By ALAN SCHWARZ
Published: May 29, 2013 * *
An analysis published Wednesday by the American Medical Association said children with attention deficit hyperactivity disorder who take stimulant medication do not have a lower risk over all for later substance abuse, contradicting the longstanding and influential message that such medicines tend to deter those with the disorder from abusing other substances.
The paper, written by three researchers at the University of California, Los Angeles, examined data from 15 previous studies on the subject and determined that, on average, medications like Adderall and Ritalin had no effect one way or the other on whether children abused alcohol, marijuana, nicotine or cocaine later in life.
A 2003 study in the journal Pediatrics had concluded that the introduction of stimulant medication to children with A.D.H.D. reduced the risk of such abuse later in life, a finding that has been repeated by doctors and pharmaceutical companies not only to assuage parents’ fears of medication but also to suggest that the pills would protect their children from later harm.
“I always doubted the whole ‘protection’ argument, and I wasn’t the only one, but that message was really out there,” said Liz Jorgensen, an adolescent addiction specialist at Insight Counseling in Ridgefield, Conn. “Hopefully, this message will be heard loud and clear.”
The study comes amid growing concern about the persistent rise in A.D.H.D. diagnoses and prescriptions for medication among children. A recent New York Times analysis of data collected by the Centers for Disease Control and Prevention found that 11 percent of all children ages 4 through 17 — 6.4 million over all — had received a diagnosis of A.D.H.D. from a medical professional. The diagnosis rate rose to 19 percent for boys of high school age.
Stimulant medication is by far the most prevalent treatment for childhood A.D.H.D., with the vast majority of children at least trying medication and about 60 percent of them staying on it long term. Stimulants can drastically improve the lives of children with severe A.D.H.D. but are also increasingly abused by high school and college students for their jolts of focus toward schoolwork.
Side effects can include appetite and growth suppression, sleep disturbance and occasionally psychosis, especially when the stimulants are abused.
The paper released Wednesday in the journal JAMA Psychiatry analyzed data from studies conducted from 1980 to 2012, and included more than 2,500 children with A.D.H.D. from the United States, Canada and