reported more drunkenness from alcohol, more alcohol problems,
and more cigarette smoking than the adolescents without childhood
ADHD. Children with ADHD who developed severe conduct problems by
adolescence (about 26% of them) reported the highest levels of
drinking, smoking, and drug use. 

The ADHD symptom of inattention versus hyperactivity and oppositional
defiant disorder/conduct disorder (ODD/CD) better predicts later
substance use, suggest the authors, because "executive functions
associated with inattention and not hyperactivity may be at the root
of the progression to substance use. A child may begin having poor
academic performance and peer difficulties and then gravitate toward
nonconformist peer groups as an adolescent where substance abuse is
accepted as a way of life," said Molina. 

The study may not have found strong prediction from symptoms of
impulsivity because they are few and confounded with the hyperactivity
symptoms. Both inattention and impulsivity are likely to play
important roles in prediction of later substance use outcomes for ADHD

This study sheds light on the importance of early identification and
treatment of problems with paying attention in childhood. Knowing the
early signs of ADHD, providing early intervention, and providing help
to teachers and parents through the teenage years, may help teachers
and parents recognize risk factors and intervene before a child's use
of alcohol and drugs turns into a life long dependence, said the

Article: "Childhood Predictors of Adolescent Substance Use in a
Longitudinal Study of Children With ADHD," Brooke S. G. Molina, Ph.D.,
Western Psychiatric Institute and Clinic and University of Pittsburgh
School of Medicine and William E. Pelham, Jr., Ph.D., State University
of New York at Buffalo; Journal of Abnormal Psychology, Vol. 112, No.

Full text of the article is available from the APA Public Affairs
Office or at

Brooke S. G. Molina, PhD can be reached by phone at 412-624-4633. 

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