Relapse Among Adolescent Drug Abusers Following Treatment: The Role of Probable ADHD Status

• NCJ Number: 205533
• Journal: Journal of Child & Adolescent Substance Abuse Volume: 13 Issue: 3 Dated: 2004 Pages: 1-16
• Author(s): William W. Latimer; Jenna Ernst; Jodi Hennessey; Randy D. Stinchfield; Ken C. Winters
• Date Published: 2004
• Length: 16 pages
• Grant Number(s): DA00254; DA10777; DA05104
• Sponsoring Agency: National Institute on Drug Abuse
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study examined the relationship between probable ADHD (attention-deficit hyperactivity disorder) status and posttreatment relapse among 220 adolescents who were receiving 12-step treatment for psychoactive substance use disorders.

Abstract

All study participants met criteria for at least one current DSM-III-R psychoactive substance use disorder, and all of them had at least an alcohol or cannabis-use disorder. Analyses were based on two waves of data obtained at intake and at a 6-month follow-up via site chart records, the Personal Experience Inventory, and adolescent and parent versions of the Adolescent Diagnostic Interview (ADI). A urine sample was also collected at the intake and follow-up assessments to validate self-reports of substance use. The adolescent version of the ADI contained five items on ADHD diagnostic criteria. Of the total sample, 83 (38 percent) were identified as having probable ADHD. The measure of substance use frequency focused on alcohol, marijuana, and other illicit drug-use-frequency variables. The findings show that the drug-abusing youth with probable ADHD status had 2.5 times the risk of posttreatment alcohol relapse when compared to youth without probable ADHD status when controlling for demographics, pretreatment conduct-disordered behavior, pretreatment alcohol-use frequency, and treatment factors. A significant crude association between probable ADHD status and other drug relapse was not maintained when adjusted for pretreatment conduct-disordered behavior, pretreatment frequency of other drug use, or treatment factors. Various conceptual models are offered to explain substance-specific associations between probable ADHD status and posttreatment relapse. The unique risk of alcohol relapse by drug-abusing youth with ADHD may be related to the self-medication of ADHD symptoms by using a substance that operated on the central nervous system as a depressant. A related possibility is that recovering youth with ADHD are more likely to use alcohol following treatment to self-medicate negative feelings associated with recurrent patterns of interpersonal rejection and conflict associated with their comorbid condition. Study limitations are discussed. 3 tables and 27 references