Current Psychiatry Reports

, 16:436

The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders

  • Courtney A. Zulauf
  • Susan E. Sprich
  • Steven A. Safren
  • Timothy E. Wilens
Child and Adolescent Disorders (T Benton, Section Editor)

DOI: 10.1007/s11920-013-0436-6

Cite this article as:
Zulauf, C.A., Sprich, S.E., Safren, S.A. et al. Curr Psychiatry Rep (2014) 16: 436. doi:10.1007/s11920-013-0436-6
Part of the following topical collections:
  1. Topical Collection on Child and Adolescent Disorders


Adolescents and young adults with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) are increasingly presenting in clinical practice. The overlap and role of treatment for these co-occurring disorders remains unclear. A review of the literature was conducted to highlight and update recent evidence on the overlap of ADHD and SUD, the role of ADHD medication on later SUD, and the treatment of ADHD and SUD in adolescents and young adults. Recent work continues to highlight the high risk for comorbid ADHD in patients with SUD; and conversely, the high risk for SUD developing in ADHD across the lifespan, particularly in the context of comorbid conduct disorder. Although the data remains discordant, it appears that ADHD pharmacotherapy does not increase the risk for SUD. Medication treatment alone does not appear to be particularly effective in treating SUD in currently active substance abusing individuals with ADHD. Structured therapies may be effective in treating adolescents and young adults with ADHD and SUD. Further controlled trials evaluating the sequence and effect of structured psychotherapies and/or ADHD pharmacotherapy on SUD relapse in these groups are warranted.


Adolescence Substance use disorders Attention deficit/hyperactivity disorder Stimulants comorbidity Cognitive-behavioral therapy 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Courtney A. Zulauf
    • 1
  • Susan E. Sprich
    • 2
  • Steven A. Safren
    • 3
  • Timothy E. Wilens
    • 1
    • 4
    • 5
  1. 1.Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHDMassachusetts General HospitalBostonUSA
  2. 2.Cognitive-Behavioral Therapy ProgramMassachusetts General HospitalBostonUSA
  3. 3.Department of Behavioral MedicineMassachusetts General HospitalBostonUSA
  4. 4.Center for Addiction MedicineMassachusetts General HospitalBostonUSA
  5. 5.YAW 6A, Massachusetts General HospitalBostonUSA

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