Adults with ADHD and substance use disorder started using substances at a younger age and had higher rates of cannabis, alcohol, and methamphetamine use compared to those without ADHD.
Addiction psychiatrists, ADHD clinicians, and parents of children with ADHD
ADHD group started substance use at a younger age
What the researchers found
The ADHD group had a lower age of onset for substance use. ADHD individuals had higher rates of alcohol, cannabis, methamphetamine, and tramadol use, while the non-ADHD group had higher rates of Ritalin, methadone, ecstasy, morphine, and hypnotics. The pattern suggests ADHD is associated with earlier initiation and preference for stimulating and cannabis-type substances.
Why it matters
The lower age of onset in ADHD has clinical implications: earlier substance initiation is associated with worse long-term outcomes. Identifying ADHD in young people could provide a window for preventive intervention before substance use begins.
The numbers in context
50 ADHD, 90 non-ADHD. ADHD group: higher alcohol, cannabis, methamphetamine, tramadol. Non-ADHD: higher Ritalin, methadone, ecstasy, morphine, hypnotics. ADHD group started substances earlier.
How the study worked
Longitudinal study of 140 adults (50 with ADHD, 90 without) with substance use disorder in addiction detention in Tehran (2021-2022). ADHD diagnosed via SCID and Conner's questionnaire. Onset age and patterns of 10 substances compared.
What this study cannot tell us
Study conducted in addiction detention, limiting generalizability. Small ADHD sample (n=50). Cross-sectional assessment of retrospectively reported onset ages introduces recall bias. Iranian cultural context may differ from other countries.
How to read the evidence
Small clinical sample with validated ADHD diagnosis, but limited by addiction detention setting and retrospective design.
When this study was published
2024 study using 2021-2022 data
The bigger picture
ADHD persists into adulthood in 60% of cases and affects 4% of adults. The overlap with substance use disorders suggests shared neurodevelopmental pathways, with impulsivity and sensation-seeking as potential mechanisms driving earlier and broader substance experimentation.
Questions still open
- Would treating ADHD earlier reduce substance use initiation? Why do ADHD individuals prefer different substances than non-ADHD individuals? Could cannabis use in ADHD be partly self-medication for attention symptoms?
Common questions
Do people with ADHD use more cannabis?
Should ADHD be screened in substance use treatment?
Read the original research
Patterns of substance use and initiation timing in adults with substance abuse: a comparison between those with and without attention deficit hyperactivity disorder.
Annals of medicine and surgery (2012), 86(8), 4397-4401
Citation
Vaziri-Harami, Roya; Khademi, Mojgan; Zolfaghari, Anahita; Vaziri-Harami, Saharnaz. (2024). Patterns of substance use and initiation timing in adults with substance abuse: a comparison between those with and without attention deficit hyperactivity disorder.. Annals of medicine and surgery (2012), 86(8), 4397-4401. https://doi.org/10.1097/MS9.0000000000002272
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