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ADHD stimulant medications do not increase substance abuse risk, study claims

UCLA researchers have concluded that attention deficit hyperactivity disorder (ADHD) medications do not increase a child's risk of developing substance abuse problems.

It has been known that children with ADHD are more likely than other kids to develop alcohol and drug addictions as adults, however until this current research, it was unclear if the medications played a role.

"We found the children were neither more likely nor less likely to develop alcohol and substance-use disorders as a result of being treated with stimulant medication," lead author Kathryn Humphreys, a doctoral candidate in UCLA's Department of Psychology, said in a press release. "We found no association between the use of medication such as Ritalin and future abuse of alcohol, nicotine, marijuana and cocaine."

ADHD is one of the most common childhood neurobehavioral disorders. Children with ADHD may have a hard time paying attention, controlling impulsive behaviors or be overly active. The Centers for Disease Control and Prevention said in May that it believed7 percent of school-aged children have ADHD, but other studies have reported higher estimates.

The disorder is most commonly treated by medications called "stimulants," according to the National Institute of Mental Health. The stimulants provide an opposite, calming effect for children with ADHD by reducing hyperactivity and impulsivity, and improving their ability to focus and learn. Examples include Ritalin and Adderall.

Besides increased risk for substance abuse and other mental health woes, childhood ADHD was linked to obesity in male adults in a study published in May in Pediatrics. There's also been concern for the ADHD medications themselves. The American Academy of Neurology warned doctors that they should stop prescribing ADHD medications to healthy children just to help them with their studies.

Previous research on animals showed that ADHD medications could lower the body's ability to experience pleasure by altering the brain's dopamine system. This could theoretically increase the desire to take more medication, which could lead to other stimulant abuse.

"Early in development, we know that brain structure is changing in immense ways and it could be that at one point in development or in certain brains, (children) are more or less reactive (to the brain effects of the drug)," senior study author Dr. Steve S. Lee, a UCLA associate professor of psychology, explained to TIME. "That could be one mechanism for evidence of a 'sensitization' effect, where they would (later) enjoy it more."

Liz Jorgensen, an adolescent addiction specialist at Insight Counseling in Ridgefield, Conn., told the New York Times that she personally saw many adolescents whose introduction to drugs came from their ADHD medications. She was not connected to the study.

"It teaches them very boldly that this is the way to feel different -- this is the way to feel better," she said. "Aversion to prescription drugs can be lifted at that early age."

But, the ADHD treatments have also been shown to lower stress, which could lower addiction risk because the child would be more likely to get along with peers and do better in school, Lee pointed out.

Psychologists looked at 15 long-term studies, including data from three studies that have not been published. In total, the research involved more than 2,500 children with ADHD from childhood into adolescence and early adulthood. The children were 8 on average when the study began and 20 when the study ended.

While the study did not show that there was an increased risk of addiction due to the medication, the researchers pointed out that does not mean that the treatment doesn't have any other effects. They also emphasized that the results are an average and may not apply to every child.

"For any particular child, parents should consult with the prescribing physician about potential side effects and long-term risks," Lee said in the press release. "Saying that all parents need not be concerned about the use of stimulant medication for their children is an overstatement; parents should have the conversation with the physician. As with other medications, there are potential side effects, and the patient should be carefully evaluated to, for example, determine the proper dosage."

The study was published in the May 29 issue of JAMA Psychiatry.

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