ADHD patients seeking cannabis treatment had more anxiety and started substance use younger

Among 239 ADHD patients with substance use disorders, those seeking treatment for cannabis use had higher rates of lifetime anxiety disorder, earlier onset of substance use, and more work-related impairment compared to those seeking treatment for cocaine.

Martínez-Luna, Nieves et al.·Journal of attention disorders·2021·Moderate EvidenceCross-Sectional
RTHC-03325Cross SectionalModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=41

What This Study Found

In multivariate analysis, the cannabis group had significantly higher rates of lifetime anxiety disorder and younger age at onset of any substance use disorder. The cannabis/cocaine polysubstance group showed more work-related impairment. ADHD features were similar across all groups regardless of primary substance.

Key Numbers

1,538 SUD patients screened; 239 (15.5%) had ADHD; cannabis n=41, cannabis/cocaine n=36, cocaine n=74; 80% male; mean age 32.9 years

How They Did This

From 1,538 substance use disorder patients evaluated for ADHD, 239 (15.5%) had ADHD. These were divided into cannabis (n=41), cannabis/cocaine (n=36), and cocaine (n=74) groups. Assessment included EuropASI, CAADID, SCID, ASRS, WURS, BIS-11, and multinomial regression.

Why This Research Matters

ADHD patients with substance use disorders represent a complex clinical population. Understanding how the primary substance of concern relates to psychiatric comorbidity and functional impairment helps tailor treatment approaches.

The Bigger Picture

The finding that cannabis-seeking ADHD patients had more anxiety and earlier substance use onset suggests they may represent a more vulnerably-rooted pattern of use, potentially involving self-medication, compared to cocaine-seeking ADHD patients.

What This Study Doesn't Tell Us

Cross-sectional treatment-seeking sample. Relatively small subgroups. Cannot determine causation or direction of relationships. Single treatment center in Spain.

Questions This Raises

  • ?Are ADHD patients using cannabis to manage anxiety symptoms?
  • ?Would treating the underlying ADHD and anxiety reduce cannabis use?
  • ?How should treatment differ for cannabis-primary versus cocaine-primary ADHD patients?

Trust & Context

Key Stat:
15.5% of substance use disorder patients also had ADHD
Evidence Grade:
Moderate-sized clinical sample with validated assessments, though cross-sectional design and single center limit conclusions.
Study Age:
Published in 2021.
Original Title:
Psychiatric Comorbidity and Addiction Severity Differences in Patients With ADHD Seeking Treatment for Cannabis or Cocaine Use Disorders.
Published In:
Journal of attention disorders, 25(7), 978-988 (2021)
Database ID:
RTHC-03325

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Were ADHD symptoms different depending on the drug used?

No. ADHD features were similar across cannabis, cocaine, and polysubstance groups, suggesting the core ADHD presentation does not differ by primary substance of abuse.

How common was ADHD among substance use disorder patients?

About 1 in 6 (15.5%) substance use disorder patients in this study met criteria for ADHD.

Read More on RethinkTHC

Cite This Study

RTHC-03325·https://rethinkthc.com/research/RTHC-03325

APA

Martínez-Luna, Nieves; Daigre, Constanza; Palma-Álvarez, Felipe; Perea-Ortueta, Marta; Grau-López, Lara; Roncero, Carlos; Castell-Panisello, Eudald; Ramos-Quiroga, Josep Antoni. (2021). Psychiatric Comorbidity and Addiction Severity Differences in Patients With ADHD Seeking Treatment for Cannabis or Cocaine Use Disorders.. Journal of attention disorders, 25(7), 978-988. https://doi.org/10.1177/1087054719875787

MLA

Martínez-Luna, Nieves, et al. "Psychiatric Comorbidity and Addiction Severity Differences in Patients With ADHD Seeking Treatment for Cannabis or Cocaine Use Disorders.." Journal of attention disorders, 2021. https://doi.org/10.1177/1087054719875787

RethinkTHC

RethinkTHC Research Database. "Psychiatric Comorbidity and Addiction Severity Differences i..." RTHC-03325. Retrieved from https://rethinkthc.com/research/martinez-luna-2021-psychiatric-comorbidity-and-addiction

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.