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.
Psychiatrists treating ADHD with comorbid substance use, addiction medicine specialists, and researchers studying ADHD-substance use interactions.
15.5% of substance use disorder patients also had ADHD
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot tell us
Cross-sectional treatment-seeking sample. Relatively small subgroups. Cannot determine causation or direction of relationships. Single treatment center in Spain.
How to read the evidence
Moderate-sized clinical sample with validated assessments, though cross-sectional design and single center limit conclusions.
When this study was published
Published in 2021.
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.
Questions still open
- 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?
Common questions
Were ADHD symptoms different depending on the drug used?
How common was ADHD among substance use disorder patients?
Read the original research
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
Citation
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
Explore the wider topic
- Physical vs Psychological Cannabis Dependence: What Science Actually Shows
- The Gap Between Cannabis Perception and Science: Why What We Believe Outpaces What We Know
- Cannabis Use Disorder: Am I Addicted? Self-Assessment Guide
- Cross-Addiction After Quitting Weed: When One Habit Replaces Another
- Is Weed Addictive? What the Research Actually Shows
- Is Cannabis Addictive? What the DSM-5 and Brain Science Say
- Quitting Weed and Alcohol Together: What to Know About Dual Cessation
- Is Rehab Necessary for Weed? An Honest Assessment
- Signs You May Have Cannabis Use Disorder: An Honest Self-Assessment
- Weed Vape Pen Addiction: Why Vaping Makes It Harder to Quit