Young men with ADHD are more likely to develop persistent problematic substance use patterns
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.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- ADHD linked to persistent alcohol problems but maturing out of cannabis use
- Evidence Grade:
- Moderate: large prospective cohort with adjustment for confounders, but short follow-up and male-only sample.
- Study Age:
- Published in 2019.
- Original Title:
- Adult attention-deficit/hyperactivity disorder, risky substance use and substance use disorders: a follow-up study among young men.
- Published In:
- European archives of psychiatry and clinical neuroscience, 269(6), 667-679 (2019)
- Authors:
- Estévez-Lamorte, Natalia, Foster, Simon, Eich-Höchli, Dominique, Moggi, Franz, Gmel, Gerhard, Mohler-Kuo, Meichun
- Database ID:
- RTHC-02025
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Does ADHD increase risk of cannabis problems?
Counterintuitively, this study found ADHD was associated with maturing out of risky cannabis use and was negatively linked to cannabis use disorder at follow-up. However, ADHD did predict persistent risky alcohol and nicotine use.
Why might ADHD affect different substances differently?
The study suggests substance-specific factors matter. Early age of first alcohol use distinguished who persisted vs. matured out of alcohol problems, while ADHD symptom severity and baseline problem levels mattered more for cannabis and nicotine trajectories.
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Cite This Study
https://rethinkthc.com/research/RTHC-02025APA
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
MLA
Estévez-Lamorte, Natalia, et al. "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, 2019. https://doi.org/10.1007/s00406-018-0958-3
RethinkTHC
RethinkTHC Research Database. "Adult attention-deficit/hyperactivity disorder, risky substa..." RTHC-02025. Retrieved from https://rethinkthc.com/research/estevez-lamorte-2019-adult-attentiondeficithyperactivity-disorder-risky
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.