Meta-analysis found about 1 in 4 people with ADHD have had cannabis use disorder in their lifetime | Research

The takeaway

A meta-analysis of 14 studies estimated that 26.9% of people with ADHD have a lifetime history of cannabis use disorder, and they are nearly 3 times more likely to develop CUD than the general population.

Psychiatrists and psychologists treating ADHD; addiction specialists screening patients with attention difficulties.

27% lifetime CUD prevalence in ADHD; 2.9x higher risk

What the researchers found

Lifetime CUD prevalence in ADHD populations was 26.9%, with current prevalence at 19.2%. Risk ratios showed individuals with ADHD were 2.85 times more likely to have lifetime CUD and 2.91 times more likely to have current CUD compared to general population controls. Prediction intervals were wide (lifetime: 12.4%-48.8%; current: 5.5%-39.1%), reflecting substantial variability across studies.

Why it matters

The nearly 3-fold elevated risk of CUD in ADHD populations suggests that cannabis screening should be routine in ADHD treatment. The high prevalence also raises questions about whether some ADHD patients are self-medicating with cannabis.

The numbers in context

14 studies included. Lifetime CUD prevalence: 26.9% (prediction interval 12.4%-48.8%). Current CUD prevalence: 19.2% (prediction interval 5.5%-39.1%). Lifetime risk ratio: 2.85. Current risk ratio: 2.91.

How the study worked

Systematic review and meta-analysis of 14 studies from PubMed, PsycINFO, and Web of Science. Mixed and random-effects models for prevalence estimation and risk ratio calculation.

What this study cannot tell us

Substantial heterogeneity across studies (wide prediction intervals). Only 14 studies met inclusion criteria. Could not distinguish between recreational and self-medicating use. Meta-analysis of observational studies cannot establish causal direction.

How to read the evidence

Meta-analysis with risk ratio calculations, though wide prediction intervals reflect high heterogeneity across included studies.

When this study was published

2024 study

The bigger picture

With ADHD affecting 5-7% of the population and cannabis becoming more accessible through legalization, the intersection of these two conditions represents a growing clinical challenge. Understanding why ADHD increases CUD vulnerability could inform both prevention and treatment.

Questions still open

Does treating ADHD reduce CUD risk? Are ADHD patients using cannabis to manage attention or emotional symptoms?

Common questions

Why are people with ADHD more likely to develop cannabis problems?

The study did not determine the mechanism. Possible explanations include impulsivity associated with ADHD, self-medication for attention or emotional symptoms, and shared genetic vulnerability between ADHD and substance use disorders.

Should people with ADHD avoid cannabis?

The study shows elevated risk but does not make clinical recommendations. The nearly 3-fold higher CUD risk suggests that people with ADHD should be aware of their heightened vulnerability if they choose to use cannabis.

Read the original research

The prevalence of cannabis use disorder in attention-deficit hyperactivity disorder: A clinical epidemiological meta-analysis.

Journal of psychiatric research, 172, 391-401

View on PubMed ↗Publisher’s paper ↗

Citation

Froude, Anna M; Fawcett, Emily J; Coles, Ashlee; Drakes, Dalainey H; Harris, Nick; Fawcett, Jonathan M. (2024). The prevalence of cannabis use disorder in attention-deficit hyperactivity disorder: A clinical epidemiological meta-analysis.. Journal of psychiatric research, 172, 391-401. https://doi.org/10.1016/j.jpsychires.2024.02.050