Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders, affecting roughly 5.4 million children since 2007. Somewhat disturbingly, only 66.3 percent of those diagnosed receive treatment. This is not due to a lack of funding or improper diagnosis, but because of a controversy regarding the effect of drug treatments on patients later in life.

Stimulants are widely used since 70 to 80 percent of patients with ADHD respond positively to treatment. Most stimulant drugs for treating ADHD help to balance and boost the brain's normal activity by providing chemicals, or neurotransmitters, that are present in normal brains and missing in the disordered brains. For example, active ingredient methylphenidate is in many drugs that supply dopamine to those affected by ADHD, since their brains lack proper levels of it. The reestablishment of ideal levels of neurotransmitters help to manage the main symptoms of ADHD: inattentiveness and hyperactivity.

The controversy over the use of stimulants stems from illicit drug use; cocaine, nicotine, heroin, and marijuana have effects based on changes in neurotransmitters. Addiction to illicit drugs is also based on their alteration of brain chemistry. When drugs provide stimulants, like dopamine, the brain grows accustomed to the elevated levels of neurotransmitters. The elevation from the norm causes people to seek the drugs to maintain their "high".

For a long time, it was thought that the use of psychostimulants to treat ADHD, which at its core is a neurological disorder that manifests in behavior, would give children a preference for, or sensitization toward, drugs later in life.

In a recent study, Dr. Steven S. Lee and colleagues performed analyses of the effects of ADHD psychostimulant medication, methylphenidate, and the patient's drug use or preference later in life. ADHD patients who used methylphenidate-containing medications were compared to ADHD patients who did not receive treatment. The drugs tested were alcohol, cocaine, nicotine, and marijuana. Previous studies indicated that the age at which the medication was used could have some effect on nonalcoholic substance use disorders.

Dr. Lee and colleagues found that use of ADHD medication has little to no association with the use or abuse of alcohol, marijuana, or nicotine, while it has negligible association with cocaine use. The researchers found that the use of ADHD psychostimulatory medications does not prevent drug use later in life, nor does it arouse the use of other substances. This is likely because children are given these stimulants to create the balance of chemicals in normal brains - their brains are not hit with the flood of chemicals that drugs would normally cause. In this way, there is no preference for drug use in ADHD patients in their adult years - all drug use is willful.

Often, parents will choose to use nonstimulant medication for newly diagnosed children. While there are no apparent drawbacks to the nonstimulant medications, the stimulants pose no risk and are often more effective. Dr. Lee's study has proven that methylphenidate, found in common ADHD treatments like ritalin, concerta, and metadate, does not increase the odds of drug use later in life.

Source: Humphreys KL, Eng T, Lee SS. Stimulant medication and Substance Use Outcomes: A Meta-analysis, JAMA Psychiatry. 2013

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