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Study breakdown

Up to 46% of people seeking cannabis addiction treatment may have undiagnosed ADHD

Cross SectionalModerate evidence
The takeaway

In a study of 99 adults seeking treatment for cannabis use disorders, ADHD prevalence was estimated at 34-46% depending on the screening tool used, far higher than the general population rate.

Addiction medicine clinicians, ADHD specialists, and cannabis treatment program administrators.

ADHD prevalence 34-46% in cannabis treatment seekers vs ~4-5% general population

What the researchers found

Among 99 adults seeking cannabis use disorder treatment, ADHD prevalence was estimated at 34% (CAARS), 45% (WURS), 46% (ASRS), or 36% (WURS+CAARS combined). The Wender Utah Rating Scale paired with the Conners Adult ADHD Rating Scale provided the best combination of sensitivity (0.71) and specificity (0.95) for ADHD screening in this population.

Why it matters

If one-third to nearly half of cannabis treatment seekers have ADHD, failing to screen for and treat ADHD could undermine cannabis treatment outcomes. This finding suggests ADHD screening should be routine in cannabis treatment settings.

The numbers in context

99 participants; ADHD prevalence 34-46% depending on screening tool; WURS+CAARS: sensitivity 0.71, specificity 0.95; general population ADHD prevalence ~4-5%.

How the study worked

Cross-sectional validation study using the Conners Adult ADHD Diagnostic Interview (CAADID) as gold standard to assess sensitivity and specificity of four ADHD screening tools in 99 cannabis use disorder treatment seekers.

What this study cannot tell us

Small sample (n=99); treatment-seeking population may over-represent comorbid conditions; cross-sectional; ADHD screening tools validated against CAADID, which itself has limitations; prevalence may not reflect non-treatment-seeking cannabis users.

How to read the evidence

Moderate: gold-standard ADHD diagnostic interview used, but small treatment-seeking sample.

When this study was published

Published 2020.

The bigger picture

People with ADHD may use cannabis to self-medicate symptoms like restlessness and difficulty concentrating. Addressing ADHD directly could reduce cannabis dependence by treating the underlying condition driving use.

Questions still open

  • Does treating ADHD improve cannabis use disorder outcomes? Should all cannabis treatment programs screen for ADHD?

Common questions

Is ADHD common among people with cannabis addiction?
Very. This study estimated ADHD prevalence at 34-46% among cannabis treatment seekers, roughly 8-10 times higher than the general population rate of 4-5%.
How should clinicians screen for ADHD in cannabis patients?
The study found the Wender Utah Rating Scale combined with the Conners Adult ADHD Rating Scale provided the best sensitivity (0.71) and specificity (0.95) for detecting ADHD in this population.

Read the original research

ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders.

Journal of attention disorders, 24(11), 1487-1492

Citation

Notzon, Daniel P; Pavlicova, Martina; Glass, Andrew; Mariani, John J; Mahony, Amy L; Brooks, Daniel J; Levin, Frances R. (2020). ADHD Is Highly Prevalent in Patients Seeking Treatment for Cannabis Use Disorders.. Journal of attention disorders, 24(11), 1487-1492. https://doi.org/10.1177/1087054716640109

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