The Association between Attention Deficit Hyperactivity Disorder in Adolescence and Substance Use Disorders in Adulthood

Objectives—To determine whether attention deficit hyperactivity disorder in adolescence (ADHD) is related to substance use disorders (SUDs) in adulthood, and whether conduct disorder (CD) mediates this relationship. Design—A prospective design incorporating five assessments, spanning the mean ages of 14 to 37. Two baseline assessments were taken at ages 14 and 16, and three outcome assessments were taken between the ages 27–37. Setting—United States. Participants—A community sample of participants initially drawn from upstate New York in 1975, and followed to a mean age of 37. Intervention(s) or Main Exposure(s)—The Diagnostic Interview Schedule for Children was used for assessing ADHD and CD, and the University of Michigan Composite International Diagnostic Interview (UM-CIDI) was used for assessing SUDs. Main Outcome Measure(s)—A diagnosis of a SUD was given to the participants in adulthood. Results—Attention deficit hyperactivity disorder in adolescence was related to SUDs in adulthood. This association, however, was indirect, as CD served as a mediator between ADHD and SUDs. Conclusions—Although adolescent ADHD is not prospectively associated with SUDs in adulthood, it remains a significant risk factor for SUDs through the correlations between ADHD and CD, and CD with SUDs.