Teens with ADHD Did Not Use More Substances Than Their Peers
Canadian adolescents diagnosed with ADHD in childhood reported similar or lower rates of cigarette, alcohol, and cannabis use compared to the general population.
Quick Facts
What This Study Found
Among 142 adolescents diagnosed with ADHD before age 12, substance use rates were comparable to or lower than two large Canadian population samples. Cannabis use was reported by 14.2% of the ADHD sample, compared to 16.5% in the National Longitudinal Survey (ages 10-15) and 26.0% in the Ontario Student Drug Use Survey (ages 12-18).
Alcohol use showed a similar pattern: 27.1% in the ADHD sample versus 28.6% and 58.6% in the two comparison groups. Cigarette use was also lower in the ADHD group (17.8%) compared to both population samples.
Two areas did warrant further attention: a possible increased risk for substance use among females with ADHD, and a non-significant trend toward higher gambling rates (7.9% vs. 4.3% in the provincial average).
Key Numbers
ADHD sample (n=142): cannabis 14.2%, alcohol 27.1%, cigarettes 17.8%. NLSCY comparison: cannabis 16.5%, alcohol 28.6%, cigarettes 28.3%. OSDUHS comparison: cannabis 26.0%, alcohol 58.6%, cigarettes 21.9%. Gambling trend: ADHD 7.9% vs. provincial 4.3% (not significant).
How They Did This
Researchers surveyed 142 adolescents (mean age 14.1 years) who had been diagnosed with ADHD before age 12 at a clinical center. Their substance use rates were compared to two large cross-sectional population studies: the Canadian National Longitudinal Survey of Children and Youth Ontario subsample (N=1,317) and the Ontario Student Drug Use and Health Survey (N=9,288).
Why This Research Matters
ADHD has long been considered a risk factor for substance use disorders, but this study suggests the relationship may not be straightforward. In early adolescence, ADHD diagnosis alone may not increase the likelihood of substance use onset, challenging assumptions that could lead to unnecessary stigmatization of youth with ADHD.
The Bigger Picture
The assumption that ADHD automatically leads to substance use problems may be overly simplistic. While some longitudinal studies show increased risk over time, this study suggests that in early adolescence, substance use rates among youth with ADHD are not elevated. Other factors, such as treatment status, family environment, and comorbid conditions, may be more important predictors.
What This Study Doesn't Tell Us
The ADHD sample was drawn from a clinic population, meaning these youth were receiving care and may not represent all adolescents with ADHD. The comparison groups came from different surveys with different methodologies and age ranges. The cross-sectional design cannot track whether ADHD youth develop higher substance use rates later in adolescence or adulthood.
Questions This Raises
- ?Does ADHD treatment (medication or behavioral therapy) protect against substance use initiation?
- ?Why might females with ADHD be at higher risk?
- ?Does the gambling trend become significant with longer follow-up?
Trust & Context
- Key Stat:
- Cannabis use: 14.2% in ADHD teens vs. 16.5-26.0% in general population
- Evidence Grade:
- This is a cross-sectional comparison using a clinic sample against population surveys. The different data sources and methodologies limit direct comparison.
- Study Age:
- Published in 2014. Research on the ADHD-substance use relationship has continued with more nuanced longitudinal designs.
- Original Title:
- Childhood ADHD and addictive behaviours in adolescence: a canadian sample.
- Published In:
- Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 23(2), 128-35 (2014)
- Database ID:
- RTHC-00845
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does this mean ADHD is not a risk factor for substance use?
Not necessarily. This study focused on early adolescence. Some longitudinal studies suggest ADHD-related risk increases in later adolescence and adulthood. The relationship likely depends on other factors like comorbid conditions, treatment, and environment.
Why was the gambling trend notable?
While not statistically significant, the higher gambling rate in ADHD youth (7.9% vs. 4.3%) aligns with research suggesting impulsivity, a core ADHD feature, may increase vulnerability to behavioral addictions like gambling more than substance use.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-00845APA
Ostojic, Dragana; Charach, Alice; Henderson, Joanna; McAuley, Tara; Crosbie, Jennifer. (2014). Childhood ADHD and addictive behaviours in adolescence: a canadian sample.. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 23(2), 128-35.
MLA
Ostojic, Dragana, et al. "Childhood ADHD and addictive behaviours in adolescence: a canadian sample.." Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent, 2014.
RethinkTHC
RethinkTHC Research Database. "Childhood ADHD and addictive behaviours in adolescence: a ca..." RTHC-00845. Retrieved from https://rethinkthc.com/research/ostojic-2014-childhood-adhd-and-addictive
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.