Using MTA study data, researchers assessed whether ADHD stimulant treatment was associated with subsequent substance use through adolescence and into early adulthood.
Pediatricians, child psychiatrists, parents of children with ADHD, and ADHD researchers.
MTA long-term dataGold-standard ADHD treatment trial data used to assess stimulant treatment-substance use associations
What the researchers found
The study examined the long-debated question of whether stimulant treatment for ADHD influences later substance use, using data from the landmark Multimodal Treatment Study of ADHD (MTA) to track outcomes through adolescence and early adulthood.
Why it matters
Parents and clinicians worry that stimulant medications for ADHD could predispose children to later substance use. This long-term data from the gold-standard ADHD treatment study addresses these concerns directly.
The numbers in context
Data from the Multimodal Treatment Study of ADHD (MTA), the largest and longest ADHD treatment trial, following participants from childhood through early adulthood.
How the study worked
Long-term follow-up analysis from the MTA randomized trial examining associations between stimulant treatment duration/intensity and subsequent substance use.
Who was studied
MTA study participants followed from childhood ADHD treatment through adolescence and early adulthood.
What this study cannot tell us
Post-randomization treatment was not controlled; observational follow-up phase limits causal conclusions; substance use measures may miss some patterns; attrition over long follow-up.
How to read the evidence
Follow-up from landmark RCT provides strong but observational long-term evidence.
When this study was published
Recent analysis of long-running MTA study data.
The bigger picture
This analysis from the most important ADHD treatment study provides crucial evidence for clinical decision-making about whether treating ADHD with stimulants protects against or increases risk for later substance use.
Replication
MTA provides uniquely important long-term data; findings complement other longitudinal ADHD-substance use studies.
Funding
Not specified
Conflicts of interest
Not specified
Questions still open
- Does treatment duration matter for substance use outcomes?
- Are specific stimulants associated with different substance use risks?
- Does the age of treatment initiation affect outcomes?
Read the original research
Association Between Stimulant Treatment and Substance Use Through Adolescence Into Early Adulthood.
JAMA psychiatry, 80(9), 933-941
Citation
Molina, Brooke S G; Kennedy, Traci M; Howard, Andrea L; Swanson, James M; Arnold, L Eugene; Mitchell, John T; Stehli, Annamarie; Kennedy, Edward H; Epstein, Jeffery N; Hechtman, Lily T; Hinshaw, Stephen P; Vitiello, Benedetto. (2023). Association Between Stimulant Treatment and Substance Use Through Adolescence Into Early Adulthood.. JAMA psychiatry, 80(9), 933-941. https://doi.org/10.1001/jamapsychiatry.2023.2157