ADHD CHILDREN AT HIGH RISK FOR DRUG, ALCOHOL ABUSE

Two different studies confirm that children with attention deficit hyperactivity disorder (ADHD) are at high risk of developing alcoholism or drug problems later in life.

The first study, by Monika Johann et al., evaluated 314 adult alcoholics (262 males and 52 females) and 220 non-alcoholic controls.

"Our results indicate that individuals with persisting ADHD symptoms in adulthood seem to be at high risk of developing an alcohol- use disorder," Johann says. "Moreover, there is evidence for a highly increased severity of alcohol dependence in subjects with ADHD."

The researchers performed a gene analysis to see if two gene variants implicated in ADHD and alcoholism could be responsible for the ADHD/alcoholism connection, but they found no evidence of a link. However, they say their findings indicate a distinct pattern in ADHD subjects with alcoholism. Compared to other alcoholics, adult alcoholics with ADHD drank a much higher amount of alcohol daily, became problem drinkers earlier in life, were more prone to suicidal thoughts, had a higher number of court appearances, had a higher rate of antisocial personality disorder, and had a stronger family history of alcoholism.

Commenting on the study, physician Ema Loncarek, a specialist in treating drug addiction, says, "Dr. Johann's findings of a phenotype are very close to what we see in drug addicts with ADHD, and what has been described before by other authors. We see on a regular basis that drug addicts with ADHD are difficult to handle. They start to abuse drugs earlier than other people, change earlier to 'hard' drugs, take longer to start treatment, and take longer to successfully finish therapy."

A separate study, by Brooke Molina and William Pelham, Jr., compared the drug use of 142 teens diagnosed in childhood with ADHD and 100 non-ADHD controls. The ADHD children were part of a study that followed their development from childhood.

The researchers found that childhood ADHD increased the risk for use and abuse of alcohol and heavy drugs, and increased the risk for early tobacco and drug use. Interestingly, Molina notes, "Childhood ADHD symptoms, particularly the inattention dimension of ADHD, predicted later substance use to a greater degree than childhood antisocial behaviors."

"Comorbidity of alcohol dependence with attention-deficit hyperactivity disorder: differences in phenotype with increased severity of the substance disorder, but not in genotype (serotonin transporter and 5-hydroxytryptamine-2c receptor)," M. Johann, G. Bobbe, A. Putzhammer, and N. Wordaz, Alcoholism: Clinical & Experimental Research, Vol. 27, No. 10, October 2003, 1527-34. Address: M. Johann, Department of Psychiatry, University of Regensburg, Regensburg, Germany, monika.johann@bzk.uni-regensburg.de.

"Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD," B. S. Molina and W. E. Pelham, Jr., Journal of Abnormal Psychology, Vol. 112, No. 3, August 2003, 497-507. Address: B. S. Molina, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, molinab@msx.upmc.edu.

"Adult alcoholism and attention-deficit hyperactivity disorder are connected," news release, Alcoholism: Clinical & Experimental Research, October 14, 2003.

"Severity of ADHD in children increases risk of drug use in adolescence," news release, American Psychological Association, August 17, 2003.