Among nearly 5,000 young Swiss men, those with ADHD were more likely to have persistent risky alcohol and nicotine use, but surprisingly tended to mature out of risky cannabis use over 15 months.
People with ADHD interested in substance use risk, parents, and anyone interested in how neurodevelopmental conditions relate to substance use patterns.
ADHD linked to persistent alcohol problems but maturing out of cannabis use
What the researchers found
ADHD predicted persistent risky alcohol and nicotine use and was positively linked to alcohol use disorder but negatively linked to cannabis use disorder at follow-up. For all substance use disorders, ADHD was associated with both persistence and maturing out, with early alcohol initiation distinguishing between these trajectories for AUD.
Why it matters
The counterintuitive finding that ADHD was associated with maturing out of risky cannabis use, while predicting persistent alcohol and nicotine problems, suggests that substance-specific prevention strategies are needed rather than blanket approaches.
The numbers in context
4,975 Swiss men, mean age 20. ADHD predicted persistent risky alcohol use, persistent risky nicotine use, and maturing out of risky cannabis use. ADHD was positively linked to AUD but negatively to CUD at 15-month follow-up.
How the study worked
Prospective cohort of 4,975 Swiss men (mean age 20) from the Cohort Study on Substance Use Risk Factors, with baseline and 15-month follow-up assessments of ADHD, risky substance use, and substance use disorders, adjusted for sociodemographics and comorbidity.
What this study cannot tell us
Male-only sample limits generalizability to women. Relatively short 15-month follow-up. Swiss military conscript population may not represent broader populations. Self-reported substance use and ADHD assessment.
How to read the evidence
Moderate: large prospective cohort with adjustment for confounders, but short follow-up and male-only sample.
When this study was published
Published in 2019.
The bigger picture
ADHD is one of the most common neurodevelopmental conditions, and its relationship with substance use is not monolithic. These findings suggest that young men with ADHD may naturally reduce cannabis use as they enter their twenties, even as alcohol and nicotine problems persist.
Questions still open
- Why does ADHD predict maturing out of cannabis use but persistence of alcohol use? Would targeted interventions during late adolescence prevent the transition to persistent problematic alcohol use in ADHD populations?
Common questions
Does ADHD increase risk of cannabis problems?
Why might ADHD affect different substances differently?
Read the original research
Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men.
European archives of psychiatry and clinical neuroscience, 269(6), 667-679
Citation
Estévez-Lamorte, Natalia; Foster, Simon; Eich-Höchli, Dominique; Moggi, Franz; Gmel, Gerhard; Mohler-Kuo, Meichun. (2019). Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men.. European archives of psychiatry and clinical neuroscience, 269(6), 667-679. https://doi.org/10.1007/s00406-018-0958-3
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