Children with ADHD are at high risk of developing substance misuse in adolescence and adulthood. The abuse potential of stimulant medication and the impact of medication treatment on long-term risk of substance misuse are areas of ongoing controversy. Existing literature indicates that treatment of ADHD with medication does not increase the risk of development of substance misuse in the treated individual. Stimulant medications can, however, be diverted or misused, either for subjective euphoric effects or for effects on performance. Integrated treatment of both substance misuse and ADHD should be provided. Strategies to minimize the risk for misuse or diversion of medications include use of extended-release formulations of currently used stimulant medications, new non-stimulant medications and novel pro-drugs. This article provides a brief overview of the extant literature and offers practical guidelines for the management of young people with ADHD and co¬morbid substance misuse.
Keywords: substance misuse, substance dependence, substance abuse, co-morbidity, children, young people, abuse potential