A mixed-methods study from the MTA adult follow-up found that persistent substance users with ADHD perceived cannabis as enhancing positive mood and improving negative mood and ADHD symptoms, though broad perceptions about substance use and mood did not differ between ADHD and non-ADHD groups.
Clinicians treating ADHD in adults with substance use; addiction researchers studying self-medication; patients with ADHD who use cannabis.
ADHD substance users specifically perceived cannabis as improving ADHD symptoms and negative mood
What the researchers found
Researchers analyzed narrative comments from 92 persistent and desistent substance users from the MTA (Multimodal Treatment Study of ADHD) adult follow-up (ages 21.7-26.7).
Persistent substance users generally perceived that substance use positively affects emotional states and that positive emotional effects outweigh negative ones. This perception did not differ between ADHD and non-ADHD groups.
However, qualitative analysis revealed ADHD-specific perceptions: both ADHD and non-ADHD persistent users reported that cannabis enhanced positive mood, but ADHD persistent users additionally perceived cannabis as improving negative mood and ADHD symptoms specifically.
These self-medication perceptions may help explain why cannabis use is elevated among people with ADHD and why it persists despite potential negative consequences.
Why it matters
Understanding why people with ADHD are more likely to use cannabis persistently requires understanding their subjective experience. If they perceive cannabis as genuinely helping their ADHD symptoms and mood, simply telling them to stop may be ineffective without providing alternative symptom management.
The numbers in context
92 total (67 persistent, 25 desistent substance users). 50 ADHD, 17 comparison group among persisters. No ADHD group differences in broad substance-mood perceptions. ADHD-specific perception: cannabis improves negative mood and ADHD symptoms.
How the study worked
Mixed qualitative-quantitative analysis. 67 persistent and 25 desistent substance users from the MTA adult follow-up. 50 ADHD and 17 comparison group among persisters. Narrative coding of substance use-emotion perceptions.
What this study cannot tell us
Small qualitative sample. Self-reported perceptions may not reflect actual therapeutic benefit. MTA participants have extensive treatment histories that may not generalize. Persistent users may be motivated to justify continued use.
How to read the evidence
Preliminary. Qualitative findings from a well-established longitudinal study (MTA), but small sample and self-reported perceptions limit generalizability.
When this study was published
Published in 2018. Research on cannabis use in ADHD has continued, with some exploring cannabinoid-based treatments.
The bigger picture
Self-medication is a widely discussed but under-studied aspect of cannabis use in ADHD. This study provides direct qualitative evidence that people with ADHD perceive cannabis as therapeutic, which has implications for how clinicians should address cannabis use in this population.
Questions still open
- Does cannabis actually improve ADHD symptoms, or is the perception driven by placebo or mood effects? Would providing better ADHD treatment reduce cannabis use in this population? Could cannabinoid-based treatments be developed specifically for ADHD?
Common questions
Does cannabis actually help ADHD?
Why is cannabis use more common in people with ADHD?
Read the original research
How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning.
Journal of attention disorders, 22(9_suppl), 49S-60S
Citation
Mitchell, John T; Weisner, Thomas S; Jensen, Peter S; Murray, Desiree W; Molina, Brooke S G; Arnold, L Eugene; Hechtman, Lily; Swanson, James M; Hinshaw, Stephen P; Victor, Elizabeth C; Kollins, Scott H; Wells, Karen C; Belendiuk, Katherine A; Blonde, Andrew; Nguyen, Celeste; Ambriz, Lizeth; Nguyen, Jenny L. (2018). How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning.. Journal of attention disorders, 22(9_suppl), 49S-60S. https://doi.org/10.1177/1087054716685842
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