Adult ADHD and Substance Abuse: Diagnostic and Treatment Issues

Abstract

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral, developmental disorder most often diagnosed during childhood, marked by the core symptoms of inattention, hyperactivity, and impulsivity that results in social, academic, and occupational underachievement. Although the disorder has a prevalence of 3–9% in the general childhood population and 1–5% in the general adult population, it affects between 11 and 35% of “substance-abusing” adults, oftentimes complicating treatment response. The present review discusses diagnostic assessment issues, prevalence, comorbidity, pharmacotherapy, and psychological interventions in substance-abusing adults with ADHD.

Keywords:

• attention deficit hyperactivity disorder (ADHD)
• substance-user populations
• dual-diagnosis
• assessment
• treatment

Additional information

Notes on contributors

Aparna S. Kalbag

Aparna S. Kalbag, Ph.D., is a Research Scientist at the New York State Psychiatric Institute, Columbia-Presbyterian Medical Center who completed her doctorate in Clinical Psychology from the University of Colorado at Boulder in 2001. Her research interests are in the areas of comorbidity between ADHD and cocaine and heroin dependence and comorbidity between depression and marijuana dependence. She also has a strong interest in the role of family factors in substance use disorders and in developing culturally sensitive psychological therapies for those with substance use disorders. She has authored 3 peer-reviewed papers and 13 scientific presentations. She currently is the recipient of a National Institutes of Health Loan Repayment Program award and has been a past recipient of a National Institute of Mental Health Grant, Research Supplement for a project entitled “Classifying Course of Illness in Bipolar Disorder.”

Frances R. Levin

Frances R. Levin, M.D., is a Research Psychiatrist at the New York State Psychiatric Institute, Associate Director of Substance Abuse Education at the NYSPI and Q. J. Kennedy Associate Professor and Director of the Addiction Psychiatry Fellowship Program at the College of Physicians and Surgeons of Columbia University. Dr. Levin graduated Phi Beta Kappa from Brown University. She received her medical training at Cornell University Medical College and her psychiatric residency at New York Hospital-Payne Whitney Clinic and completed a combined research and clinical substance abuse fellowship at the National Institute on Drug Abuse and the University of Maryland. Dr. Levin has numerous presentations and publications to her credit in the fields of substance abuse and dual diagnosis disorders and has served on several governmental advisory panels. Dr. Levin is the director of three multiple-site NIH-funded research studies to develop and evaluate new medications for the treatment of drug abuse. Her research interests include medications for cocaine abuse and treatment of patients who abuse drugs and also have psychiatric problems. Dr. Levin is a national expert on the treatment of drug abusers with adult attention-deficit hyperactivity disorder (ADHD).