Is ADHD underdiagnosed in among illicit psychostimulant users?


Mental health providers may be overly cautious to diagnose ADHD in patients who abuse drugs because of the possible misuse of stimulnat mediactions in these patient population.

A study was conducted in Sydney, Australia to investigate the nature and correlates of symptomatology consistent with adult ADHD among illicit psychostimulant users. The study involved 269 users who regularly take either cocaine or methamphetamineor both. All 269 used illegal psychostimulants weekly or more for one year. About 71% of the users used the illegal substance more than three times per week for 12 months and about 88% are psychostimulant dependent. The 269 users are aged from 19 to 62 years with an average of 35.6. About 86% had received treatment for substance dependence and 52% were undergoing treatment at the time the study is conducted and 88% were jobless.

About 45% were diagnosed to be positive for adult ADHD and 90% showed signs of inattention which is more common than hyperactivity/impulsivity which accounted for 57%. Those individuals with ADHD symptoms ar more prone to have serious polysubstance dependence, and higher early school drop rate.

The researchers pointed out that if ADHD is identified as comorbid, it may assist in planning the appropriate treatment options for substance abuse and will reduce the risk of non-compliance with treatment plans due to symptoms of impulsivity, disorganization and inattention. The study concluded that it is important to recognize the high risk of ADHD in patients who are seeking substance abuse treatment because if ADHD is not diagnosed and remained untreated, it may impact the retention, compliance and outcome of treatment.