ADHD Medication Helped People With ADHD and Cocaine Dependence Use Less Marijuana
Treating ADHD with extended-release amphetamine salts in people who also had cocaine dependence was associated with more marijuana-free weeks, suggesting treating underlying ADHD may reduce cannabis use.
Quick Facts
What This Study Found
In a secondary analysis of a 14-week randomized controlled trial, researchers found that people with co-occurring ADHD and cocaine dependence who received mixed amphetamine salts (MAS-XR) had a significant decrease in the proportion of weeks where they used any marijuana, compared to placebo.
However, among the weeks when participants did use marijuana, the proportion of days they used did not change. In other words, the medication helped more people have completely marijuana-free weeks, but when people did use, their pattern of use was similar to placebo.
Key Numbers
57 participants total (37 MAS-XR, 20 placebo). Marijuana users were defined as those reporting use in the 30 days before the study. The MAS-XR group showed significantly more marijuana-free weeks over the 14-week trial.
How They Did This
This was a secondary analysis of a 14-week randomized controlled trial. The original trial compared placebo, MAS-XR 60 mg, and MAS-XR 80 mg in people with co-occurring ADHD and cocaine dependence. For this analysis, both MAS-XR groups were combined (n=37) versus placebo (n=20). Marijuana use was tracked using timeline follow-back methods. Analysis used logistic mixed effects models.
Why This Research Matters
ADHD, cocaine dependence, and cannabis use frequently co-occur. This finding suggests that effectively treating ADHD with stimulant medication may reduce cannabis use as a secondary benefit, possibly because some people use cannabis to self-medicate attention difficulties. If treating the underlying condition reduces substance use, it supports an integrated treatment approach.
The Bigger Picture
The self-medication hypothesis suggests that some people with ADHD use cannabis to manage their symptoms. If stimulant treatment for ADHD reduces cannabis use, this supports the idea that addressing root neurological conditions may be more effective than targeting substance use alone.
What This Study Doesn't Tell Us
This was a secondary analysis, not the primary aim of the trial. The sample was small (57 participants). All participants also had cocaine dependence, limiting generalizability to people with ADHD and cannabis use without cocaine involvement. The study was not designed or powered to detect cannabis use outcomes.
Questions This Raises
- ?Would ADHD treatment reduce cannabis use in people without co-occurring cocaine dependence?
- ?Do people with ADHD who use cannabis for symptom management see similar reductions with stimulant treatment?
- ?Would longer treatment periods produce stronger effects on marijuana use days?
Trust & Context
- Key Stat:
- MAS-XR group had significantly more marijuana-free weeks over 14 weeks compared to placebo.
- Evidence Grade:
- Moderate evidence from a secondary analysis of a well-designed RCT. The small sample size and secondary nature of the analysis limit the strength of conclusions.
- Study Age:
- Published in 2016. The relationship between ADHD treatment and cannabis use continues to be studied.
- Original Title:
- Mixed-amphetamine salts increase abstinence from marijuana in patients with co-occurring attention-deficit/hyperactivity disorder and cocaine dependence.
- Published In:
- The American journal on addictions, 25(8), 666-672 (2016)
- Authors:
- Notzon, Daniel P(2), Mariani, John J(7), Pavlicova, Martina(8), Glass, Andrew, Mahony, Amy L, Brooks, Daniel J, Grabowski, John, Levin, Frances R
- Database ID:
- RTHC-01234
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Does treating ADHD reduce marijuana use?
This study found that ADHD medication was associated with more marijuana-free weeks in people who also had cocaine dependence. However, this was a small secondary analysis and the effect needs confirmation in larger studies focused specifically on this question.
Were people using marijuana to self-medicate ADHD?
The study did not directly test self-medication, but the finding that treating ADHD reduced cannabis use is consistent with this hypothesis. Some researchers believe people with untreated ADHD may use cannabis to manage symptoms.
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Cite This Study
https://rethinkthc.com/research/RTHC-01234APA
Notzon, Daniel P; Mariani, John J; Pavlicova, Martina; Glass, Andrew; Mahony, Amy L; Brooks, Daniel J; Grabowski, John; Levin, Frances R. (2016). Mixed-amphetamine salts increase abstinence from marijuana in patients with co-occurring attention-deficit/hyperactivity disorder and cocaine dependence.. The American journal on addictions, 25(8), 666-672. https://doi.org/10.1111/ajad.12467
MLA
Notzon, Daniel P, et al. "Mixed-amphetamine salts increase abstinence from marijuana in patients with co-occurring attention-deficit/hyperactivity disorder and cocaine dependence.." The American journal on addictions, 2016. https://doi.org/10.1111/ajad.12467
RethinkTHC
RethinkTHC Research Database. "Mixed-amphetamine salts increase abstinence from marijuana i..." RTHC-01234. Retrieved from https://rethinkthc.com/research/notzon-2016-mixedamphetamine-salts-increase-abstinence
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.