Won’t they do other drugs?

By R. Scott Benson, M.D.



This is a question I get every time I talk with a family about medication treatment for their child with attention deficit hyperactivity disorder (ADHD). And the best answer has been “some will, some won’t”.



But at the APA meeting in New Orleans there was a report from the research group at the Mass General in Boston. They have been able to suggest answers to a lot of question about the outcome of children with ADHD. There is a higher rate of substance use problems in adolescents and adults who have a diagnosis of ADHD. But in this 10 year follow-up of children they asked “What are the predictors?”



Their data confirmed that a diagnosis of ADHD was associated with an increased incidence of drug and alcohol problems. But the finding of severe conduct problems in these children was even more highly associated with future substance use problems.



The take home message for me is that medication alone will not be sufficient to address the severe problems that many children with ADHD present. Parent training, especially for those with severely disruptive behaviors, is a necessary, integral part of their treatment.