Young adults with attention deficit hyperactive disorder and the risk of developing illicit substance use

Abstract

People with attention deficit hyperactivity disorder (ADHD) deserve to live a normal life like everyone else. Unfortunately, many go undiagnosed and therefore treatment is delayed. As a result, they are more at risk of developing substance misuse disorder to counteract ADHD symptoms. Not everyone with ADHD will use drugs, yet prevention and increased awareness will eventually lead to control the condition. The main aim was to critically appraise studies which had evaluated whether young adults with ADHD are at an increased risk of using illicit substances rather than those without ADHD. Therefore the following PICO question had been established: ‘‘Are young adults with attention deficit hyperactive disorder at an increased risk to develop illicit substance use when compared to young adults without attention deficit hyperactive disorder?’’ An inclusion and exclusion criteria was developed to serve as guidelines through the literature search and find studies pertaining to the PICO question. Using the Medical Subject Headings (MeSH) keywords had been identified and combined together in order to find relevant articles. By using a variety of databases a systematic search was conducted. A total number of six studies had been retrieved; two Cohort studies and four Cross-Sectional studies. The appraisal tool for Cross-Sectional Studies (AXIS) and CASP (Critical Appraisal Skills Programme) were used to assess studies for the methodological rigour. Some studies found that there is no significant difference with regards to heroin use in people with ADHD and those without the condition, whilst others found that there was a significant difference between both groups with regards to cocaine and cannabis so as to self-medicate. A variety of recommendations have been addressed for local practice, education and public health policy with the intention to improve future research. Multicentre trials are ideal to conduct larger studies. Malta would benefit from local research to establish guidelines.