ADHD in Young Men Was Linked to Earlier Drug Use, Riskier Patterns, and More Substance Disorders
In a study of 5,677 Swiss men, ADHD was associated with earlier initiation of alcohol, nicotine, and cannabis, riskier use patterns, and higher rates of substance use disorders, even after controlling for antisocial personality.
Quick Facts
What This Study Found
Researchers examined the relationship between ADHD and substance use in 5,677 Swiss men (average age 20) from a representative cohort study.
Men with ADHD were more likely to have used nicotine, cannabis, and other illicit drugs (but not alcohol) at some point. ADHD was positively associated with earlier initiation of alcohol, nicotine, and cannabis, with riskier use patterns for these substances, and with alcohol use disorders and nicotine and cannabis dependence.
Importantly, antisocial personality disorder (ASPD) was also strongly associated with these patterns. After adjusting for ASPD, the ADHD associations were reduced but remained significant, suggesting that ADHD has an independent contribution to substance use risk beyond its overlap with antisocial behavior.
Key Numbers
5,677 Swiss men (mean age 20). ADHD associated with lifetime nicotine, cannabis, and illicit drug use (but not alcohol). ADHD associated with earlier initiation of alcohol, nicotine, and cannabis. Associations reduced but remained significant after ASPD adjustment.
How They Did This
Cross-sectional analysis from the Cohort Study on Substance Use Risk Factors (C-SURF), a representative sample of 5,677 Swiss men (mean age 20). ADHD was assessed with the Adult ADHD Self-Report Screener. Substance use was assessed for alcohol, nicotine, cannabis, and other drugs, controlling for demographics, depression, and ASPD.
Why This Research Matters
This large, representative study clarifies that ADHD independently contributes to substance use risk in young men, even after accounting for the substantial overlap with antisocial personality. This has implications for targeted prevention in ADHD populations.
The Bigger Picture
The ADHD-substance use link is well-established, but this study advances the field by demonstrating that the association persists even after controlling for antisocial personality, which has been a major confound in prior research. Early intervention for ADHD could potentially reduce substance use vulnerability.
What This Study Doesn't Tell Us
Only male participants were included. ADHD was assessed by self-report screener rather than clinical diagnosis. The cross-sectional design cannot determine whether ADHD causes earlier or riskier substance use. Swiss military recruitment-based sampling may not represent all young men.
Questions This Raises
- ?Would ADHD treatment in adolescence reduce later substance use risk?
- ?Are the patterns similar in young women with ADHD?
Trust & Context
- Key Stat:
- ADHD independently predicted substance use risk even after controlling for antisocial personality
- Evidence Grade:
- This is a large representative cohort study with comprehensive adjustment for confounders, providing strong cross-sectional evidence on the ADHD-substance use relationship.
- Study Age:
- Published in 2016. The evidence on ADHD and substance use has continued to accumulate.
- Original Title:
- Adult attention-deficit/hyperactivity disorder and its association with substance use and substance use disorders in young men.
- Published In:
- Epidemiology and psychiatric sciences, 25(3), 255-66 (2016)
- Authors:
- Estévez, N, Dey, M, Eich-Höchli, D, Foster, S, Gmel, G, Mohler-Kuo, M
- Database ID:
- RTHC-01147
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does ADHD cause drug use?
ADHD is consistently associated with earlier substance use, riskier patterns, and more substance disorders. This study showed the association is independent of antisocial personality. However, cross-sectional data cannot prove causation. Multiple mechanisms may be involved including impulsivity, self-medication, and shared genetic factors.
Does treating ADHD reduce substance use risk?
Some research suggests that treating ADHD with medication may reduce substance use risk, though findings are mixed. This study did not address treatment effects. Regardless, early identification and management of ADHD, including substance use screening, are recommended.
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Cite This Study
https://rethinkthc.com/research/RTHC-01147APA
Estévez, N; Dey, M; Eich-Höchli, D; Foster, S; Gmel, G; Mohler-Kuo, M. (2016). Adult attention-deficit/hyperactivity disorder and its association with substance use and substance use disorders in young men.. Epidemiology and psychiatric sciences, 25(3), 255-66. https://doi.org/10.1017/S2045796015000360
MLA
Estévez, N, et al. "Adult attention-deficit/hyperactivity disorder and its association with substance use and substance use disorders in young men.." Epidemiology and psychiatric sciences, 2016. https://doi.org/10.1017/S2045796015000360
RethinkTHC
RethinkTHC Research Database. "Adult attention-deficit/hyperactivity disorder and its assoc..." RTHC-01147. Retrieved from https://rethinkthc.com/research/estevez-2016-adult-attentiondeficithyperactivity-disorder-and
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.