Evidence map›Paper›PMID 28659039›Full record

ArticleThe American journal of psychiatry2017

ADHD Medication and Substance-Related Problems.

Patrick D Quinn, Zheng Chang, Kwan Hur, Robert D Gibbons, Benjamin B Lahey, Martin E Rickert, Arvid Sjölander, Paul Lichtenstein, Henrik Larsson, Brian M D'Onofrio

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
75citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

75 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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15 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Patrick D QuinnFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Zheng ChangFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Kwan HurFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Robert D GibbonsFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Benjamin B LaheyFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Martin E RickertFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Arvid SjölanderFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Paul LichtensteinFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Henrik LarssonFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.
Brian M D'OnofrioFrom the Department of Psychological and Brain Sciences, Indiana University, Bloomington; the Center for Health Statistics and the Departments of Medicine and of Public Health Sciences, University of Chicago, Chicago; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; and the School of Medical Sciences, Örebro University, Örebro, Sweden.

Funding

Indiana Clinical and Translational Sciences InstituteUL1TR001108 · NCATS · INDIANA UNIVERSITY INDIANAPOLIS · PI DENNE, SCOTT C., SHEKHAR, ANANTHA · 2013 to 2017
$23.3M
Indiana Clinical and Translational Sciences InstituteTL1TR001107 · NCATS · INDIANA UNIVERSITY INDIANAPOLIS · PI DENNE, SCOTT C., SHEKHAR, ANANTHA · 2013 to 2017
$2.0M
Risks and Benefits of ADHD Medication for Psychiatric and Neurologic ProblemsR01MH102221 · NIMH · TRUSTEES OF INDIANA UNIVERSITY · PI D'ONOFRIO, BRIAN M, LARSSON, HENRIK · 2014 to 2017
$1.7M
Pharmacoepidemiologic Studies of Prescription Opioid Analgesic RisksK99DA040727 · NIDA · TRUSTEES OF INDIANA UNIVERSITY · PI QUINN, PATRICK DONOVAN · 2016 to 2017
$275k
NCATS NIH HHS TL1 TR001107NCATS NIH HHS UL1 TR001108NIDA NIH HHS K99 DA040727NIMH NIH HHS R01 MH102221
6 · The paper itself

Abstract

objectiveSubstance use disorders are major contributors to excess mortality among individuals with attention deficit hyperactivity disorder (ADHD), yet associations between pharmacological ADHD treatment and substance-related problems remain unclear. This study investigated concurrent and long-term associations between ADHD medication treatment and substance-related events.

methodThe authors analyzed 2005-2014 commercial health care claims from 2,993,887 (47.2% female) adolescent and adult ADHD patients. Within-individual analyses compared the risk of substance-related events (i.e., emergency department visits related to substance use disorders) during months in which patients received prescribed stimulant medication or atomoxetine relative to the risk during months in which they did not.

resultsIn adjusted within-individual comparisons, relative to periods in which patients did not receive ADHD medication, male patients had 35% lower odds of concurrent substance-related events when receiving medication (odds ratio=0.65, 95% CI=0.64-0.67), and female patients had 31% lower odds of concurrent substance-related events (odds ratio=0.69, 95% CI=0.67-0.71). Moreover, male patients had 19% lower odds of substance-related events 2 years after medication periods (odds ratio=0.81, 95% CI=0.78-0.85), and female patients had 14% lower odds of substance-related events 2 years after medication periods (odds ratio=0.86, 95% CI= 0.82-0.91). Sensitivity analyses supported most findings but were less consistent for long-term associations among women.

conclusionsThese results provide evidence that receiving ADHD medication is unlikely to be associated with greater risk of substance-related problems in adolescence or adulthood. Rather, medication was associated with lower concurrent risk of substance-related events and, at least among men, lower long-term risk of future substance-related events.

Indexed as

AdolescentAdultAtomoxetine HydrochlorideAttention Deficit Disorder with HyperactivityCentral Nervous System StimulantsComorbidityFemaleHumansMaleSex FactorsSubstance-Related DisordersUnited StatesYoung AdultAtomoxetine HydrochlorideCentral Nervous System StimulantsAlcohol AbuseAttention Deficit Hyperactivity DisorderCNS StimulantsEpidemiologyPsychoactive Substance Use Disorder

Identifiers

PMID28659039
PMCPMC5581231

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.