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Review: no evidence that stimulant medication for ADHD influences lifetime risk of substance use or dependence

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Question

Question: Does exposure to stimulant medication for attention deficit hyperactivity disorder (ADHD) have an effect on the lifetime risk of substance use or dependence?

Outcomes: Lifetime substance use or dependence (alcohol, cocaine, marijuana, nicotine and illicit non-specific drug). Method of assessing substance use/dependence is not reported for included studies.

Methods

Design: Systematic review and meta-analysis.

Data sources: PubMed search for key words related to ADHD and substance use, supplemented by a hand search of reference lists of relevant articles, listservs of research organisations and contact with authors who have published longitudinal studies of children with and without ADHD; study inclusion dates January 1980 to February 2012.

Study selection and analysis: Longitudinal studies in children with ADHD where pharmacological treatment preceded the measurement of substance use. ORs were calculated for the risk of substance use/dependence among children with ADHD treated with stimulant medication compared with those not treated. Results were pooled using a random-effects model, and heterogeneity was assessed using the Cochran Q test. Publication bias was assessed using …

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