Does Early Exposure to Stimulants Lead to Substance Use Disorders Later on?

Abstract

Attention deficit/hyperactivity disorder (ADHD) denotes childhood problems of hyperactivity, inattention, and impulsivity, leading to impairments in daily functioning, scholastic performance, and relationships with peers. Although the rationale for stimulant medication is to reduce the morbidity associated with having ADHD, critics have argued that methylphenidate and other prescribed stimulant drugs (PSDs) are overly prescribed and inherently dangerous. Researchers have also raised concerns that PSDs might prime the central nervous system, thus rendering individuals more susceptible to substance use disorders (SUDs) later in life. There is also a strong comorbidity between ADHD and SUDs in adulthood. If many adults with SUDs were prescribed stimulants for ADHD as children or during adolescence, this could suggest that taking these drugs during these critical developmental periods increase the risks for SUDs later on. Research articles (i.e., both animal and human data) were reviewed to ascertain if any associations exist between PSDs and brain and behavioral changes. Review articles, meta-analyses, clinical trials, and clinical data were examined to assess associations between PSDs during childhood and adolescence and the development of SUDs in adolescence and adulthood. Contentious evidence does suggest that PSDs are not likely responsible for substance use and SUDs in adolescence, although it remains equivocal if PSDs offer any protection against substance use and abuse in adolescence. Although PSDs do reduce symptoms of ADHD that may interfere with learning in childhood, the evidence raises the possibility that these drugs might be responsible for substance use and SUDS in some adults.