No Evidence That Substance Use Causes ADHD Symptoms in Adolescence

• Date: 01 July 2017
• DOI: 10.1177/0022042617697018
• Published date: 01 July 2017
• Subject Matter: Articles

https://doi.org/10.1177/0022042617697018

Journal of Drug Issues

2017, Vol. 47(3) 405 –410

© The Author(s) 2017

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DOI: 10.1177/0022042617697018

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Article

No Evidence That Substance Use

Causes ADHD Symptoms

in Adolescence

Aja Louise Murray1, Manuel Eisner1,

Ingrid Obsuth1, and Denis Ribeaud2

Abstract

There is a robust association between attention-deficit hyperactivity disorder (ADHD)

symptoms and elevated substance use. Several plausible causal pathways from ADHD to

substance use have been articulated and supported empirically. In this study, we tested the

recent suggestion that substance use could also influence levels of ADHD symptoms. Using

the three most recent waves of data from the Zurich Project on the Social Development of

Children and Youth (z-proso), we found significant and strong cross-lagged effects of ADHD

symptoms on substance use but no significant effects in the opposite direction. This suggests

that individual differences in substance use are not related to increases in ADHD symptoms in

adolescence. Adolescent-onset symptoms of ADHD are thus unlikely to be caused by substance

use, and targeting substance use problems is unlikely to reduce ADHD symptoms.

Keywords

substance use, ADHD, adolescence

Attention-deficit hyperactivity disorder (ADHD) is defined by impairing levels of hyperactivity/

impulsivity and/or inattention (American Psychiatric Association [APA], 2013). There is a well-

established association between ADHD symptoms and substance use (e.g., Lee, Humphreys,

Flory, Liu, & Glass, 2011), and various pathways have been identified by which ADHD symp-

toms can lead to increased substance use (e.g., Molina & Pelham, 2014). For example, ADHD

symptoms with an onset in early childhood may transact with environmental risk factors leading

to the emergence and escalation of behavioral problems over development, including substance

use in adolescence and adulthood (e.g., Beauchaine & McNulty, 2013). Much less attention has

been paid to the idea that substance use could create risk for later ADHD symptoms; however,

with the increasing recognition that ADHD symptoms may not reach clinically significant levels

until adolescence and beyond, a search for precipitating factors occurring beyond childhood has

been initiated (e.g., see Castellanos, 2015). Substance use during adolescence may represent such

a candidate (e.g., Crean, Crane, & Mason, 2011; Squeglia, Jacobus, & Tapert, 2009). Substance

1University of Cambridge, UK

2University of Zurich, Switzerland

Corresponding Author:

Aja Louise Murray, Violence Research Centre, Institute of Criminology, University of Cambridge, Sidgwick Avenue,

Cambridge CB3 9DA, UK.

Email: am2367@cam.ac.uk

697018JODXXX10.1177/0022042617697018Journal of Drug IssuesMurray et al.

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